Esmeralda Perez

Dr Cassel

Eng 1201-2V3

25 March 22

What are treatment options for people with anxiety and depression?

A Literature Review

Introduction: Everywhere around the world there are adults and especially teens going through

depression and anxiety. It has gotten worse, increased, and is affecting our everyday lives. It is already

hard being a teenager because you are going through changes, new stages in life, hormones, mood

swings, dealing with school, and more, so dealing with anxiety and depression can be incredibly stressful

and overwhelming. Teens find it extremely hard to talk about this and most of the time they are afraid

of seeking help because they do not know where to start or how. This brings me to my question, what

are treatment options for people with anxiety and depression?

Depression and anxiety can be dangerous disorders because when you are not receiving the right help

or any help at all, you get worse physically and mentally. An example of depression as stated in the

article, “Antidepressants are an effective treatment for Depression,” “She doesn’t do anything all day,

just lies around and stares at the wall” (Carter, Betty Smartt). While others see this as laziness, it can be

deeper than that because this can be a sign of depression. It has been proven that antidepressants fix

the chemical imbalances in the brain. The medicine Prozac and Zoloft are new medicines that have

amazing results with only a few side effects (Carter, Betty Smartt).

As stated in the article, “Depression treatment options for adults,” “Depression may cause serious, long-

lasting symptoms and often disrupts the ability to perform routine tasks” (Rush, A John). Symptoms of
depression can be depressed mood, poor concentration, recurrent thoughts of death or suicide, feelings

of worthlessness, excessive guilt, loss of energy, sleeping too much, or too little, change in appetite, or

weight, loss of interest, or pleasure in most, or all activities (Rush, A John). If you see yourself dealing

with these symptoms then you should start small and see your doctor, investigate psychotherapy, and

medications. There are many treatment options available for everyone because everyone has their own

way of getting better and not everyone gets better or deals with things the same. Some people prefer

counseling, psychiatrists, psychotherapy, medications, exercises, therapists, or meditating. It just all

depends on what you are comfortable with and what you think works best for you.

When dealing with depression, antidepressants come in handy the most because it is what most people

go to. The more commonly used medications mentioned in the article are Selective serotonin reuptake

inhibitors (SSRIs), Serotonin-norepinephrine reuptake inhibitors (SNRIs), Atypical antidepressants, and

Serotonin modulators (Rush, A John). The less commonly used antidepressants are Tricyclic

antidepressants and Monoamine oxidase inhibitors (MAOIs) (Rush, A John). At first, it is extremely hard

selecting a medicine that works for you, but do not think that you cannot help yourself because you can,

it just takes time. For people with mild to moderate depression who start treatment with an

antidepressant, we suggest SSRIs (Rush, A John). This medicine offers as much benefit as any other

medication, but the difference is it has the least amount of risk in terms of safety and side effects (Rush,

A John).

At the end of the day, the decision stays with you and how you choose to get better because it depends

on what you prefer, and whether you have insurance or not. Side effects are normal when you are

taking medications and especially if it is your first time. Some side effects can be nausea, headaches,

drowsiness, mood swings, etc. It just depends on what kind of medicine and the dose because the dose

plays a huge role in this, for example, health care providers tend to start their patients on low doses and
slowly increase them as necessary (Rush, A John). Everyone is different so some people see changes fast

and for others it takes longer, but it can take up to 6 to 12 weeks to see a full effect.

In fact, the people who see some benefit early on after starting an antidepressant appear to be the ones

most likely to completely recover (Rush, A John). If you do not see a change or if you feel like the

medications are not helping then you might need to increase your dose, switch medications, or try other

things. If you are a person who does not like taking medications, then this treatment is for you, and that

is psychotherapy. All forms of psychotherapy include support from a professional who is focused on

helping you to make positive changes (Rush, A John). There are many types of therapy and those are

cognitive-behavioral therapy (CBT), interpersonal psychotherapy, family and couples therapy, problem-

solving therapy, and psychodynamic psychotherapy (Rush, A John).

Cognitive-behavioral therapy (CBT) is when you work with a therapist to identify and reshape the

thought and behavior patterns that contribute to your depression (Rush, A John). Interpersonal

psychotherapy is when you focus on your relationships, the way you interact with other people in your

life, and the different roles you play (Rush, A John). Family and couples therapy is when you attend

therapy sessions along with your partner or family members so that you can work together on the issues

that are contributing to your depression (Rush, A John). Problem-solving therapy is when you take a very

practical and systematic approach to the problems in your life and find an effective way to solve them.

In psychodynamic- psychotherapy you might explore childhood or historic life events and work to

reduce their influence by gaining insight into how they may be shaping your current behavior (Rush, A

John).

If you do not want to try therapy, then another treatment you could try is clinical guided self-help and

this involves the use of workbooks (hardcopy, compact disc, or internet-based), audiotapes, or

videotapes (Rush, A John). Instead of you attending formal therapy sessions, some people work on their
own with a little guidance from a health care provider (Rush, A John). The good thing about

psychotherapy is that its benefits last even after treatment stops, whereas antidepressants wear off

quickly (Rush, A John). If you do not want to try these treatments, then you could always try relaxation,

exercises, and positive activities. Several studies suggest that exercise can ease depression (Rush, A

John). They suggested three to five exercises per week, and they should last about half an hour to an

hour and the exercise should involve walking, running, and cycling.

It is not a surprise that people, especially teens that have depression, also have anxiety as well.

Antidepressants can help with both of those symptoms but sometimes take a while to start working

(Rush, A John). Relaxation exercises and psychotherapy may also help with accompanying anxiety and

insomnia (Rush, A John). One thing that you may not know is that there are devices that stimulate the

brain, and these devices are called “neuromodulation” interventions; they may be recommended for

people who do not respond to medications and psychotherapy (Rush, A John). The interventions include

transcranial magnetic stimulation (TMS) and electroconvulsive therapy (ECT).

Transcranial magnetic stimulation involves placing a device against the scalp to pass magnetic waves

into the brain (Rush, A John). Electroconvulsive therapy involves passing an electric current through the

brain (while the person is under general anesthesia) (Rush, A John). Another thing that you may not

know about is severe major depression, and this should be taken more seriously because people with

severe major depression usually need to be seen by a psychiatrist and sometimes need to be

hospitalized (Rush, A John). Some symptoms of severe major depression can be that they have thoughts

of and plans for suicide or homicide, delusions, hallucinations, refuse to eat or drink, and that they have

a condition called catatonia, which involves being unable to move or talk normally (Rush, A John). Some

health care providers start with SNRIs because studies suggest that these medications are more likely

than SSRIs to alleviate severe depression (Rush, A John).

We talked about the importance of depression, now it is time to talk about the importance of anxiety.

As stated in the article, “Anxiety disorders” “Each year, mental health specialists at Mayo Clinic see more

than 32,000 people who have anxiety disorders (Mayo Clinic). Anxiety should be seen as important as

depression because anxiety is not something that goes away in one day, it takes time. Some symptoms

of anxiety can be feeling nervous, restless, tense, increased heart rate, sweating, breathing rapidly,

trembling, feeling weak, tired, trouble sleeping, having trouble concentrating etc (Mayo Clinic). No one

can fully understand the causes of anxiety disorders but as stated in the article, “Life experiences such as

traumatic events appear to trigger anxiety disorders in people who are already prone to anxiety” (Mayo

Clinic).

For example, some of the things that can increase your risk of developing an anxiety disorder is trauma,

stress buildup, stress due to an illness, drugs, alcohol, and other mental health problems (Mayo Clinic).

Some of the types of anxiety disorders are anxiety disorder due to a medical condition, panic disorder,

separation anxiety disorder, and social anxiety disorder (Mayo Clinic). Anxiety disorder due to a medical

condition includes symptoms of intense anxiety or panic that are directly caused by a physical health

problem (Mayo Clinic). Panic disorder involves repeated episodes of sudden feelings of intense anxiety

and fear or terror that reach a peak within minutes (panic attacks) (Mayo Clinic). Separation anxiety

disorder is a childhood disorder characterized by anxiety that's excessive for the child's developmental

level and related to separation from parents or others who have parental roles (Mayo Clinic).

Social anxiety disorder involves high levels of anxiety, fear, and avoidance of social situations due to

feelings of embarrassment, self-consciousness, and concern about being judged or viewed negatively by

others (Mayo Clinic). You should see a doctor when you feel you're worrying too much and it’s

interfering with your work, relationships, or other parts of your life, your fear or anxiety is upsetting to

you and difficult to control, you have suicidal thoughts or behaviors, you feel depressed, or have trouble
with alcohol or drug use (Mayo Clinic). What you may not know is that medical problems can be linked

to anxiety, and these can include heart disease, diabetes, chronic pain, respiratory disorders, drug

misuse, etc (Mayo Clinic). The best treatment for anxiety is psychotherapy and medications.

Psychotherapy involves working with a therapist to reduce your anxiety symptoms (Mayo Clinic).

Cognitive-behavioral therapy is the most effective form of psychotherapy for anxiety disorders because

it focuses on teaching you specific skills to improve your symptoms and gradually return to the activities

you avoided because of anxiety (Mayo Clinic). Several types of medications are used to help relieve

symptoms depending on the type of anxiety disorder you have and whether you also have other men

physical health issues (Mayo Clinic). Another thing to try for anxiety can be changing your lifestyle

around you because believe it or not but it makes a huge difference and changes. A few things you can

do is eat healthy, make sleep a priority, quit smoking and cut back or quit drinking caffeinated

beverages, make sleep a priority, keep physically active, keep physically, avoid alcohol, and recreational

drugs (Mayo Clinic). Take it day by day and you will see that it starts to make a change around you and

the people around you as well.

Since we talked about anxiety and depression separately, let's talk about them together. As stated in the

article, “Psychobiotics as treatment for anxiety, depression, and related symptoms: a systematic review”

“Severity of both anxiety and depression are highly influenced by stress” (Smith, Kristen S). Among new

therapy techniques, modifying intestinal microbiota and gut health has become increasingly popular

(Smith, Kristen S). Probiotics are defined as consumed microorganisms that beneficially contribute to

host gut microbial flora (Smith, Kristen S). Prebiotics are chemical compounds/nutrients that influence

gut microbiome composition by feeding specific bacterial species (Smith, Kristen S).

Six out of 12 studies found probiotics to reduce depression while two studies found probiotics to reduce

anxiety (Smith, Kristen S). Certain bacterial species are researched specifically for their benefits to host’s
mental health, such as Bifidobacterium longum (B. Longum) and Lactobacillus helveticus (Smith, Kristen

S). Both of these species have aided in decreasing gastrointestinal discomfort in stress-affected

individuals and improving emotional behavior in mice and psychological outcomes in healthy humans

(Smith, Kristen S). B. longum reduced anxious and depressive behaviors in mice and reduced anxiety and

stress responses in healthy volunteers (Smith, Kristen S). Almost all of these studies evaluating

psychological distress are completed in healthy human subjects (Smith, Kristen S).

We covered anxiety, depression, and the treatments options for these two but now it is time to talk

about doctors and how they are overprescribing psychiatric medication to children. As stated in the

article, “Doctors are overprescribing psychiatric medication to children” Approximately 5 million

American children, some as young as two, are given potentially dangerous psychiatric drugs, alone and

in combination, including Ritalin, Prozac, Zoloft, Wellbutrin, and Dexadrine (Diller, Lawrence H). Most of

the time doctors prescribe any kind of medication to children and teens, and instead of helping them get

better the medications make it worse or trigger something which can later in the future become a huge

problem. A survey was done, and it was found that the use of Prozac-like drugs for children under 18 is

up 74 percent, 7-12 age group is up 151 percent, 6 and under is up 580 percent (Diller, Lawrence H).

Even though some medications help it’s very important that you receive the right one and do your

research before taking it.

In conclusion, there are many treatment options for anxiety and depression. You should take baby steps

and start off small, for example, you should change your lifestyle and if that doesn’t work talk to your

doctor and see if he/she can help you out. Everything takes time and it is okay because once you find

what works best for you then it will be worth it because the important thing is you want to get better.
 Work Cited

Diller, Lawrence H. "Doctors Are Overprescribing Psychiatric Medication to Children." Treating

the Mentally Ill, edited by Kyla Stinnett, Greenhaven Press, 2004. At Issue. Gale In

Context: Opposing Viewpoints, link.gale.com/apps/doc/EJ3010326208/OVIC?

u=dayt30401&sid=bookmark-OVIC&xid=c7967950. Accessed 23 Mar. 2022. Originally

published as "Kids on Drugs," www.salon.com, 2000.

Carter, Betty Smartt. "Antidepressants Are an Effective Treatment for Depression."

Antidepressants, edited by Katherine Read Dunbar, Greenhaven Press, 2006. At Issue.

Gale In Context: Opposing Viewpoints, link.gale.com/apps/doc/EJ3010366203/OVIC?

u=dayt30401&sid=bookmark-OVIC&xid=b15ffa14. Accessed 25 Mar. 2022. Originally

published as "Taming the Beast: My Life on Antidepressants," The Christian Century,

vol. 120, 9 Aug. 2003, p. 21.

Rush, A John. “Patient Education: Depression Treatment Options for Adults (beyond the

Basics).” UpToDate, 21 Oct. 2021, https://www.uptodate.com/contents/depression-

treatment-options-for-adults-beyond-the-basics.

Smith, Kristen S., et al. “Psychobiotics as Treatment for Anxiety, Depression, and Related

Symptoms: A Systematic Review.” Nutritional Neuroscience, vol. 24, no. 12, Dec. 2021,

pp. 963–77. EBSCOhost, https://search.ebscohost.com/login.aspx?

direct=true&db=s3h&AN=153688043&site=eds-live.
“Anxiety Disorders.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 4 May

2018, https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-

20350961.