For people suffering the effects of anxiety or depression, and in many cases both anxiety and depression, any news of a breakthrough medication is worth looking in to. In recent months, with a pandemic in full swing, many people are experiencing these mental health conditions for the first time. In addition, many who were already managing anxiety or depression have seen their condition deteriorate this year. Considering which medications for anxiety and depression are most effective is a top concern for these folks.
As with any prescribed medication, a careful review of risk and reward benefits must be considered. Many psychotropic medications cause side effects, to varying degrees, which can make them unbearable. For example, the common side effects associated with antidepressants include nausea, headaches, weight gain, decreased libido, and blurred vision. Someone who has an adverse effect will typically trial a different medication that might be a better fit for them. So, while these medications can be a lifesaver for many, it isn’t always easy to determine which drug is the best one for a given condition or person.
New medications for anxiety and depression continue to progress through the clinical trials towards FDA clearance. Recently, there are some newly approved medications that offer hope to many who might not have responded to an earlier brand. In addition to pharmaceuticals, continued study of alternative medications for treating depression and anxiety has led to holistic remedies that are also worth considering.
About Anxiety Disorder
Anxiety disorder is the most prevalent mental health disorder in America, with approximately 40 million adults affected by some type of anxiety. The most common type of anxiety is called generalized anxiety disorder, or GAD, affecting about 3.1% of the population, or nearly 7 million adults. GAD is characterized by pervasive worrying, so much so that it can impair daily functioning. Individuals with GAD tend to ruminate over events that have already occurred, second-guessing themselves, or they may dwell on upcoming events and worry incessantly about anticipated outcomes. Fear and worry that are out of proportion to the trigger drive this disorder, with symptoms that include:
- Excessive worry
- Stomach problems
- Trouble concentrating
- Short-term memory problems
There are a number of types of anxiety disorder. These include:
Generalized anxiety disorder (GAD): Excessive and irrational fear and worry that may cause shortness of breath, heart palpitations, sweating, dizziness, and sleep problems.
Phobia: Extreme and unreasonable fear related to a specific object or situation, causing avoidance behaviors.
Social anxiety: Intense fear of being judged or rejected by others, causing such symptoms as sweating, blushing, muscle tension, nausea, rapid heartbeat, and lightheadedness, in addition to avoidant behaviors.
Panic disorder: A sudden, unpredictable episode that features chest pain, trembling, shortness of breath, nausea, sense of doom, but differs from a panic attack in that there is no particular trigger.
Post-traumatic stress disorder (PTSD): A prolonged response to having experienced or witnessed a traumatic event that features flashbacks or nightmares, insomnia, irritability, substance abuse, and avoidance behaviors.
Obsessive-compulsive disorder (OCD): Involves an alternating cycle of obsessive fears and compulsive behavioral responses to the fears.
About Depressive Disorder
According to the National Institute of Mental Health, about 17.3 million adults in the U.S. suffer from a depressive disorder. The DSM-5 has listed specific symptoms related to depressive disorder, and stipulates that a cluster of 5 or more symptoms of depression persist most of the time for more than two weeks to receive a MDD diagnosis. Other forms of depression will have specific features, so there will be some variance in symptoms between the types.
In addition to the DSM-5, a psychiatrist may use screening tools to help in diagnosing the depression, such as the Hamilton Depression Rating Scale (HAM-D) or the Patient Health Questionnaire (PHQ-9). A physical exam can help rule out a medical condition, such as diabetes, cancer, HIV/AIDS, heart disease, or multiple sclerosis, as the cause of the depression symptoms.
The different types of depression include:
- Major Depressive Disorder (MDD). MDD symptoms include persistent sadness, changes in eating habits and sleep habits, difficulty concentrating, feelings of shame or guilt, loss of interest in activities usually enjoyed, and suicidal thoughts.
- Dysthymia (Persistent Depression Disorder). This is a type of MDD that lasts for more than two years. Someone with dysthymia may experience periods of severe depression alternating with periods of milder depression, but no relief of the depressive symptoms for at least two years or more.
- Premenstrual dysphoric disorder. A severe form of PMS that features extreme mood swings, anger, sadness, and irritability.
- Postpartum Depression. Some women experience serious symptoms of MDD during and/or after giving birth. The symptoms may be so severe that the mother is unable to care for her child, or themselves, and often experience severe fatigue, exhaustion, and anxiety in addition to the profound sadness.
- Seasonal Affective Disorder (SAD). In certain climates individuals may experience symptoms of MDD that are caused by a lack of sun exposure during the winter months, which can lead to a vitamin D deficiency. The individual may experience weight gain, hypersomnia, and isolation behaviors in addition to the symptoms of depression.
- Bipolar Disorder. This disorder features alternating dramatic and unpredictable shifts between depressive and manic moods. The low mood episodes can last days or weeks.
- Psychotic Depression. This is basically MDD with psychotic features. The individual may experience delusional thoughts or hallucinations in addition to the symptoms of depression. Sometimes there is a theme for the illness, such as symptoms revolving around emotions related to a serious financial problem or illness.
New Medications for Anxiety
In the last few years there have been some ongoing clinical trials on several new medications for the treatment of anxiety disorder. The mental health industry is anticipating some successful new entries to help patients once the drugs work their way through the studies and the FDA approval process. Some of the promising drugs on the horizon include:
Aloradine: Aloradine is a central nervous system neuroactive nasal spray for the treatment of social anxiety.
NBTX-001: NBTX-001 contains the noble gas xenon for the treatment of post-traumatic stress disorder (PTSD).
SRX246: SRX246 is a highly-selective vasopressin receptor antagonist for the treatment of generalized anxiety disorder and PTSD.
New Medications for Depression
Just as for the treatment of anxiety, there are several new medications on the way for the treatment of depression. These include:
Zulresso: Zulresso (brexanolone) is an IV medication for treating postpartum depression in women.
Oleptro: Oleptro is a newly approved medication that is basically a reformulation of the older antidepressant, trazodone.
Esketamine: Esketamine was approved in 2019 and is a derivative of the anesthetic ketamine, which has shown to have an antidepressant effect.
Holistic Treatments for Anxiety and Depression
A variety of homeopathic supplements have been found to help people manage symptoms of depression or anxiety:
- Supplements for depression:
- St. John’s Wort
- Supplements for anxiety:
- Passion flower
In addition to the role of nutritional supplements for treating anxiety and depression, a whole host of complementary holistic activities have been found to be beneficial as well. These include:
Yoga. Yoga blends the spiritual with purposeful poses, positions, and movements that are choreographed for calming the mind while toning muscles and stretching the body.
Mindfulness. By practicing mindfulness, which is a type of meditation, you learn to draw distracting thoughts back to the present moment, and to focus on the senses and the breathing process.
Deep breathing. Simple breathing exercises can have a swift and significant impact on reducing stress levels. Deep breathing can be done anywhere at any time, offering a fast reduction in heart rate and blood pressure when anxiety symptoms emerge.
Meditation. Allowing yourself the space for quiet reflection, meditation, or prayer is immensely relaxing. These short 15-minute sessions can be done in the solitude of nature or your own room.
Aromatherapy. Essential oils are derived from plants and flowers and used in aromatherapy. Aromatherapy is delivered in vapor form through a diffuser to be inhaled. The oils can also be applied topically to strategic places on the body. Several of the oils are used to reduce symptoms of anxiety and depression.
Journaling. Keeping a journal can help you process emotions, getting them out of your head and on to paper. Recording your feelings in a journal can reduce the power of sad thoughts.
Acupuncture. Acupuncture is an ancient Eastern medical intervention that uses fine needles to open up blocked energy pathways. There is evidence that opening up these pathways, called “qi,” can reduce stress and alleviate depression.
The Role of Cognitive Behavioral Therapy for Anxiety and Depression
While there are many evidence-based psychotherapies available for treating individuals with anxiety and/or depression, cognitive behavioral therapy (CBT) remains the most popular among mental health professionals. CBT is a short-term therapy, usually 3 or 4 months in duration, which focuses on the relationship between thoughts and subsequent behaviors. CBT helps the individual adopt new thought patterns that result in better mood regulation.
CBT works by helping the person take notice of dysfunctional or negative thought habits, such as negative self-talk, that then influence their subsequent behaviors and mood. A therapist guides the individual toward recognizing how disordered or irrational thoughts can negatively impact their state of mind, and then assists them in creating new thought patterns that are more positive and productive. CBT is prescribed in conjunction with medications for anxiety and depression for optimum clinical results.
The Treatment Specialist an Online Resource for Mental Health Information
The Treatment Specialist is an online resource for informative articles on mental health conditions and treatment options for adults, teens, and families. For more information and guidance please contact the team at (866) 644-7911.