Finding the right treatment plan for your anxiety or depression doesn’t have to be confusing. Living with conditions can affect people in different and similar ways. The right plan will help ease your symptoms, limit unwanted side effects, and help you feel more like your true self again.
If you need help, our board-certified primary care online doctors are available day and night to review your full health history and discuss your symptoms. Your doctor will offer tailored treatment options and help you decide the next steps to manage your depression and anxiety symptoms.
Diagnosis: how do I know if I have depression or anxiety?
You shouldn’t self-diagnose anxiety or depression, although you may want to talk to a doctor if you experience symptoms that last for at least two weeks and interfere with your relationships and daily activities.
There are online resources such as mental health screening tools that can help identify potential signs of anxiety or depression.1 These tools are not diagnoses, but they can be a starting point for further exploration.
Consulting with a doctor or mental health professional is the most reliable way to get diagnosed.
Symptoms of depression
You may be experiencing depression if you notice symptoms such as:
- A persistent feeling of sadness or hopelessness that lasts for at least two weeks
- A loss of interest in hobbies and activities you usually enjoy
- Significant changes in appetite or sleep
- Feeling worthless or guilty for unknown reasons
- Having trouble concentrating or making decisions
- Thoughts of self-harm, death or suicide.
If you're having suicidal thoughts, call emergency services (911) or a suicide hotline such as the national lifeline (988) right away.
Symptoms of anxiety
Anxiety can manifest in both physical and mental symptoms. Physically, you may experience:
- Rapid heartbeat
- Sweating
- Shortness of breath
- Nausea
- Muscle tension
Mentally, anxiety can cause:
- Excessive worry
- Difficulty concentrating
- Irritability
- Restlessness
- Trouble sleeping
If these symptoms start to significantly impact your day-to-day life, it may be a sign of an anxiety disorder. The good news is that anxiety disorders are highly treatable, often with therapy, medication, or a combination of the two.
Understanding anxiety and depression
Anxiety and depression are interrelated mental health conditions that affect mood, thoughts, behaviors, and physical well-being. Anxiety manifests as a feeling of apprehension about what may happen in the future, leading to worry and excessive nervousness, while Depression is described as persistent feelings of sadness, emptiness, and a lack of motivation. How these develop can occur for different reasons, but they’re incredibly common and you are not alone in feeling them! Family history (genetics), your own childhood and upbringing, traumatic events, and social stressors are some of the factors that can influence developing anxiety, depression, or both.
Anxiety and depression are often connected to ADHD, bipolar disorder or other concurrent disorders.
If you have ADHD, there is a fair chance you may also struggle with anxiety, depression, or both. Nearly 30-50% of adults with ADHD also have symptoms of an anxiety disorder, and 20-30% experience major depression.2
The good news is that certain medications can effectively treat multiple disorders at once. Non-stimulant ADHD medications such as Qelbree®, Strattera®, and Intuniv®, along with stimulant ADHD treatments like Vyvanse® or Ritalin®, may also help reduce symptoms of anxiety or depression. *
*Plushcare doctors cannot prescribe controlled substances including stimulants like Vyvanse® or Ritalin®.
Anxiety and depression can also overlap with other disorders such as:
- Bipolar Disorder (BPD), characterized by drastic mood swings and episodes of both Depression and Mania
- Attention Deficit Hyperactivity Disorder (ADHD/ADD), which can present with similar symptoms to anxiety and depression
- Obsessive-Compulsive Disorder (OCD), which includes having intrusive thoughts and repetitive behaviors that severely impact your daily life and may worsen anxiety.
- Postpartum depression, symptoms of which can include fatigue, sadness, anxiety, difficulty bonding with your baby, and intrusive thoughts.
How to get medication for anxiety and depression
Don’t let logistical barriers stop you from getting the treatment you need. There are more options than ever before to conveniently and affordably manage your mental health.
Sometimes, anxiety and depression may require more intensive treatment plans. This could involve combining different medications, trying different therapy approaches, or even hospitalization for close monitoring and treatment.*
Medications for anxiety and depression may help improve symptoms of these other mental disorders, however, a proper diagnosis is crucial before you start any medication.
*Not all mental health conditions can be safely managed by telehealth or primary care doctors. If your Plushcare doctor feels you need more specialized care with a psychiatrist, they will help guide you with referrals and resources.
Best medications for anxiety and depression
If you’re struggling with anxiety, depression, or both, medications can help. The most common are antidepressants, specifically SSRIs (selective serotonin reuptake inhibitors). These are first-time treatments that include Lexapro™(escitalopram), Zoloft® (sertraline), Prozac® (fluoxetine), and Cymbalta® (duloxetine). Many of these are used to treat symptoms of both disorders.
It may take trying different medicines and doses to find what works best for you, and there are many other medications beyond this list that may be prescribed.3
Whatever medication you try, be patient through the initial side effects. It can take four to six weeks for the medication to start working. Be sure to track your symptoms and side effects with your doctor to determine if adjustments are needed. The proper medicine and dose, combined with therapy or self-help strategies, can help you feel relief from anxiety and depression.
Alternative treatment options
Beyond medication, several alternative therapies may help alleviate symptoms of Anxiety and Depression including:
- Exercise, which releases endorphins that improve your mood and act as natural stress relievers.
- Therapy, such as cognitive behavioral therapy (CBT)4 or interpersonal therapy (IPT)5, that teaches you strategies to help manage negative thoughts and emotions.
- Limiting alcohol and caffeine intake
- Eating a healthy diet
- Reducing screen time, especially before bed
- Maintaining a routine sleep schedule
While alternative treatments may require trial and error, natural remedies may help to improve your general well-being.
Herbal supplements/natural medication to help with depression and anxiety
When it comes to managing anxiety and depression, natural herbal supplements may help to relieve symptoms with anti-inflammatory properties and calming effects.
Examples include:
- Ashwagandha (600 to 1,000 mg three times a day)6
- CBD oil (5 to 10 mg daily and work up as needed)
- Chamomile or lavender
- L-theanine in green tea (200 to 400 mg one to three times a day)7
- Magnesium (400 to 500 mg a day)8
- Omega-3 (1,000 mg of fish oil three times a day)9
The right supplements, combined with lifestyle changes like exercise, therapy, meditation, or deep breathing, can make a big difference in your anxiety levels and allow you to feel more at ease. These herbal remedies tend to have fewer side effects than prescription drugs. However, always check with your doctor first, especially if you're on other medications.
Dosage
If you want to start or change anxiety or depression medications, our doctors can determine the proper dosage based on your medical history, symptoms, and health. Dosages typically start patients at a low dosage and gradually increase. It’s important to be patient and follow your doctor's instructions carefully; slowly increasing the dosage can take at least several weeks to find what works best for you.
Only change or stop a dosage after consulting your doctor. It may help to track your symptoms at each dosage to determine what seems most effective and tolerable. Report any significant side effects right away.
Discontinuing anxiety and depression meds
If after trying different medications and dosages, your symptoms are not improving, or the side effects are extremely negative, discontinuing the medication may be the best option. Your doctor will develop a plan to discontinue the drug gradually, as suddenly stopping can lead to withdrawal symptoms.
Some signs it may be time to discontinue or change a depression or anxiety medication include:
- Worsening symptoms such as an increase in anxiousness, restlessness, or insomnia
- Severe side effects that impact your quality of life, such as weight gain, sexual dysfunction, or narcolepsy.
- A lack of efficacy, with unchanging symptoms after six to eight weeks
- A desire to try alternative treatments
Discontinuing medication is an important decision and should only be done under medical guidance. But finding the proper treatment for your anxiety and depression is essential for your health and well-being. Don't lose hope; there are many options to try, and our doctors can help.
Antidepressants and risk of suicide
Studies suggest there is a slight increase in suicidal thoughts and behaviors when starting an anti-depressant, particularly in the first few weeks.10 Because of this, the FDA requires a black box warning on these medications for children and young adults under 25.11
It's crucial for anyone starting these medications to have regular check-ins with their doctor to discuss mood changes, potential thoughts of suicide, and other side effects.12 However, for many people, these treatments can save their life by helping manage Depression, which in turn can improve their quality of life.
Drug interactions
When taking medication for anxiety, depression, and ADHD, it’s important to be aware of possible drug interactions. Side effects and reduced effectiveness may be due to interactions with other medications such as:
- Heart rhythm drugs
- Opioid painkillers
- St. John's wort or melatonin supplements
Always tell your doctor about any supplements or over-the-counter drugs you're taking in addition to your prescriptions. Our primary care doctors can help adjust as needed to find the right balance to avoid problems.
Cost of anxiety and depression medications
Generic versions of common medications such as escitalopram (Lexapro™), sertraline (Zoloft®), and bupropion (Wellbutrin®) are often very affordable. Don't hesitate to ask your doctor if lower-cost alternatives could work for you.
We have competitive prices on the market, even without insurance, so we can help you find a treatment plan catered to your needs.
FAQs
Do antidepressants cause weight gain?
Worrying about weight gain as a side effect of antidepressants is a valid concern. Some antidepressants are more likely to cause weight gain than others, but this is often minimal, usually under a ten-pound change.
The weight gain may be attributed to side effects of the medications, such as an increased appetite, changes in metabolism, or fluid retention. Lifestyle changes such as diet and exercise can help counteract these effects. You should talk to your doctor about other options or switching medications if weight gain becomes a concern.
What is the most popular antidepressant for anxiety?
One of the most prescribed medications for anxiety are selective serotonin reuptake inhibitors (SSRIs). Among them, escitalopram (Lexapro) is a popular choice. It has fewer side effects than many similar medications and is effective for treating a wide range of anxiety disorders. Always talk to your doctor and be sure to disclose your full health history. Everyone’s body responds differently to antidepressant and anxiety medications.
