If you are suffering from symptoms of depression, see your doctor. The first step in diagnosis is to rule out the possibility that a physical disorder is causing your symptoms. Your doctor will probably do blood tests to check your hormone levels, thyroid function, and other indicators of possible problems.
If the depressed state persists and deepens, especially if there is no obvious cause, seek help from a mental-health professional. The prognosis is good for most people with clinical depression. A knowledgeable mental-health professional will tailor his or her treatment approach to your individual situation.
If depression is a reaction to a specific event, counseling, psychotherapy, cognitive-behavioral therapy, and/or the simple passage of time will most likely resolve the problem.
If there is no obvious cause for the depression, or if reactive depression persists longer than might be expected, or if you are having suicidal thoughts, more aggressive therapy is needed. This means drug therapy and, possibly, hospitalization. The mainstay of drug treatment has long been a group of medications called tricyclic antidepressants, including amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Tofranil), and nortriptyline (Aventyl, Pamelor). These drugs do not take effect immediately, so a test period of at least two weeks is necessary to determine whether they are working.
Another type of drug used to treat depression is the monoamine oxidase (MAO) inhibitor. These are usually resorted to only when the others have failed. Phenelzine (Nardi}) and tranylcypromine (Parnate) are in this class. These drugs can cause high (sometimes extremely high) or low blood pressure, headaches, liver stress, seizures, nausea, vomiting, diarrhea, stomach pain, rashes, sensitivity to light, and sexual dysfunction. There are also important dietary restrictions that must be adhered to. You must avoid cheeses, chocolate, wine, beer, liver, and more. Eating any of these forbidden foods while on an MAO inhibitor can result in a dangerous spike in blood pressure. Also to be avoided are certain medications, including many over-the-counter cough and cold preparations, eye drops used for glaucoma, and drugs used to treat asthma and emphysema. If you must take an MAO inhibitor, consult your doctor before taking any other medication, whether prescription or over the counter.
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