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When are people generally diagnosed with bipolar disorder?

We tend to see symptom onset most often in younger adults, as is consistent with most other major mental health diagnoses. In part, this is due to so many life changes and transitions happening at younger ages. 

This is important when you remember that the brain continues to develop through age 25 or so. Coupled with risk factors, the onset of many life changes—and a still-developing brain—can lead to the development of a mental health condition.

Bipolar disorder is caused by a combination of biological and environmental factors. Risk factors include:

• Genetics
• Diet
• Stress
• Trauma
• Intense emotional conflicts within families

If you would like to discuss your mental health concerns with a licensed mental health professional, Brightside Health can help. Start with a free assessment.

Does bipolar disorder get worse with age?

Similar to other medical conditions that can worsen if left untreated, bipolar disorder can worsen with age if not treated. Mental health practitioners can help you manage symptoms of bipolar disorder so that you can live a more meaningful and fulfilling life.

It is worth noting that there seems to be a prevalence of comorbid medical conditions in older adults with bipolar disorder. According to multiple studies, “older adults with BD experience higher rates of chronic medical diseases,” including:

• Cardiovascular disease
• Diabetes
• Chronic pulmonary disease

Additionally, older adults with bipolar disorder tend to have “higher levels of obesity, endocrine/metabolic, and respiratory disease compared with older adults with major depressive disorder” according to the same report published by the International Journal of Geriatric Psychiatry.

The authors of the report found that:

Some comorbid medical disorders may be viewed as a consequence of mood disorder, while others may contribute to the pathogenesis [how the disease progresses from initial symptoms to worsening presentation] (Leboyer et al., 2012). Furthermore, treatments for medical disorders may contribute to mood disorder symptoms, and some mood disorder treatments, such as antipsychotic medications, may contribute to or exacerbate medical conditions.

The implication seems to be that the “worsening” of bipolar in the aging process seems to be tied up in the overall health of the individual, and can have much to do with other medications and conditions. It’s important to know that the mind and body work together and can influence each other. Taking care of yourself with the right treatment for bipolar disorder can help set you up for success in other areas of your life, including your physical health. 

Does bipolar II get worse with age?

As we’ve discussed in our blog, there’s a diagnostic differentiation in bipolar disorder.  These are often characterized as bipolar I and bipolar II.

People with bipolar I have experienced at least one manic episode and one major depressive episode. The National Institute of Mental Health explains that bipolar I is characterized by “manic episodes that last at least 7 days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks.”

Bipolar II features the same major depressive episodes as bipolar I, but without manic episodes. Instead, those with bipolar II will experience hypomanic episodes, which are shorter and less disruptive than the manic episodes described above.

While both major types of bipolar disorder can get worse over time, especially if not successfully treated, there seems to be a decrease in manic episodes as individuals age. In fact, as Dr. Eric Youngstrom explains to the American Psychological Association:

The biggest way that the illness seems to change with age is that older individuals are more likely to experience depression and less likely to have mania, whereas in childhood it is more mania or a mixture of high energy with negative mood. Researchers and clinicians have described that pattern for more than a century.

The key takeaway from this is that bipolar disorder is a lifelong mental health condition that can change over time.

Signs that bipolar is getting worse

One of the first things to watch out for as you age with bipolar disorder is a change in episodes. Whether they are manic or depressive episodes, you should contact your mental healthcare provider if you are experiencing them more frequently or notice a difference in intensity. It’s also a good idea to let people close to you know, such as your closest support network, so they can watch for any changes too.  

As we said above, older individuals with bipolar disorder are more prone to experience depressive symptoms than manic symptoms, so be on the lookout for the symptoms of bipolar depressive episodes. These may include:

• Difficulty concentrating 
• Changes in appetite
• Fatigue
• Changes to your sleep patterns
• Feeling hopeless, worthless, or helpless
• Little interest in activities you usually enjoy
• Restlessness 
• Suicidal thoughts or ideas of self-harm

If you start to experience these symptoms more frequently than you did in the past, it may be a sign that your bipolar disorder is getting worse. In every case, it’s worth a discussion with your mental health provider. 

Outlook

Even as there seems to be evidence that bipolar can get worse with age, there’s plenty of reason for hope. With proper treatment, support, coping skills, and a watchful eye on your symptoms, you can manage bipolar disorder throughout life.

One of the best approaches to thinking about long-term management of bipolar and related disorders is to take it day to day. Evaluate your symptoms, and stick to your treatment plan. 

If you are concerned about bipolar disorder, or about any mental health symptoms you may be experiencing, contact Brightside Health today. 

Take our free assessment

Resources: 

If you are in emotional distress or thinking about hurting yourself in any way please make use of these resources:

• Visit: If you are having a medical or mental health emergency, call 911 or go to your local emergency department
• Text: The Crisis Text Line provides 24-hour free and confidential help. Text ‘HOME’ to 741-741 to connect with a counselor immediately
• Call: You can call the 988 Suicide & Crisis Lifeline simply by dialing 988 to talk with a live counselor 24 hours per day

The post Does bipolar get worse with age? appeared first on Brightside.

Bipolar disorder is a complex mental health condition, and there are significant differences in the onset and symptoms of bipolar disorder in females versus males. While we recognize and honor the challenges of a gender binary definition of “male” and “female,” many of the nuances in bipolar disorder symptoms in females relate to reproductive hormones operating since birth.

There are a number of unique features of bipolar disorder in females. A recent study published in the Indian Journal of Psychiatry summarized these distinctions as:

• A later age of onset of bipolar disorder in females
• Seasonality of symptoms
• Atypical presentation
• A higher degree of mixed episodes

Let’s review some of the symptoms of bipolar disorder, and then look more closely at where biological differences occur.

If you are experiencing the signs and symptoms of bipolar disorder, or have other mental health concerns, you can talk to a mental health professional at Brightside Health. Start with a free assessment.

Symptoms of bipolar disorder

As we have discussed before in our blog, bipolar disorder is a mental health condition associated with extreme mood swings. Those with bipolar disorder experience episodes of mania (elevated moods and emotional highs), and depressive episodes (emotional lows and depressed moods). These episodes, whether manic or depressive, will govern the symptoms that an individual may experience. 

Manic symptoms can include:

1. Irritability
2. Feeling jumpy or wired
3. Decreased need for sleep
4. Feeling unusually important or powerful
5. Feeling like you can do multiple things you wouldn’t typically do all at once
6. Loss of appetite
7. Poor judgment or engaging in risky behavior
8. Racing thoughts
9. Rapid speech about many different topics

Symptoms of bipolar depressive episodes can include:

1. Fatigue
2. Feeling bad about yourself 
3. Difficulty concentrating 
4. Eating more than usual
5. Feeling hopeless, worthless, or helpless
6. Little interest in activities you usually enjoy
7. Restlessness 
8. Sleeping too much or too little
9. Suicidal thoughts or ideas of self-harm

Generally, bipolar disorder is categorized into one of several major types.

Bipolar I is defined by the National Institute of Mental Health as “manic episodes that last at least 7 days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks. Episodes of depression with mixed features (having depressive symptoms and manic symptoms at the same time) are also possible.”

Bipolar II is similar, except that it does not feature manic episodes. Instead, bipolar disorder II symptoms in females and males tend to include “hypomanic” episodes which are shorter and less severe. 

Those who experience symptoms of bipolar disorder who do not quite meet the criteria for a diagnosis of bipolar I or II may be diagnosed with cyclothymic disorder or other unspecified bipolar disorder. Cyclothymic disorder is often seen as a less severe version of bipolar disorder, but the symptoms persist across years and can still be highly disruptive to one’s life. 

Bipolar disorder symptoms in females

Historically, bipolar disorder symptoms in females were dismissed and disregarded by physicians. Medical providers may improperly treat females with regard to bipolar II due to inaccurate and stereotypical portrayals of women that portray them as regularly experiencing fluctuating moods. It’s very important for mental health professionals to be aware of any potential biases in this regard.

The US Department of Health’s Office on Women’s Health explains that females with bipolar disorder are “more likely than men with bipolar disorder to have other physical and mental health conditions, including problems with alcohol use, depression caused by bipolar disorder, thyroid disease, obesity caused by medicines that treat bipolar disorder, and migraine headaches.”

Because it’s also vital that individuals and family members recognize the signs of bipolar, here are some nuances in its presentation in females to watch for. 

Often depression first

According to a study in the Indian Journal of Psychiatry, “Many female bipolar patients initially present with depressive symptoms, that is why many times they are misdiagnosed.” It is not uncommon for females to be treated for other depressive disorders instead of bipolar disorder. This also results in females being more likely to be diagnosed with bipolar II. 

Rapid cycles

As we mentioned above, bipolar II is characterized by rapid cycling between depressive lows and hypomanic highs. There seems to be a strong correlation between these mood cycles and a female’s hormonal cycles. The US Department of Health’s Office on Women’s Health says, “Changing hormones during the menstrual cycle, pregnancy, and menopause can affect how severe a woman’s bipolar disorder is.”

Later onset

Females tend to see a later onset of bipolar disorder symptoms than males do, with most diagnoses happening in their late twenties. While studies are uncertain why this is the case, it may have a good deal to do with the stereotyped notion that bipolar disorder symptoms in teenage females are frequently seen as “normal” behavior. This may be particularly the case with symptoms of bipolar II.

Treatment for bipolar disorder

Treatment is often very successful in helping manage bipolar disorder symptoms in females. Treatment generally involves a combination of therapy and medication. Medication for bipolar disorders might include mood stabilizers and second-generation antipsychotic medication. 

The importance of a support network

In addition to professional treatment, social support is an important element for managing bipolar disorder symptoms in teenage and adult women. This is especially true when it comes to having a consistent source of support who can be there at both high and low points. Having people there to watch out for us, and help us to identify the signs and symptoms of bipolar disorder when they appear, can be a vital asset.

If you think you might be experiencing the symptoms of bipolar disorder, it’s important to see a mental health provider right away. At Brightside Health, we can help treat bipolar II disorder and bipolar I disorder without acute mania.

Start with a free assessment

Resources: 

If you are in emotional distress or thinking about hurting yourself in any way please make use of these resources:

• Visit: If you are having a medical or mental health emergency, call 911 or go to your local emergency department
• Text: The Crisis Text Line provides 24-hour free and confidential help. Text ‘HOME’ to 741-741 to connect with a counselor immediately

Call: You can call the 988 Suicide & Crisis Lifeline simply by dialing 988 to talk with a live counselor 24 hours per day

The post Bipolar disorder symptoms in females: 18 signs appeared first on Brightside.

Lately, it’s become easier than ever to see a mental health provider thanks to the expansion in online health care. Brightside Health’s network includes psychiatric providers who can prescribe medication and licensed therapists who provide evidence-based therapy. 

Before we look at the ins and outs of seeing a provider, let’s quickly review what separates a psychiatrist from a therapist.

What does a psychiatrist or psychiatric provider do?

Psychiatrists are medical doctors who have completed medical school. This means that all psychiatrists carry the title of MD (Doctor of Medicine) or DO (Doctor of Osteopathic Medicine).

As for psychiatric providers — many practices utilize psychiatric mental health nurse practitioners (PMHNPs) to ensure they can treat the patients that need them. This is similar to seeing a nurse practitioner in your primary care doctor’s office. 

PMHNPs are highly-trained specialists who operate under the supervision of a board-certified psychiatrist. They can offer a range of psychiatric services, including prescribing medication.  The American Psychiatric Association says that PMHNPs “assess and diagnose, prescribe medications, provide psychotherapy, provide consultation and liaison services, and participate in policy and research development. All 50 states grant PMHNPs prescriptive authority to some level.”

When it comes to psychiatric providers, whether they are physicians or NPs, the focus is on the biological factors that impact mental health. A psychiatric provider will look at things like genetics and chemical imbalances that may contribute to mental health problems. 

A psychiatric provider assesses an individual and may perform a range of medical tests. Then the provider develops a personalized treatment plan, which may include medication. The provider prescribes medication, handles treatment adjustments, refills, medication management, and more.

Psychiatry vs. therapy

Therapists are a bit different. Therapists generally don’t go to medical school. Instead, they pursue a graduate education in psychology, often earning doctoral degrees (PhD, PsyD, or EdD). Becoming a therapist also requires certification and licensure.

A therapist will focus on the psychological aspects of mental health. They will look at your thoughts, feelings, and behaviors. Therapists will typically offer talk therapy that utilizes a range of tactics and techniques. One of the main objectives is to help you cope with the challenges you face.

Can you see a psychiatrist online?

You can absolutely see a psychiatric provider online. Evidence even suggests that telepsychiatry services provide similar outcomes as face-to-face visits. Online psychiatry services begin with an initial consultation and can provide both diagnostic medical advice and prescription medications if they are warranted. For many people in remote areas, online mental health care is the perfect option.

Can you see a psychiatrist without a referral?

Just like any medical specialist, your ability to see a psychiatrist without a referral depends on your medical insurance. Because we can’t determine the answer to this question specifically for every insurance policy, let’s look at how it works at Brightside Health.

Self-paying individuals

If you are self-paying for Brightside Health with a credit card, you do not need a referral. You’re free to contact us and set up an appointment at any time. We’ve made sure our care is affordable even without insurance, and paying for Brightside services directly is always an option. We also accept HSA/FSA payments if you have one of those accounts.

Start with a free assessment

Cigna and Aetna insurance plans

We accept Cigna and Aetna insurance plans. You do not need a referral if you are using one of those insurance plans for Brightside Health. You will only be responsible for copays, deductibles, or coinsurance.

After your visit, Brightside will submit claims for services rendered to your insurance plan. When your insurance has processed the claim, they will send you an Explanation of Benefits (EOB), telling you what services were billed, what amount was covered by the insurer, and what balance, if any, you owe.

Other insurance or providers

If you have different insurance coverage, or if you wish to see a mental health professional elsewhere, you will need to contact your insurance company. You may need a referral from your primary care doctor in order for your insurance to cover your care.

How to get a referral for a psychiatrist

If you do need a referral to see a psychiatric provider, your first stop should be your primary care doctor. Talk to them about how and what you are feeling and ask to be referred to a psychiatric provider. Many doctors and systems offer collaborative care, meaning all of your providers work together to treat you.

There’s an exception to this suggestion, and that’s if you are in crisis.

If you are in emotional distress or thinking about hurting yourself at any point, please make use of these resources:

1. Visit: If you are having a medical or mental health emergency, call 911 or go to your local emergency department
2. Text: The Crisis Text Line provides 24-hour free and confidential help. Text ‘HOME’ to 741-741 to connect with a counselor immediately
3. Call: You can call the 988 Suicide & Crisis Lifeline at 800-273-TALK to talk with a live counselor 24 hours per day

There is always help available. We also recommend reaching out to a family member or friend to let them know you are having these thoughts and to ask for help and support.

If you’re interested in starting your journey with psychiatric care, Brightside Health is here to help. Our team of world-class professionals are just a phone call or click away, and are happy to assist every step of the way.

Start with a free assessment

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When it comes to treating depression, psychiatric providers have several medication options to choose from. The most popular medications, and generally considered the first option for most people with moderate to severe symptoms, are selective serotonin reuptake inhibitors (SSRI). But if these aren’t effective for the individual, or if SSRIs aren’t the best choice for other reasons such as side effects, doctors will examine alternatives to SSRIs to treat depression. One of the SSRI alternatives they may explore for depression is a class of medicines called serotonin and norepinephrine reuptake inhibitors, also known as SNRIs.

It can be difficult to determine whether SNRIs or SSRIs will be best for depression within an individual, so let’s take a look at how each class of medication works, and what may cause a provider to encourage one over the other.

How does an SSRI work?

As we said above, selective serotonin reuptake inhibitors (SSRIs) are often the first choice in treating depression. The Mayo Clinic says that SSRIs “are the most commonly prescribed antidepressants. They can ease symptoms of moderate to severe depression, are relatively safe, and typically cause fewer side effects than other types of antidepressants do.”

Our psychiatric providers use SSRIs to help balance the serotonin levels in your brain—increasing those levels can improve your mood. Serotonin is one of the major chemical messengers (neurotransmitters) used to carry a signal from one brain cell to another.

SSRIs make more serotonin available in the brain. This may help your brain grow new cells and form stronger connections between neurons. SSRIs do this by blocking the reuptake of serotonin, which means more serotonin is available to help transmit messages between neurons.

SSRIs may also help generate cells in an important part of your brain that regulates mood and anxiety. This region is called the dorsolateral prefrontal cortex (DLPFC). When cells in this region are activated, they can help regulate mood, memories, anxiety, anger, and fear.

There are several SSRI options on the market, including name brands like Prozac (fluoxetine), Zoloft (sertraline), Celexa (citalopram), and Lexapro (escitalopram). Your psychiatric provider will determine which of these SSRIs are best for depression and at what dose, as efficacy depends on several factors and interactions.

How does an SNRI work?

Serotonin and norepinephrine reuptake inhibitors (SNRIs) are a newer class of medicines that work just a bit differently than SSRIs. It’s this difference that may help a provider determine whether an SSRI or an SNRI will better treat your unique depression symptoms. 

The key distinction lies in the inhibition of the reabsorption of norepinephrine. As implied in their name, SNRIs prevent the brain from reabsorbing both serotonin (like SSRIs) and the neurotransmitter norepinephrine. As a result, SNRIs can boost levels of serotonin and norepinephrine—neurotransmitters, or chemical messengers, in your brain that affect your mood.

Serotonin creates feelings of well-being, and norepinephrine promotes alertness and energy. SNRIs work by increasing available amounts of these neurotransmitters in the brain, making you feel better and improving symptoms of depression and anxiety.

Some of the most common brand names for SNRIs include Cymbalta (duloxetine) and Effexor (venlafaxine). 

SNRI vs SSRI for depression: How do you choose the right one for you?

If SNRIs work on norepinephrine as well as serotonin, then doesn’t that make them a better alternative than SSRIs for depression? Not necessarily. 

Both SSRIs and SNRIs have side effects that impact each individual differently. SNRIs are typically second-line agents when an SSRI has failed because in general SSRIs have fewer side effects, but sometimes SNRIs are used to treat specific conditions such as chronic pain. The Mayo Clinic says:

All SNRIs work in a similar way and generally can cause similar side effects, though some people may not experience any side effects. Side effects are usually mild and go away after the first few weeks of treatment.

Some of the common side effects for SNRIs, The Mayo Clinic continues, include headaches, nausea, dizziness, and changes in sexual function, such as reduced sexual desire, difficulty reaching orgasm or the inability to maintain an erection (erectile dysfunction). It’s worth noting that the side effects list is very similar to the one they list for SSRIs. 

In deciding whether to prescribe SSRIs or SNRIs for depression, a provider will take all of these side effects into account, and will also evaluate any interactions the medicines may have with anything you are currently taking. All of these factors will also help your provider determine which particular SNRI or SSRI is best for your depression. As we explain on our blog, “If you try one SSRI and find that your body does not tolerate it well, you may still be able to tolerate a different SSRI. If you are experiencing unwanted side effects, your provider will work with you to adjust your medication or recommend another SSRI that may be a better fit for your needs.” And if they can’t meet that need with an SSRI, then they may try an SNRI.  

Generally speaking, a provider will work to find a medication for which the benefits far outweigh any side effects. Typically, that may take a bit of trial and error—however, at Brightside, our providers have access to our clinical decision-making tool, PrecisionRx, which supports them in personalizing treatment to you and finding the right SSRI, SNRI, or other medication to get on top of depression.

Are SNRIs or SSRIs better for depression?

The truth is, it’s impossible to know for sure or even to tell which SNRI or SSRI is best for depression, without knowing a lot of specifics about an individual, their specific depression symptoms or presentation, their comorbidities, and more. On our blog we explain, “Experiences with depression may vary as individuals respond to medications in different ways. This is why matching you with the right medication for your individual needs is essential.” 

What we can tell you is that, if you are experiencing depression, you and your Brightside provider can find the best SSRI or SNRI for you, if medication is the right choice. Your provider will want to know about your needs and family medical history, and they may try more than one medication before they find the right fit. Using our precision psychiatry technology, Brightside analyzes a variety of data about a member, including preferences and present symptoms, to recommend the medication that is likely to be most tolerable and effective for you. In a representative study of over 6K Brightside members, conventional prescribing practices only covered 13% of the unique treatment plans we prescribed.

Your provider may also recommend alternatives to SSRIs to treat your depression —an MAOI for example, or treatment that includes therapy. Treating depression often takes a combination of medication and therapy. 

Brightside is here to help with all of this. Get started by taking our free assessment today.

The post Are SNRIs better than SSRIs for depression? appeared first on Brightside.

Selective serotonin reuptake inhibitors (SSRIs) are an effective treatment when taken at the right dosage for many individuals with depression, anxiety, and other mental health conditions. Common SSRIs include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil), and sertraline (Zoloft). Occasionally, however, the dose of an SSRI can be too high, and that can cause uncomfortable side effects. 

It’s a good idea to know some of the signs your antidepressant dose is too high s, and to know when to talk to your psychiatric provider.

As a matter of fact, it’s a good idea to talk with your provider about any of these questions, because they know your history and other factors that may impact your dosage. What is considered a high dose of Zoloft for one individual may be the perfect dose for another. The same is true for Prozac dosage. Only your provider will know then to increase antidepressant dosage or how to interpret signs that your antidepressant dose is too low or high. 

Here are a few signs to watch for if you’re taking an SSRI.

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Want to speak 1:1 with an expert about your anxiety & depression?

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How do I know if my SSRI is too high?

There are a few things you should watch for that may indicate your dose is too high. From side effects to mood changes, here are a few things to watch for.

Be on the lookout for increased side effects

One of the easiest ways to tell if your SSRI dose is too high is if you are experiencing an increase in side effects. Remember, though, that side effects are normal when starting an antidepressant, and they tend to decrease over time. 

Individuals may experience mild side effects with SSRIs, which your provider can work with you to minimize. These may include:

• Headaches
• Sweating
• Drowsiness
• Insomnia
• A loss of interest in sexual activity
• A loss of appetite
• Dizziness
• Mild anxiety 

While this list is partial, it’s vital to note that, as the United Kingdom’s National Health Service explains, “The majority of people will only experience a few mild side effects when taking them. It’s important to persist with treatment, even if you’re affected by side effects, as it will take several weeks before you begin to benefit from treatment. With time, you should find that the benefits of treatment outweigh problems related to side effects.”

If your SSRI dose is too high, then the frequency and severity of those side effects may increase. Psychiatric Times explains that a dose reduction may help, saying, “Should bothersome adverse effects emerge, watchful waiting is often a reasonable option since most adverse effects diminish over time. Either reducing the dose or adjusting the dosing schedule can be tried before switching to another antidepressant.”

Pay attention to emotional blunting

Another signal that your SSRI dose is too high is an effect called “emotional blunting.” Harvard University’s Dr. Michael Craig Miller explains that occasionally a high dose of an SSRI can make people feel as though all of their emotions have dulled. Dr. Miller says, “You might not cry at a movie’s happy ending or laugh with the same gusto. Or you might feel apathetic and not get the same kick out of doing things you enjoy, like playing golf or painting.”

In an article published by the British Journal of Psychiatry, researchers found that study participants “described a general reduction in the intensity of all the emotions that they experienced, so that all their emotions felt flattened or evened out, and their emotional responses to all events were toned down in some way.”

It then went on to say, “Very common descriptions of this phenomenon included feelings of emotions being ‘dulled’, ‘numbed’, ‘flattened’ or completely ‘blocked’, as well as descriptions of feeling ‘blank’ and ‘flat’. A few participants described a more extreme phenomenon, in which they did not experience any emotions at all.”

Both articles attribute this emotional blunting to an overly high dose of SSRIs, and both studies found that if the dose was reduced, the phenomenon improved. If you are feeling like your emotions are dull or missing, it’s important to share this information with your psychiatric provider who can help manage your medication and dosage.

Watch for serotonin syndrome

One of the most concerning symptoms of a too-high dose of an SSRI is a condition called “serotonin syndrome” (or serotonin toxicity). SSRIs work by preventing your body from reabsorbing the neurotransmitter serotonin once it has been released. 

By keeping serotonin in your brain, SSRIs help the neurotransmitter make you feel better. The Cleveland Clinic says, “Serotonin affects the brain and other body systems. It plays a role in many body functions. It affects your mood, sleep habits, and even how hungry you are.”

All of that is good, and there is ample evidence to show that low levels of serotonin is linked to depression, and that increasing serotonin-by keeping it in the brain longer-can help relieve depression.

But sometimes, and often due to a dose of SSRI that is too high for an individual, or when an SSRI is used in combination with certain other medications, there can be far too much serotonin in the system, and that can cause problems that range from mild to severe.

The Cleveland Clinic explains that: “A rise in serotonin levels can cause serotonin syndrome. This increase in serotonin can happen when a person:

• Takes more than one medication that affects serotonin levels
• Recently started on medication or increased the dose of a medication known to increase serotonin levels
• Takes too much of one serotonin-related medication, accidentally or on purpose”

If an individual’s dose of SSRI is too high, or even too high for their own body, then there is a risk of serotonin syndrome.

The Mayo Clinic provides a list of the symptoms of serotonin syndrome. They say:

“Serotonin syndrome symptoms usually occur within several hours of taking a new drug or increasing the dose of a drug you’re already taking.

Signs and symptoms include:

• Agitation or restlessness
• Insomnia
• Confusion
• Rapid heart rate
• Dilated pupils
• Loss of muscle coordination or twitching muscles
• High blood pressure
• Muscle rigidity
• Heavy sweating
• Diarrhea
• Headache
• Shivering
• Goosebumps”

The Mayo Clinic also indicates that “severe serotonin syndrome can be life-threatening. Signs include:

• High fever
• Tremor
• Seizures
• Irregular heartbeat
• Unconsciousness”

If you are experiencing any of the symptoms in the first list, talk to your psychiatric provider right away, and if you are experiencing any of the severe symptoms, seek emergency medical help immediately.

Do remember, however, that serotonin syndrome is rare. It’s not a likely outcome of a too-high dose of SSRI.

What should I do if I think my dose is wrong?

The most important thing to do if you are worried that your SSRI dose is too high for you is to discuss it openly with your provider. They can help adjust your medication so that you can feel better faster, and stay that way longer. 

You should never adjust your dose on your own. Remember, for example, that decreasing or increasing Zoloft dosage can cause anxiety, and likewise with other antidepressants. You will want your provider to be watching closely

At Brightside, we use precision psychiatry to personalize your treatment plan to your exact symptoms. With over 1,000 medication/dose combinations using FDA-approved medications with proven safety profiles and clinically-meaningful benefits, our psychiatric providers can help you feel better at home. Within 12 weeks, 86% of Brightside members experience clinically significant improvement and 71% achieve remission of symptoms. A recent external analysis also found that Brightside’s medication treatment performed 50% higher in response and remission rates when compared to treatment as usual from a leading U.S. health system.

You can also use our measurement-based online check-in tool to track your progress and symptoms over time. Your provider will also have access to this chart, so they can provide support and connect with you if there’s ever an increase in symptoms due to your medication dosage.

If you are dealing with anxiety, depression, or another mental health condition, don’t wait to get the quality care you deserve. Brightside providers can help.

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Wellbutrin is in a class of drugs called antidepressants. Wellbutrin is an antidepressant medication commonly prescribed for the treatment of depression. Unlike many antidepressants that are SSRIs or SNRIs, Wellbutrin is an NDRI (norepinephrine and dopamine reuptake inhibitor).

Norepinephrine and dopamine are two neurochemicals—chemicals that impact the nervous system—that can affect mood. A reuptake inhibitor works to prevent these chemicals from being reabsorbed to help make them available for use longer inside your body, usually in higher amounts at once. When used properly, Wellbutrin may be highly effective at improving symptoms of depression.

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What are the symptoms of depression?

People experience depression in different ways. Some feel profound sadness or hopelessness. Many also feel overwhelmed, stressed, and burned out. Some people may have low self-esteem or feel nothing at all.

The main symptoms of depression include:

• Having little interest or pleasure in doing things
• Feeling down, depressed, or hopeless
• Feeling tired or having little energy
• Poor appetite or overeating
• Feeling bad about yourself or feeling like a failure
• Trouble concentrating on things
• Moving or speaking so slowly that other people could have noticed, or being fidgety/restless
• Thoughts that you would be better off dead, or thoughts of hurting yourself

There are many treatments for depression, including medication and therapy. Wellbutrin is just one example of antidepressant medication. There’s no shame in taking antidepressants— around 13% of Americans take them and millions have benefitted from them.

If you take medication for depression, working to build a stronger understanding of how you should be using your medication can help you achieve better results. If you are not sure which medication might be best for you, or if you have tried other medications but have not noticed any improvements, it may be a good idea to consult your provider about Wellbutrin or other antidepressants like SSRIs or SNRIs. Your provider can answer any questions or concerns you may have, and they can also work with you to come up with a tailored treatment plan. 

How does Wellbutrin work?

Wellbutrin is the brand name for bupropion, which is neither an SSRI nor an SNRI, but rather an NDRI. Bupropion (Wellbutrin, Wellbutrin SR, Wellbutrin XL, Aplenzin) is used to treat depression. Bupropion (Wellbutrin XL, Aplenzin) can also be used to treat seasonal affective disorder (SAD), which is a subtype of depression, and bupropion (Zyban) is used as part of a treatment plan to help people stop smoking. Wellbutrin works by preventing your body from reabsorbing norepinephrine and dopamine, which can lessen symptoms of anxiety and depression.

Wellbutrin is thought to have comparable effects to other antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), which makes it a good option if other medications have proved to be ineffective for your needs. 

Like many other antidepressants, Wellbutrin can take a few weeks to start causing noticeable changes, and it may even take up to 12 weeks to produce its full effects by building up in your body. Patience is key, and unless your provider tells you otherwise, it’s generally recommended to give it the appropriate time before determining whether or not the medication is working for you. 

What are the side effects of taking Wellbutrin?

There are some potential side effects of taking Wellbutrin, including:

• Drowsiness
• Lightheadedness or dizziness
• Headaches
• Constipation
• Nausea and vomiting
• Dry mouth
• Muscle twitches
• Weight loss
• Sleep troubles
• Sore throat

These side effects are often mild and temporary, typically improving within a week or two. You should always alert your provider of any side effects you are experiencing.

Some rare, but more serious side effects may occur in which case you should call your provider or seek medical attention immediately:

• Suicidal thoughts
• Significant worsening of any symptoms of depression
• Dizziness and fainting
• Severe headaches
• Irregular, fast, or pounding heartbeat
• Rashes, such as hives
• Confusion or hallucinations
• Seizures or convulsions

If you experience these more serious side effects, this may indicate that your body is not tolerating your medication properly, and a change in medication may be in order. You will want to find a medication that is both tolerable and effective. Your provider will be able to work with you to get to the root of the problem and help you find a solution.

What class of antidepressant is Wellbutrin?

Wellbutrin (bupropion hydrochloride) is an antidepressant of the aminoketone class, used to manage depression.

Is Wellbutrin XL an SNRI or NDRI?

Wellbutrin XL is an extended-release form of Wellbutrin. Like Wellbutrin and Wellbutrin SR, it is not an SNRI. Wellbutrin XL is an NDRI (norepinephrine and dopamine reuptake inhibitor) antidepressant.

What are the long-term side effects of Wellbutrin?

To date, there are no known problems associated with the long-term use of bupropion. It is a safe and effective medication when used as directed, though it may increase your blood pressure.

What antidepressant is closest to Wellbutrin?

Wellbutrin (bupropion) is an atypical antidepressant, meaning it doesn’t fit into other classes. Atypical antidepressants are unique medications that work differently from other antidepressants and typically change the levels of one or more neurotransmitters in the brain. Wellbutrin affects the norepinephrine and dopamine neurotransmitters.

Forfivo XL, Aplenzin, and Zyban are other brands of bupropion.

Is Wellbutrin safer than an SSRI or SNRI?

You will need to talk to a provider to determine what types of medications are safe for you. In general, these types of antidepressants are safe for most people. 

According to the Mayo Clinic, SSRIs are also generally safe for most people, though in some circumstances they can cause problems. For example, high doses of citalopram may cause dangerous abnormal heart rhythms, so doses over 40 milligrams (mg) a day should be avoided according to the FDA and the manufacturer.

Likewise, SNRIs are safe for most people, though in some circumstances they can cause concerns. For example, certain SNRIs may raise your blood pressure or worsen liver problems.

Summary Of FDA warning 

According to NAMI, here is a comprehensive summary of the FDA warning that accompanies antidepressants, including Wellbutrin, SSRIs, and SNRIs:

Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients with major depressive disorder (MDD), both adult and pediatric, may experience worsening of their depression and/or the emergence of suicidal ideation and behavior (suicidality) or unusual changes in behavior, whether or not they are taking antidepressant medications. This risk may persist until significant remission occurs.

In short-term studies, antidepressants increased the risk of suicidality in children, adolescents, and young adults when compared to placebo. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24. Adults ages 65 and older taking antidepressants have a decreased risk of suicidality. 

Individuals, their families, and caregivers should be alert to the emergence of anxiety, restlessness, irritability, aggressiveness, and insomnia. If these symptoms emerge, they should be reported to the individual’s prescriber or healthcare professional. 

All people being treated with antidepressants for any reason should watch for and notify their healthcare provider for worsening symptoms, suicidality, and unusual changes in behavior, especially during the first few months of treatment.

Proper usage: What you need to know

Proper usage of Wellbutrin involves consideration of several factors. Before you start taking Wellbutrin, you should inform your provider of the following:

• Any symptoms you are experiencing that you find particularly bothersome
• If you are experiencing suicidal thoughts or are harming yourself
• Any medications you have previously taken for your symptoms, including how effective they were or were not 
• Any adverse effects you have previously experienced from medications
• Any health conditions you are experiencing aside from the condition you are currently looking to treat
• Any other medications you are already taking, including vitamins and supplements
• If you are pregnant, trying to conceive, or are breastfeeding
• If you have a history of seizures or epilepsy

Wellbutrin may not be recommended for use by people with certain conditions or who are taking certain medications. According to the University of Michigan Health, you should not use bupropion within 14 days before or 14 days after you have used an MAOI (monoamine oxidase inhibitors inhibitor), such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine. 

The first step when it comes to proper usage of your medication is making sure that you have informed your provider of all important information that could harm your health if not disclosed. Additionally, because there can be drug interactions with Wellbutrin and other medications, you should also talk to your provider before taking any over-the-counter medication with Wellbutrin. For example, cold and allergy medications can affect your central nervous system so you should check with your provider before taking them.

How should I take Wellbutrin?

Talk to your provider for instructions and follow them carefully. In general, you may take Wellbutrin with or without food. But if you have nausea, take the medicine with food.

Swallow the tablet whole. Do not chew, crush, or break it. 

What are the forms of Wellbutrin?

There are three main forms of Wellbutrin available, including immediate-release, sustained-release, and extended-release, and the proper dosing for you will depend on your situation as well as which form of Wellbutrin your provider has prescribed.

The three forms are:

• IR (immediate-release)
• SR (sustained-release)
• XL (extended-release)

Can I take Wellbutrin while pregnant or breastfeeding? 

Wellbutrin is not a recommended treatment during pregnancy. The National Alliance on Mental Illness (NAMI) states:

If you are planning on becoming pregnant, notify your health care provider to best manage your medications. People living with major depressive disorder (MDD) who wish to become pregnant face important decisions, each with risks and benefits as they relate to how the illness, medications, and risks to the fetus may interact. Untreated MDD has risks to the fetus, as well as the mother. It is important to discuss the risks and benefits of treatment with your doctor and caregivers. 

Bupropion has also been evaluated for smoking cessation during pregnancy and is recommended only after other therapies have failed.

Caution is advised with breastfeeding since bupropion does pass into breast milk.

What should I do if Wellbutrin is not working for me?

If the medication is not providing relief from your symptoms, you should consult your provider. Your provider will work with you to determine if your dosing needs to be adjusted, and by how much.

You should take care to follow the specific instructions included with your medication as well as any instructions your provider has personally given you. If you have any questions or concerns, it is always best to play it safe and consult your provider rather than trying to guess what may be the correct way to use your medication. In general, drinking alcohol should be avoided with bupropion. 

If you are seeking high-quality mental health care that you can access right from the comfort of your home while still also having access to effective medication, Brightside is here to help. 

With Brightside, you have unlimited access to the care you need, including precision prescribing, psychiatry and therapy experts, and science-backed approaches that can help you feel like yourself again. Depression can be difficult, but Brightside is here to get you the care you deserve, whether that’s therapy, medication, or a combination of both. 

The bottom line

Wellbutrin is not an SSRI or an SNRI—it is an NDRI, one of many commonly prescribed antidepressants. This means that the drug works by blocking your body from reabsorbing dopamine and norepinephrine, resulting in higher levels of both of these chemicals, which are associated with the regulation of your moods and emotions. 

Wellbutrin is the brand name for bupropion, and while it may be highly effective, it can take several weeks to work. In fact, it may take around 12 weeks for Wellbutrin to produce its fullest effects after building up in your system, so patience is key with this medication as with many others. You may notice positive effects on your sleep, energy, or appetite before noticing an impact on mood. These can be good indicators that the medication is working.

When you begin taking Wellbutrin, you should carefully follow your provider’s instructions alongside any instructions that come along with the medication itself.

If Wellbutrin proves to be ineffective at bringing you relief from your symptoms, your provider will recommend other medications that may be a better fit for you.

Brightside provides you with access to both expert psychiatric providers and licensed therapists, as well as medication so that you can get the care you need all in one place. Get started with Brightside by taking a free assessment today and see if medication like Wellbutrin may be helpful for you.

The post Is Wellbutrin an SSRI, SNRI, or NDRI? appeared first on Brightside.

Responsible prescribing of psychiatric medication includes thoughtful diagnosis to determine if medication is right for an individual, careful selection of medication to maximize symptom reduction and minimize side effects, ongoing monitoring, and intentional tapering. Unfortunately, traditional care paths and telemedicine platforms often fall short of adhering to these best practices. 

At Brightside Health, we built our clinical protocols, platform, and care delivery to ensure safe, responsible standards of prescribing for every member. We offer personalized, data-driven mental health plans—including medication, therapy, or both—to help individuals get the care they need to feel better faster, and stay that way longer. Our psychiatric providers, who are psychiatric nurse practitioners or MDs, follow the American Psychiatric Association (APA) practice guidelines for prescribing medication and ensure:

• An ongoing 1:1 supportive relationship between licensed provider and member throughout treatment, without intermediaries 
• Careful, thorough diagnosis and consideration of whether or not medication is appropriate—with evidence-based therapy and self-care commonly recommended first or as complementary to treatment
• If medication is appropriate, rigorous analysis and selection of treatment to maximize benefit, minimize side effects, and personalize to a member’s needs and preferences
• Consistent measurement of symptoms using clinical assessments (PHQ-9, GAD-7) and check-ins to inform treatment adjustment
• A structured, intentional care plan for every individual with the goal of tapering and ending medication when appropriate

These stringent standards allow Brightside to deliver informed, responsive care that is both clinically sound and human, leading to measurably better outcomes. We started by treating individuals with more severe mental health needs and have expanded to treat nearly the full spectrum of severity, complexity, and acuity. Using what we refer to as precision psychiatry, we developed a clinical decision support tool that analyzes data about an individual to predict which medication is most likely to work. 

By personalizing treatment to a member’s unique symptom clusters, they’re able to achieve superior outcomes. Within 12 weeks, 86% of Brightside members experience clinically significant improvement and 71% achieve remission of symptoms altogether. A recent external analysis found that Brightside’s care performed 50% higher in response and remission rates when compared to treatment as usual from a leading U.S. health system.

What types of conditions does Brightside treat? 

Brightside treats individuals with a range of symptom severity, with a specialization in those with complex mental health needs across the full range of mood and anxiety disorders. In situations where remote care may not be appropriate for an individual’s needs, we guide them to appropriate local care resources.

The conditions Brightside treats include:

• Generalized anxiety disorder
• Major depressive disorder
• Panic disorder
• Phobia
• Social anxiety disorder
• Obsessive-compulsive disorder (OCD)
• Post-traumatic stress disorder (PTSD)
• Seasonal affective disorder
• Postpartum depression
• Premenstrual dysphoric disorder (PMDD)
• Insomnia
• Bipolar II disorder

How does an individual get prescribed medication?

Members can access Brightside directly or through certain insurance plans. Once they complete a comprehensive intake assessment that captures over 100 unique data points, they can schedule an appointment and meet with a psychiatric provider in as little as 24 hours. 

At that first 30-minute appointment, the psychiatric provider takes time to get to know the member and evaluates their symptoms and history before any diagnosis is made. From there, the provider will recommend treatment plan options which they’ll explain and discuss collaboratively with the member. The psychiatric provider may recommend therapy, self-care, medication, or any combination. Currently, about half of Brightside members are engaged in both therapy and medication, or therapy alone. 

If a psychiatric provider concludes that a member will likely benefit from medication, including to lessen symptoms in order to actively engage in a therapeutic relationship, they’ll consider information provided by Brightside’s clinical decision-making tool, PrecisionRx, before selecting a medication. The technology analyzes a variety of data about a member, including medical history and preferences, as well as present symptom clusters, to recommend which medication is likely to be most tolerable and effective. In a representative study of over 6K Brightside members, conventional prescribing practices only covered 13% of the unique treatment plans prescribed.

This degree of personalization is remarkably worthwhile; as a result of our innovative proprietary technology and our licensed providers’ expertise, Brightside’s response rate at first medication is 70%. The population effect size of any given antidepressant is about 35%. Brightside care is more likely to get the medication right the first time and optimize it for each individual’s needs. 

What medications do you prescribe?

Brightside only prescribes FDA-approved medications that have a proven safety profile and deliver clinically-meaningful benefits to our members, including antidepressant medication like SSRIs and SNRIs. There’s never a guarantee that our providers will write a prescription. If a member is prescribed medication after an evaluation, it can be picked up at the local pharmacy of their choice. 

We do not prescribe controlled substances as we are committed to providing safe and effective care. Prescribing controlled substances, especially in a virtual environment, comes with risk. While controlled medications may provide symptom relief quickly, they are less effective at providing lasting relief. Individuals can develop addiction and tolerance in a short period of time, requiring a higher dosage of medication to generate the same effect. Due to this high risk of abuse and limited efficacy, Brightside does not prescribe controlled substances, focusing instead on safe, effective treatments. 

How are members supported throughout the process? 

With our measurement-based care approach, Brightside monitors members’ progress through online check-ins based on the GAD-7 and PHQ-9, as well as text-based analysis. The Brightside platform monitors for any scenario where a member may need support, immediately notifying their provider to conduct a review and proactively intervene as needed to keep each member’s treatment on track. In addition to any responsive care needs, members also meet with their provider via video visits every three months at a minimum.

Members in the therapy plan also engage in a therapeutic program based on the Unified Protocol, a modern enhancement of Cognitive Behavioral Therapy (CBT). Licensed therapists guide members through the clinically-proven program and release video lessons with key skills, which creates a holistic, collaborative approach to mental health care. Engaging in both medication and therapy leads to a 60% higher chance of recovery than one treatment alone. Every Brightside member also receives self-care resources, focused on developing daily habits that support mental wellness.

Throughout their care, Brightside members have support available whenever they need it. Members can request case reviews or message their provider to ask questions and share information at any time. We also have a psychiatrist on call 24 hours a day, 7 days a week. 

Our psychiatric providers typically recommend members continue medication for nine to 12 months, depending on symptom severity, and treatment may be shorter or longer based on each individual’s needs. All individuals have structured, intentional care plans with the goal of tapering and ending medication. When that time for concluding treatment arises, members are aware, supported, and monitored by their provider.

How are providers supported?

Each Brightside provider has a supervisor who both proactively and responsively reviews and supports their care delivery. They also engage in case consults and community counsel with other expert Brightside providers. 

Brightside has implemented a continuous quality improvement system that oversees the entire clinical process, which is fully HIPAA compliant.

If you have a question about Brightside Health’s medication plan, you can reach out to support@brightside.com. 

The post Understanding our psychiatry: How Brightside Health prescribes medication appeared first on Brightside.

Before we get started talking about over-the-counter medicine for anxiety and stress, there are a few vital things that we need to note. First of all, no anxiety remedy is as effective as professional mental health care. Therapy and psychiatry are the most effective ways to manage anxiety or other mental health conditions. In fact, therapy and psychiatry treatment in combination can lead to better results.

Furthermore, because anxiety medications need oversight by a medical provider, they are only available through prescription. 

That said, there are some over-the-counter (OTC) remedies and supplements that may be linked to reduced feelings of anxiety and its accompanying symptoms. Learning more about these options may open new doors for you when it comes to coping with your symptoms.

Vitamins or supplements are widely available in many different shapes and sizes, and it can be overwhelming to assess all of the options by yourself, especially if you are not entirely sure where to start.

This is your complete guide to over-the-counter anxiety medication options and the top seven choices that may bring you results. Just remember that the best anxiety medications will be prescribed by a psychiatric provider.

Want to speak 1:1 with a therapist or psychiatric provider about your anxiety & depression? Start with a free assessment. 

Want to speak 1:1 with an expert about your anxiety & depression?

Start with a free assessment

7 vitamins and supplements for anxiety

Over-the-counter anxiety treatment options aren’t often the first recommended option as treatment options like prescription medications and therapy are usually the most effective; however, these OTC options can work to supplement these two main treatment methods as examples of complementary and alternative medicines.

Some OTC vitamins and supplements may be effective at reducing symptoms of anxiety, but it is always important to consult your provider before you start taking a new vitamin or supplement, especially if you are taking any other medications.

While more research is needed to establish how effective supplements really can be, if you use them properly, they generally are not harmful.

1. Magnesium

Magnesium is a very important vitamin that can be found in leafy green vegetables, legumes, nuts, seeds, and whole grains. Aside from supporting your regular cell function, magnesium may also support your moods and emotions, and inadequate magnesium has been linked to anxiety and other health problems.

Studies have found that magnesium can be a great remedy for mild feelings of anxiety, and may be particularly helpful for people dealing with anxiety as a symptom of premenstrual syndrome.

2. Omega-3

Omega-3 fatty acids are great for your health for many reasons, and they are naturally occurring in fish and certain plant sources like nuts and seeds.

Omega-3 fatty acids have been found to be helpful when it comes to the management of medical conditions and mental illnesses, and they can specifically help reduce inflammation and anxiety among young adults.

3. L-theanine

L-theanine is one of several amino acids, and this amino acid has commonly been promoted on account of its potential calming effects. L-theanine is frequently found in teas.

Research has shown that L-theanine may be highly effective at promoting relaxation without causing drowsiness, making it a great way to combat anxiety without becoming tired. More research is needed, but L-theanine may also be linked to reduced symptoms of stress.

4. Lavender

Taking lavender orally, or using lavender for aromatherapy, may also be very effective at reducing feelings of anxiety. Lavender has been used in medicinal remedies for centuries and is well-known for its fragrance and color.

Several trials have shown that lavender can be a great way to reduce minor symptoms of anxiety, and it may help with insomnia, too.

5. Ashwagandha

Ashwagandha is an ancient remedy that can be derived from a shrub plant that is native to India and North Africa, and it has been studied extensively.

Ashwagandha has been widely recognized for its ability to lower cortisol levels, which in turn reduces stress and anxiety since cortisol is known as the stress hormone.

6. Chamomile

Chamomile is a flowering plant, and it is very commonly found in teas. Chamomile essential oil, which is extracted from the plant itself, has also long been used for its anti-inflammatory and calming properties.

Chamomile can help reduce the effects of anxiety, but generally, its impact is only modest, and more research is needed.

7. Valerian

Valerian, like chamomile, is also a flowering plant that is widely used as an herbal supplement and can be very effective at treating insomnia. Studies have shown mixed results regarding its effectiveness when it comes to treating anxiety, but if you have insomnia-related anxiety, this herb may be largely beneficial for you.

Some studies have suggested that valerian does reduce anxiety and stress, while other studies have reported no changes at all, so more research is needed to confirm the effectiveness of this remedy.

Traditional treatment methods

While OTC options may be helpful if you are just starting to deal with your anxiety, they may not always be the most effective option for some people. Here are some more traditional methods of treatment, like prescription anxiety medication and therapy. 

Antidepressants such as SSRIs (selective serotonin reuptake inhibitors) are some of the most commonly prescribed classes of medications for anxiety, but these are not your only options. 

Even more effective, however, is psychotherapy paired with medication, though which you choose is dependent on your own individual situation.

Therapy gives you insight you may not be able to gauge looking from the inside—professionals can also bring evidence-based strategies that may help you overcome some of the social or day-to-day difficulties you’re facing because of your mental health. 

When it comes to getting high-quality, professional anxiety care, Brightside has your needs covered and we are here to help you get back to being you. 

With unlimited access to mental health services right from home and treatment options backed by science, we will work with you every step of the way in order to come up with a personalized treatment plan that will get you back on track. 

The process starts when you take our free online assessment, and then we will match you with one of our expert providers. Your provider will work with you to adjust your treatment accordingly, as many times as needed, until you find what is right for you. 

We offer evidence-based therapy, medication, as well as a combination of both, and any necessary medications will be prescribed by your provider. Even better, medication can be delivered right to your doorstep every month in most states. If you are ready to feel like yourself again, we are here for you. 

Additionally, lifestyle changes, including exercise, stress reduction strategies, yoga, mindfulness practices, and meditation are other great options that can be highly effective at helping you cope with and manage your anxiety. 

The bottom line

When it comes to treating your anxiety with over-the-counter options, it is important to note that there is no such thing as over-the-counter anxiety medication. Anxiety medications directly affect brain chemistry, and thus can only be obtained if you have a prescription. That said, there are over-the-counter remedies, like herbs, vitamins, and supplements, that are widely available and have been cited for their ability to help with anxiety symptoms, especially when paired with other treatment options like therapy and prescription medication. 

Magnesium, L-theanine, omega-3 fatty acids, and ashwagandha have especially been noted for being able to largely impact symptoms of anxiety and reduce stress, and these supplements are also highly accessible and can be found in most pharmacies or convenience stores. 

You should always consult your provider before trying any new vitamins or supplements, and this is especially important if you are taking any other medications. 

Sometimes, over-the-counter remedies like these may not be enough to get you back on your feet, and in this case, professional mental health care may be beneficial. 

Brightside is here to help. 

The post The 7 best over-the-counter anxiety medications out there appeared first on Brightside.

Zoloft is the brand name for the drug sertraline, which is a selective serotonin reuptake inhibitor, or SSRI. Zoloft is an antidepressant and is commonly prescribed for the treatment of depression, but it can also be used to relieve symptoms of anxiety as well.

When you use Zoloft properly, it may be highly effective at bringing you relief from your symptoms, and it is important to be patient when using Zoloft as it can take several weeks for the effects to be felt.

Whether you are just starting to take Zoloft, your provider has recommended Zoloft, or you’re wondering if Zoloft might be a good fit for you, this guide to using Zoloft for anxiety and depression has all of the information you need.

Remember that only a mental health practitioner can prescribe Zoloft for depression or anxiety. Brightside Health providers are available to help you—with appointments available within 48 hours. 

Want to speak 1:1 with an expert about your anxiety & depression?

Start with a free assessment

What is Zoloft? How does it work?

Many individuals report that Zoloft helps their anxiety and depression. Selective serotonin reuptake inhibitors such as Zoloft work in your body by preventing the reabsorption of serotonin, and the prevention of this process results in higher levels of serotonin available for use in your brain.

Serotonin is one of many chemicals that have been associated with depression, anxiety, panic, and obsessive-compulsive symptoms, and these symptoms are thought to be correlated with an imbalance of neurotransmitters like serotonin.

Zoloft is FDA-approved for the treatment of: 

• Depression 
• Obsessive-compulsive disorder (OCD)
• Panic disorder 
• Social anxiety disorder 
• Post-traumatic stress disorder
• Premenstrual dysphoric disorder

Your provider may also recommend Zoloft to treat other mental health conditions. 

Like many forms of prescription antidepressant medication, Zoloft can cause some mild side effects, which are often only temporary. Some individuals have no side effects at all.

Common side effects associated with Zoloft include:

• Drowsiness or tiredness
• Agitation
• Sweating
• Shaking or tremors
• Sleep disturbances, such as difficulty falling asleep
• Decreased sex drive or other sexual problems

When you begin taking Zoloft, you should make sure to consult your provider if you experience any new or worsening symptoms, such as:

• Changes in your mood or behavior
• New or worsening anxiety and new or worsening panic attacks
• Impulsivity, irritability, aggression, or hyperactivity
• New or worsening depression
• Suicidal thoughts or thoughts about harming yourself

Part of using your medication properly involves making sure that you speak to your provider if you are experiencing side effects that concern you, or that indicate that your body may not be tolerating your medication. Abruptly stopping Zoloft may result in withdrawal symptoms that may be serious. 

If a change in dose or a change in medication is necessary, your provider will work with you to come up with a tailored treatment plan regarding this shift.

How do I use Zoloft for anxiety and depression?

When it comes to how you should be taking Zoloft, it is especially important to make sure that you are carefully following any specific instructions that your provider gives to you. Your provider may provide you with directions that pertain to your specific situation and needs, and these directions may differ slightly from instructions that are provided on the medication guide or the label of the drug itself, so you should first and foremost make sure to listen to your provider.

Your dosage may depend on a number of factors, including drug interactions with other medications and the details of your primary diagnosis. 

If your provider simply instructs you to abide by the instructions on the drug label, you should carefully read and follow the proper usage guidelines on the label of your medication. Take care not to take too much or too little of your medication, and make sure you are taking your dose at the appropriate frequency, too. Pay attention to instructions on the best time of day to take Zoloft for anxiety or depression.

There are some general guidelines to follow for proper usage of Zoloft regardless of your specific instructions. Zoloft can generally be taken with or without food, and it is often recommended to take your dose once a day. Typically, the dose will not exceed 200 milligrams per day, but if your dose needs to be adjusted your provider will work with you to do so.

Like many other antidepressants, Zoloft may take 4 to 6 weeks to begin producing noticeable improvements in your symptoms. This is because it can take some time for the drug to build up in your body and produce its full effects, and this is why patience is key. Once the medication gets fully into your system, you will have a better idea if Zoloft is good for your anxiety, or if a change is indicated.

If you have questions about this process or if you believe that your medication is not working for you, you should consult your provider to see if you should wait it out or if a change in dosage or medication is necessary. Typically, your provider will start you out on a dose that is towards the lower end of the range and if this dose does not work for you, your provider will slowly increase it.

If you think you could benefit from anxiety and depression medication, Brightside Health is here to offer you the care you deserve, with unlimited access to psychiatric experts, evidence-based therapy, and data-driven prescribing—all from the comfort of your own home.

Medication can even be delivered right to your doorstep, making treatment easier and more accessible than ever.

If you are ready to get started on the path to feeling a little more like yourself again, you can get started today. Start with a free assessment.

The bottom line

Zoloft is an antidepressant that is commonly prescribed for the treatment of depression, generalized anxiety disorder, panic disorder, and other anxiety disorders. Zoloft is the brand name for sertraline, and it belongs to the class of drugs known as selective serotonin reuptake inhibitors. Selective serotonin reuptake inhibitors work in your body by preventing the reabsorption of serotonin from taking place, and this, in turn, results in higher levels of serotonin in your brain which can work to bring you relief from your symptoms.

When it comes to using Zoloft properly, you should always take care to follow any specific instructions from your provider, as well as any instructions that are included on the label of your medication. Taking too much or too little of your medication, or taking your medication too often, can result in adverse effects.

If you ever have questions or uncertainties about your medication, consult your provider for clarification.

Sources:

Sertraline | Michigan Medicine

Sertraline (Oral Route) Proper Use | Mayo Clinic 

Sertraline (Zoloft) | National Alliance on Mental Illness

The post How To Use Zoloft For Anxiety and Depression appeared first on Brightside.