Prevention

There is no way to prevent major depression, but detecting it early can diminish symptoms and help to prevent the illness from returning.

Treatment

A combination of psychotherapy and medication is most helpful. The most commonly prescribed antidepressants are in the group known as selective serotonin reuptake inhibitors (SSRIs). They include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil) and citalopram (Celexa). They are fairly easy to take and relatively safe compared to previous generations of antidepressants.

No medication is without side effects. SSRIs are known to cause problems with sexual functioning, some nausea, and an increase in anxiety in the early stages of treatment. Concerns about an increased risk of suicide in people taking SSRIs have remained a focus of researchers, although the evidence is not clear. A very small number of people taking these medications may feel worse rather than better. All troubling changes should be reported immediately to your doctor.

Other relatively new and effective antidepressants are bupropion (Wellbutrin), venlafaxine (Effexor), mirtazapine (Remeron) and duloxetine (Cymbalta). The older classes of antidepressants, tricyclic antidepressants and monoamine inhibitors, are still in use and can be very effective for people who have not responded to other treatments.

It usually takes at least two to six weeks of taking any antidepressant to see improvement. Once the right medication is found, it may take up to a few months to find a proper dose and for the full positive effect to be seen.

Sometimes, two different antidepressants are prescribed together to enhance the effect. Or, a medication from the class called mood stabilizers, such as lithium (sold under several brand names) or valproic acid (Depakene, Depakote), is added. If psychotic symptoms are present, a medication from the class known as antipsychotics is usually prescribed. These include haloperidol (Haldol), risperidone (Risperdal), olanzapine (Zyprexa, Zydis), ziprasidone (Geodon) and aripiprazole (Abilify).