How Is Depression Diagnosed
The biggest hurdle to diagnosing and treating depression is recognizing that someone is suffering from it. Unfortunately, approximately half of the people who experience depression are never diagnosed or treated for their illness. And not getting treatment can be life-threatening: up to 10 percent of people battling depression commit suicide.
Your health care provider can evaluate your condition by asking you to describe your symptoms. Since patients recovering from a medical illness, hospitalization or surgical procedure experience some common symptoms of depression including fatigue and insomnia,your health care provider will pay attention to these additional symptoms of depression:
- Withdrawal from activities
- Lack of reactivity from visits with family and friends Increased negative thoughts
Sometimes, symptoms of depression can be made worse by certain medications, a physical disorder, virus or illness. Your health care provider may perform a physical exam or laboratory tests to determine if there is a physical cause for your depressive symptoms.
Your health care provider will also evaluate your personal and family medical history, as well as any history of drug or alcohol use.
Although there are no specific blood tests used to diagnose depression, there are various screening tools and diagnostic criteria used to make the proper diagnosis.
Measure Of Blood Pressure
Standardised blood pressure was measured by specially trained nurses at the beginning of the screening procedure using a Dinamap 845XT based on oscillometry. Cuff size was adjusted after measuring the arm circumference. The Dinamap was started after the participant had been seated for 2min with the cuff on the arm, and the arm resting on a table. Blood pressure was measured automatically three times at 1min intervals. The mean of the second and third readings was used in this study.
If You Notice A Sudden Decline In Blood Pressure
A single lower-than-normal reading is not cause for alarm, unless you are experiencing any other symptoms or problems. If you experience any dizziness, lightheadedness, nausea or other symptoms, its a good idea to consult with your healthcare provider. To help with your diagnosis, keep a record of your symptoms and activities at the time they occurred.
Is low blood pressure related to low heart rate? Find out.
Written by American Heart Association editorial staff and reviewed by science and medicine advisers. See our editorial policies and staff.
Last Reviewed: Oct 31, 2016
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Warnings For Other Groups
For pregnant women: This drug is a category C pregnancy drug. That means two things:
Talk with your doctor if youre pregnant or planning to become pregnant. This drug should only be used if the potential benefit justifies the potential risk.
If you become pregnant while taking this drug, call your doctor right away.
For women who are breastfeeding: This drug passes into breast milk and may cause side effects in a child who is breastfed. Talk to your doctor if you breastfeed your child. You may need to decide whether to stop breastfeeding or stop taking this medication.
For seniors: The kidneys of older adults may not work as well as they used to. This can cause your body to process drugs more slowly. As a result, a higher amount of a drug stays in your body for a longer time. This raises your risk for side effects.
For children: It hasnt been established that this drug is safe and effective for use in children.
All possible dosages and drug forms may not be included here. Your dosage, drug form, and how often you take the drug will depend on:
- your age
- how severe your condition is
- other medical conditions you have
- how you react to the first dose
Selective Serotonin Reuptake Inhibitors
SSRIs are most frequently used as first-line treatment of major depression . Their efficacy has also been demonstrated in the treatment of generalized anxiety, panic, social anxiety, and obsessivecompulsive disorders. This class includes citalopram, escitalopram, paroxetine, fluoxetine, fluvoxamine, and sertraline. Sertraline and paroxetine have also been approved for the treatment of post-traumatic stress disorder.
Table 2. Influence of antidepressant drugs on blood pressure and heart rate.
Citalopram, Escitalopram, and Paroxetine
Sertraline, Fluvoxamine, and Fluoxetine
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Symptoms Of Low Blood Pressure
Most doctors will only consider chronically low blood pressure as dangerous if it causes noticeable signs and symptoms, such as:
- Dizziness or lightheadedness
- Dehydration and unusual thirst
- Dehydration can sometimes cause blood pressure to drop. However, dehydration does not always cause low blood pressure. Fever, vomiting, severe diarrhea, overuse of diuretics and strenuous exercise can all lead to dehydration, a potentially serious condition in which your body loses more water than you take in. Even mild dehydration can cause weakness, dizziness and fatigue.
- Lack of concentration
Antidepressant Drugs Effects On Blood Pressure
- 1Cardiorenal and Hypertension Research Unit, Physiopathology Unit, Clinica Medica Generale e Terapia Medica, Department of Medicine and Surgery , University of Parma, Parma, Italy
- 2Department of Neuroscience and Rehabilitation, Institute of Psychiatry, University of Ferrara, Ferrara, Italy
- 3Research Group on Mental and Physical Health of the Elderly , Bologna, Italy
- 4Section of Psychiatry, Department of Neuroscience, Ophthalmology, Genetics, and Infant-Maternal Science, Istituti di Ricovero e Cura a Carattere Scientifico Ospedale Policlinico San Martino, University of Genoa, Genoa, Italy
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Change In Blood Pressure And Incident Diagnosis Of Hypertension
At each health assessment of SAPALDIA2, SAPALDIA3 and SAPALDIA4 55+ surveys, BP was measured twice by trained field workers using an automatic device with a cuff of appropriate size and using the Riva-Rocci method, in the sitting position after minimum 10 min rest, on the left arm, with 3 min between measurements. The first and second BP measurements were averaged. To obtain the change in BP from SAPALDIA2 to SAPALDIA3 and SAPAPALDIA3 to SAPALDIA4 55+, we subtracted the baseline BP from the follow-up BP within a wave. The coefficients of the censored regression models are interpretable as the difference between depressed and non-depressed participants in age-related increase in BP over 10 years in mmHg. A positive coefficient for the depression variable represented a larger age-related increase in BP among depressed compared to non-depressed people, while a negative coefficient represented a smaller age-related increase in BP among depressed compared to non-depressed people over the wave. Because the length of time between follow-ups varied between 5.6 and 9.7 years among participants, we expressed the observed changes as a per-decade rate, by dividing them by the individual durations of follow-up and multiplying by 10.
How Does Hypertension Affect Your Mental Health
Just getting a diagnosis of hypertension can make you feel anxious. But its important to know that with adequate treatment, you can get your blood pressure under control and protect your heart and mental health. Having high blood pressure doesnt mean that youre destined to die of a heart attack or stroke.
Researchers have explored the connection between high blood pressure and mental health and found that it can affect your mental health in the following ways:
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Effect Of Combined Anxiety And Depression On Hypertension Or Hypotension
Logistic regression analyses confirmed the results from the linear regression analyses. We found that a high symptom level of combined anxiety/depression at all three measurements, compared to a lower symptom level, was associated with reduced odds for blood pressure 140/90 mm Hg at year 22 and, conversely, with higher odds for blood pressure < 120/75 mm Hg . Thus, the probability for development of hypertension among individuals with a high symptom level of anxiety/depression at all three examinations was 20% lower compared to those with a lower symptom level.
What Causes Low Blood Pressure
Low blood pressure may be caused by:
- Decreases in blood volume, such as from major trauma, dehydration, or severe internal bleeding or anemia
- Some medications, such as alcohol, diuretics and other drugs used to treat high blood pressure , heart medications such as beta blockers, Parkinson’s disease medications, tricyclic antidepressants, erectile dysfunction drugs , and narcotics
- Prolonged bed rest
- Pregnancy, especially during the first 24 weeks when its common for blood pressure to drop
- Heart problems, such as abnormally low heart rate, heart valve problems, heart attack, and heart failure
- Endocrine problems, such as underactive thyroid , parathyroid disease, adrenal insufficiency , low blood sugar and diabetes
- Problems with the autonomic nervous system, such as Parkinsons disease
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Clinical Depression: Symptoms And Treatment
Email ThisBlogThis!History of ResearchLink between LowBlood Pressure and DepressionContradiction to Depression/HypertensionTheoryDoes Low Blood Pressure Cause depression? What Blood Pressureis considered Very Low?
- Systolic pressure. The first number in a blood pressure reading, this is the amount of pressure your heart generates when pumping blood through your arteries to the rest of your body.
- Diastolic pressure. The second number in a blood pressure reading, this refers to the amount of pressure in your arteries when your heart is at rest between beats.
Common FactorsCausing Low Blood Pressure and DepressionMedications Cause Low Blood Pressure
More Common Side Effects
The more common side effects of bupropion can include:
- increased anger
- abnormal heart rhythms
- changes in hearing, such as ringing in the ears or hearing noises that arent real
If these effects are mild, they may go away within a few days or a couple of weeks. If theyre more severe or dont go away, talk with your doctor or pharmacist.
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Contrary To Conventional Wisdom Some Blood Pressure Drugs Are Linked To A Lower Risk Of Depression
Like all medications, blood pressure drugs sometimes cause unwanted side effects. While many are mild and short-lived, some are more worrisome, including mood changes such as depression. But contrary to what doctors have long assumed, blood pressure drugs may not raise the risk of depression. In fact, some appear to be linked to a lower risk, according to a recent study .
“The traditional view has been that blood pressure drugs that cross the blood-brain barrier are more likely to cause depression,” says Dr. Randall -Zusman, a cardiologist at Harvard-affiliated Massachusetts General Hospital. Depression has also been associated with drugs known as beta blockers. But beta blockers can also make you feel tired and listless, which may dampen your mood, Dr. Zusman explains.
Getting Your Blood Pressure Checked And Under Control
There is no harm in a person monitoring his or her blood pressure. Some people have naturally low blood pressure, and some, naturally high blood pressure. A doctor can provide a person more information regarding his or her blood pressure and what is considered normal based on health history, diet, age, etc.
If a person is informed his or her blood pressure is nothing to worry about, then it is likely anxiety related. Trying to learn healthy ways to breath can be hugely helpful in these cases. Focusing on taking slow breaths, and not trying to over-compensate for poor breathing are good places to start. Going for a walk can help as well because it can take ones mind off of whatever difficult symptoms a person is experiencing, and get his or her blood flowing.
Anxiety can cause low blood pressure through hyperventilation. Some people also find themselves with anxiety after seeing otherwise normal low blood pressure during a random fluctuation. Learning to slow down and control breathing can help, although an anxiety treatment will be more important.
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Low Blood Pressure Anxiety And More Hyperventilation
There are two factors that tend to contribute to the extent to which this drop in blood pressure occurs.
- First, when a person hyperventilates, signals are sent to the body that it is not getting enough air, even though, in reality, it is getting too much. This tends to cause people to try to yawn or take deeper breaths, and unfortunately, this ends up making hyperventilation worse, and causing a further drop in blood pressure.
- Second, hyperventilation and low blood pressure cause several symptoms that can worsen anxiety, and thus, worsen hyperventilation. When a person has low blood pressure, the heart beats faster and harder to compensate. This may cause a person to experience chest pains, and contribute to feelings of lightheadedness and dizziness. People may feel as though they may faint, and in some cases, this could occur. All of these physical symptoms can increase anxiety, increase hyperventilation, and continue to sustain a lower blood pressure.
In nearly all of these cases, the change in blood pressure tends to be temporary. Once a person is able to regain control of his or her breathing, the blood pressure levels should go back to normal. Sometimes, regaining control of breathing can take longer than other times.
Reducing Your Salt Intake
The American Heart Association recommends no more than a teaspoon of salt a day for adults. That may sound alarmingly small, but there are many painless ways to reduce your sodium intake.
Reduce canned and processed foods. Much of the salt you eat comes from canned or processed foods like soups, convenience meals, and fast food.
Cook more meals at home. Preparing your own meals gives you more control over your sodium intake. Use fresh ingredients whenever possible and cook without salt.
Use spices as alternatives to salt. Try fresh herbs like basil, thyme, or chives, or dried spices such as allspice, bay leaves, or cumin to flavor your meal without sodium.
Substitute reduced sodium versions. Choose your condiments and packaged foods carefully, looking for foods labeled sodium free, low sodium, or unsalted.
See Heart-Healthy Diet Tips to learn more.
The effects on your blood pressure
- Adopting the DASH diet, eating plenty of fruit and vegetables, and reducing your consumption of unhealthy fats can lower your blood pressure by about 11 mm Hg.
- Cutting back on sodium by about 1,000 mg per day can reduce your blood pressure by 5 to 6 mm Hg.
- Increasing your potassium intake from food to 3,500-5,000 mg can knock 4 to 5 mm Hg off your reading.
- Limiting your alcohol intake to two drinks per day if youre male, or one drink per day if youre female can lower your reading by about 4 mm Hg.
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The Link Between Blood Pressure And Depression
There may be many reasons for the association between high blood pressure and low mood, but the most likely is that people who feel down tend not to look after themselves properly, or take their medication regularly, as prescribed. As a result, any pre-existing condition including hypertension is not optimally treated.
Another possibility is that having depression is associated with chemical imbalances in the central nervous system that cause blood pressure to rise, or that hypertension affects blood flow to the brain to lower mood. Certain blood pressure medications may also affect your mood and increase the risk of developing depression. Whatever the underlying cause, depression occurs at a higher rate in people with hypertension than in the normal population.
Hyperventilation And Low Blood Pressure
Hyperventilation occurs when a persons breathing pattern changes in a way that reduces his or her CO2 levels. The most common reason this occurs is when the rate of increases , which often happens during periods of intense anxiety. It may also occur when people recognize their breathing rate increases, and try to slow the breathing through taking in deeper breaths. The body has a way of regulating the levels of oxygen and CO2 that is needed, so when a person attempts to control their breathing rate, it not uncommon to take in too much air.
Without enough carbon dioxide, the body has to work harder to function properly. Blood needs to move more quickly, and blood vessels dilate as a result. This dilation causes a drop in blood pressure but still may show up in a blood pressure reading.
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Measures Of Anxiety And Depression
The Hospital Anxiety and Depression Scale is recognised as a good screening instrument for epidemiological studies. The HADS is a selfreport questionnaire comprising 14 fourpoint Likertscaled items, seven for anxiety and seven for depression . No items relating to somatic or sleep issues are included. Earlier papers on the HADS in HUNT have shown a shared variance between HADSA and HADSD of 30%,20 and presented data relating to depression in sex and age groups.21 According to a recent literature review covering 31 studies, the HADS has shown good casefinding properties for anxiety and depression defined by Diagnostic and Statistical Manual of Mental Disorders IV in primary care and hospital settings.22 A cutoff score of 8 on both subscales was found to give an optimal balance between sensitivity and specificity, both at about 0.80 for depression and anxiety according to DSMIIIR and DSMIV. By using these cutoffs, four groups were identified for this study: anxiety only , depression only , comorbid anxiety and depression and a reference group .
Bupropion May Interact With Other Medications
Bupropion oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.
To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs youre taking. To find out how this drug might interact with something else youre taking, talk with your doctor or pharmacist.
Examples of drugs that can cause interactions with bupropion are listed below.
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