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Anxiety and Depression Medications

Learn about the symptoms and causes of anxiety and depression and explore treatment options such as anxiety and depression medications.

Overview of Anxiety and Depression

Anxiety and depression are two of the most commonly occurring mental health disorders. Depression is not just having a bad day; it is a constant feeling of sadness for an extended period of time that interferes with normal everyday functions. Approximately one in six American adults will have depression in their lifetime.1

Nearly half of people who are diagnosed with depression also have an anxiety disorder or vice versa. Anxiety is a highly treatable disorder that can result from a combination of a wide variety of factors, such as genetics, age, past trauma, and other medical conditions. Approximately 19.1% of the adult population in the US struggles with some type of anxiety disorder.2

Can a Person Have Depression and Anxiety at the Same Time?

Depression and anxiety are often co-occurring or comorbid, meaning that they happen at the same time. It is estimated that approximately 50% of individuals who meet the criteria for a major depressive disorder also suffer from an anxiety disorder.3

Signs and Symptoms of Co-occurring Anxiety and Depression

While there are many types of anxiety disorders, they are typically characterized by symptoms of excessive anxiety and persistent dread. These feelings do not go away on their own and can cause other symptoms such as panic attacks, fatigue, and feeling wound up. 

Similarly, depression can produce symptoms such as fatigue and loss of interest. Together, symptoms of co-occurring depression and anxiety can include anger, irritability, restlessness, loss of interest, chronic fatigue, appetite changes, gastrointestinal issues, and suicidal thoughts. These will be detailed further below.

Anger

Anger is a common symptom of anxiety and depression. When an individual experiences feelings of anxiety or hopelessness for long periods of time, it can lead them to become frustrated and angry. Anger is a normal emotion and usually resolves on its own. However, persistent anger is often indicative of a larger problem. Anger attacks, lingering irritability, and hostility can all be symptoms of anxiety or a major depressive disorder. Men and younger adults or children are more likely to experience this symptom.4

Irritability

Similar to anger, many individuals may experience irritability as a symptom of depression and anxiety. You may notice that you have a “shorter fuse” and are annoyed more easily. Irritability can manifest as being overly critical or aggressive toward those around you. Additionally, irritability can manifest as a defeated and hopeless outlook.

Restlessness

Struggling to sit still? Restlessness is another symptom of anxiety and depression. Feeling a need to be in motion or constantly doing something can be an indicator of depression and anxiety. 

Loss of Interest

A major indicator of both anxiety disorders and major depressive disorder is a loss of interest. Individuals may experience a loss of interest and pleasure in their usual activities and hobbies. 

Chronic Fatigue

Both depression and anxiety can lead to chronic fatigue issues. Individuals who struggle with both depression and anxiety may suffer from changes in sleeping patterns. This may present as insomnia or, conversely, as oversleeping. Individuals who struggle with both may also report feeling generally tired and low.

Changes in Appetite

Individuals may also experience weight gain or loss due to changes in appetite. Approximately half of individuals with depression experience a decrease in appetite. This is because depression and anxiety can increase cortisol levels, which can reduce appetite. Conversely, one-third of individuals experience an increase in appetite.5

Gastrointestinal Concerns

Individuals, especially children, may experience gastrointestinal problems. These issues may appear to come out of nowhere and have no clear cause. Nausea, abdominal pain, and cramping can all be signs of depression and anxiety. 

Suicidal Thoughts

Both anxiety and depression can cause suicidal thoughts. Feelings of guilt and hopelessness can result in low self-worth and can increase suicidal thoughts. Warning signs of this symptom include an increased focus on death, withdrawing from loved ones, making plans, and reckless behavior. 

What are the Main Causes of Anxiety and Depression?

While episodes of depression and anxiety can be triggered by a major life event, the causes of long-term anxiety and depression vary. Risk factors include family history, childhood trauma, brain structure, other medical conditions, and the use of medication.

Family History

Family history and genetics play a role in the development of both anxiety and depression. Both depression and anxiety have a hereditary component. Individuals who have a family history of these disorders are more likely to develop them than those who do not. Individuals whose parents have an anxiety disorder are seven times more likely to develop an anxiety disorder themselves.6

Childhood Trauma

Adverse childhood experiences, typically referred to as childhood trauma, is a major risk factor for both depression and anxiety. Neglect, emotional abuse, sexual abuse, physical abuse, and childhood hospitalization are all risk factors for depression and anxiety in adulthood. In a recent study performed on individuals with chronic depression, it was found that approximately 75.6% of the individuals had experienced childhood trauma.7

Brain Structure

Brain structure and chemistry also play a role in the development of anxiety and depression. Individuals with depression and anxiety often present with structural abnormalities in the brain. Individuals with depression are shown to have reduced gray matter and lower volume in the frontal cortex. Additionally, individuals with depression often have hyperactive limbic systems, which is related to emotional processing. Similarly, anxiety also affects the limbic system.8

Medical Conditions

Anxiety and depression can be related to other medical conditions. Individuals with heart disease, asthma, or gastrointestinal diseases such as Crohn’s disease may experience symptoms of anxiety and depression. Additionally, endocrine disorders, such as thyroid disorders and hypoglycemia, can also be related to depression and anxiety.9

Medication Use

Anxiety and depression can also be side effects of medication use. Certain cardiovascular drugs, such as captopril, enalapril, digoxin, reserpine, and hydralazine, can cause anxiety-like symptoms. Certain anticholinergics, anticonvulsants, antihistamines, steroids, and NSAIDs are also linked to anxiety. 

Stimulants such as amphetamines, caffeine, cocaine, and ephedrine can all cause anxiety. Additionally, depression and anxiety are common symptoms of withdrawal from alcohol, anxiolytics, barbiturates, narcotic agonists, and sedative-hypnotics.

Medications for Anxiety and Depression

Medication is a popular treatment choice for anxiety and depression. Medication is often used in combination with therapy, but it can also be used alone. It is important to work with a healthcare provider to determine what type of treatment for anxiety and depression will work best for you. Severe anxiety and depression can require complex treatment.

There are six different classes of drugs for depression and anxiety. These medications include selective serotonin reuptake inhibitors (SSRIs), selective serotonin & norepinephrine inhibitors (SNRIs), tetracyclic antidepressants, benzodiazepines, N-methyl-D-aspartate (NMDA) receptor antagonists, and monoamine oxidase inhibitors (MAOIs).10

Selective Serotonin Reuptake Inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) are a type of depression medication that also has applications in the treatment of anxiety. For individuals who suffer from both depression and anxiety, SSRIs can be a powerful treatment option. Many doctors consider SSRIs to be the best medication for anxiety and depression. SSRIs work by stopping the brain from reabsorbing serotonin, which is involved in mood regulation. Over time, SSRIs increase the amount of serotonin available in the brain. The effects of the medication can usually be seen in two to six weeks, with treatment lasting around six months to a year. 

Common SSRI Antidepressants

Common antidepressants in the SSRI class include:

  • Citalopram (Celexa)
  • Escitalopram oxalate (Lexapro)
  • Fluoxetine (Prozac)

Selective Serotonin & Norepinephrine Inhibitors (SNRIs)

Selective serotonin and norepinephrine inhibitors (SNRIs) work similarly to SSRIs, but they also affect the brain’s capabilities to reabsorb norepinephrine. Much like serotonin, norepinephrine is important in emotional regulation. SNRIs work to increase the amount of freely available serotonin and norepinephrine in the brain. 

Common SNRIs

Commonly prescribed SNRIs include:

  • Desvenlafaxine (Khedezla)
  • Desvenlafaxine succinate (Pristiq)
  • Duloxetine (Cymbalta)

Tetracyclic Antidepressants

Tetracyclic antidepressants are older anti-depression medications that are useful in treating both depression and anxiety. However, because of their side effects, many doctors will choose to prescribe newer SSRIs or SNRIs before prescribing tetracyclic antidepressant drugs.

Examples of tetracyclic antidepressants include:

  • Remeron (Mirtazapine)
  • Amoxapine (Asendin)
  • Desipramine (Norpramin)

Benzodiazepines

Benzodiazepines are a type of sedative drug used as an anxiety medication due to their relaxing effects. Because they tend to be habit-forming, benzodiazepines are often only prescribed in the short term, typically less than six months. Benzodiazepines tend to be a fast-acting anxiety medication, reaching peak levels in the blood within one to two hours of taking the medication. 

Common Benzodiazepines

Commonly prescribed benzodiazepines include:

  • Alprazolam (Xanax)
  • Chlordiazepoxide (Librium)
  • Clorazepate (Tranxene)

N-methyl-D-aspartate (NMDA) Receptor Antagonist

N-methyl-D-aspartate (NMDA) receptor antagonists are medications that were initially developed for anesthesia but show promising effects in rapidly treating resistant depression and anxiety. While the use of NMDA receptor antagonists as depression and anxiety medication is fairly new, it is effective in eliminating depression symptoms due to its antidepressant effects. NMDA receptor antagonist treatment is usually done in a supervised clinical setting, over the course of a few hours.

Common names for N-methyl-D-aspartate (NMDA) Receptor Antagonists include:11

  • Ketamine
  • Esketamine
  • Memantine

Monoamine Oxidase Inhibitors (MAOIs)

Monoamine oxidase inhibitors (MAOIs) are some of the oldest anti-anxiety and anti-depression medications. Because they often have many side effects, doctors will opt to prescribe newer SSRIs or SNRIs instead of MAOIs. Additionally, MAOIs have several food and drug interactions, making them a less desirable treatment option.

Popular MAOIs include:

  • Isocarboxazid (Marplan)
  • Phenelzine (Nardil)
  • Selegiline (EMSAM)

Other Treatment Options Available

Only about one-third of individuals taking medication for anxiety and depression see an improvement within the first two months of beginning treatment with medication. Medication can be a powerful tool, but it tends to be more effective in treatment when combined with therapy. Additionally, for those who do not want to take medication at all, there are some natural remedies available. 

Therapies

Many individuals struggling with anxiety and depression benefit from therapy in combination with medication or by itself. There are a number of therapy-based treatments for anxiety and depression including:12

  • Interpersonal therapy: This type of therapy seeks to improve communication in relationships and is effective in treating anxiety and depression.
  • Cognitive/behavioral therapy: Cognitive behavioral therapy (CBT) was developed specifically for the treatment of anxiety and depression. This type of therapy focuses on understanding underlying thought patterns that lead to depression and anxiety.
  • Mindfulness-Based Cognitive Therapy: Mindfulness-based cognitive behavioral therapy is very similar to traditional CBT; however, it focuses on increasing mindfulness and uses mindfulness techniques.
  • Psychodynamic therapies: Psychodynamic therapy is a form of talk therapy that focuses on examining the past to explain issues in the present.

Natural Remedies

Many individuals may choose to treat their anxiety and depression naturally rather than taking antidepressant drugs. Pills for anxiety and depression can have a wide variety of side effects, making them an unattractive choice for some people. For individuals with less severe anxiety and depression, natural remedies can prove to be effective treatments. 

Examples of Natural Remedies

Some examples of natural remedies include:13

  • Exercise: Getting thirty minutes of exercise three to five times a week can improve symptoms of depression and anxiety.14
  • Meditation: Meditation is known to relieve stress and improve mood. Meditating for thirty minutes per day can alleviate symptoms of anxiety and depression.
  • Aromatherapy: Certain essential oils can be used to improve mood, such as bergamot and lavender.
  • Herbal teas: Certain herbal teas, such as chamomile and St. John’s wort, can be effective in managing symptoms. Prior to taking any new herbal supplements or teas, consult with a healthcare provider as there can sometimes be interactions.

Consult With A Professional at Alta Centers Today

Struggling with anxiety and depression? Alta Centers are here to help. We understand that every individual is unique, and our trained professionals are ready to work with you to create a customized treatment plan tailored to your needs. Contact us today.