Marco Rabines, M.D.

Yes, exercise can be very helpful in managing anxiety. Regular physical activity can release endorphins, chemicals in the brain that act as natural painkillers and mood elevators. Here are some ways exercise helps with anxiety:
Reduces Stress Hormones: Exercise can help lower the body's stress hormones, such as cortisol, over time. It also helps increase the production of endorphins.
Improves Sleep: Exercise can contribute to more consistent and restorative sleep, which anxiety can negatively affect.
Increases Confidence: Regular exercise can boost self-confidence and improve one’s sense of well-being, which can help alleviate anxiety.
Provides Distraction: Engaging in physical activity provides a distraction, helping to break the cycle of negative thoughts that feed anxiety.
Promotes Social Interaction: Group exercise or team sports can create opportunities for social interaction, provide support, and reduce feelings of loneliness or isolation.
Improves Physical Health: Improving overall physical health can enhance mental health, creating a positive cycle of well-being.
Activities such as walking, jogging, yoga, and swimming are commonly recommended because they can effectively reduce anxiety. However, individuals need to choose an activity they enjoy, which helps ensure they will continue to engage in it regularly.

Yes, lack of rest can significantly contribute to anxiety. Sleep deprivation disrupts normal brain function, particularly in areas responsible for emotion and mood regulation. When you're sleep-deprived, the brain's ability to process emotional information is impaired, often leading to an increase in negative mood states and anxiety. Additionally, poor sleep can heighten the body's stress response, increasing the production of stress hormones like cortisol. This biological response can amplify feelings of anxiety and make individuals more reactive to stressors. Over time, chronic sleep deprivation can lead to a cycle where anxiety makes it difficult to sleep, and lack of sleep fuels more anxiety.

The duration of treatment for depression can vary significantly depending on individual circumstances, including the severity of the depression, the specific type of treatment, and how the individual responds to treatment. In brief, you can expect:
Medication: Antidepressants can take up to six to eight weeks for the full effects to be felt. Once an individual starts feeling better, it's typical to continue the medication for at least six months to a year to prevent relapse.
Psychotherapy: The length of psychotherapy can vary. Cognitive-behavioral therapy (CBT) is designed to be short-term, typically around 12-16 sessions over several months. Other approaches may take longer, depending on the individual’s progress and the depth of the issues being addressed.
Combination Therapy: A combination of medication and psychotherapy is often more effective than either treatment alone. Depending on how symptoms respond, the duration can be similar to or longer than individual treatment modalities.
Maintenance Treatment: To prevent relapse, especially in cases of recurrent depression, ongoing maintenance treatment might be recommended. This could be less frequent therapy sessions or continued medication.
The exact duration of treatment will depend on the individual’s unique needs and how they respond to treatment. It’s important for those undergoing treatment for depression to have regular consultations with their healthcare providers to assess their progress and adjust the treatment plan as necessary.

Several types of medications are commonly used to treat depression, each with different mechanisms of action:

Selective Serotonin Reuptake Inhibitors (SSRIs): These are often the first-line treatment for depression. Common SSRIs include fluoxetine (Prozac), sertraline (Zoloft), and escitalopram (Lexapro). They work by increasing the levels of serotonin in the brain.
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): These medications, such as venlafaxine (Effexor) and duloxetine (Cymbalta), increase the levels of both serotonin and norepinephrine.
Tricyclic Antidepressants (TCAs): Older drugs like amitriptyline and nortriptyline are used when newer medications are not effective. They affect multiple neurotransmitters in the brain.
Monoamine Oxidase Inhibitors (MAOIs): Such as phenelzine and tranylcypromine, these are typically reserved for cases where other treatments have failed, due to their potential for serious side effects and dietary restrictions.
Atypical Antidepressants: This group includes bupropion (Wellbutrin), which is unique as it primarily affects dopamine and norepinephrine, and mirtazapine (Remeron), which acts by increasing serotonin and norepinephrine indirectly.
The choice of medication depends on the individual's symptoms, side effects profile, previous medication responses, and other health conditions.

Several approaches can help manage depression:

Medication: Antidepressants like SSRIs and SNRIs.
Psychotherapy: Cognitive Behavioral Therapy (CBT) and interpersonal therapy.
Lifestyle Changes: Regular exercise, healthy diet, and adequate sleep.
Social Support: Engaging with family, friends, or support groups.
Mindfulness Practices: Meditation and yoga.
Professional Help: Regular check-ins with a healthcare provider.
Combining these strategies often provides the best results tailored to the individual’s needs.

Certain medications can worsen depression and should be used with caution or avoided if possible:

Benzodiazepines: While used for anxiety, they can potentially exacerbate depression.
Beta-Blockers: Drugs like propranolol can sometimes increase depressive symptoms.
Corticosteroids: These can affect mood stability and may lead to depressive symptoms.
Statins: There's some evidence suggesting they might contribute to mood changes.
Hormonal Contraceptives: Some individuals may experience mood changes on these medications.
It's important to consult with a healthcare provider before starting or stopping any medications.

Yes, medications can be effective in treating panic attacks. They are often used to help manage symptoms, especially in severe cases. Commonly prescribed medications include:

Selective Serotonin Reuptake Inhibitors (SSRIs): Fluoxetine and Sertraline are typically the first choice due to their safety and efficacy.
Serotonin-norepinephrine reuptake Inhibitors (SNRIs): Like Venlafaxine, they are also effective for anxiety disorders.
Benzodiazepines, Such as Alprazolam and Clonazepam, are used for rapid relief of acute symptoms but are generally recommended for short-term use due to the risk of dependency.
Medications are often more effective when combined with psychotherapy, such as cognitive-behavioral therapy.