Major depression is a serious medical illness affecting 9.9 million American adults, or approximately 5 percent of the adult population in a given year. Unlike normal emotional experiences of sadness, loss, or passing mood states, major depression is persistent and can significantly interfere with an individual's thoughts, behavior, mood, activity, and physical health. Among all medical illnesses, major depression is the leading cause of disability in the U.S. and many other developed countries.

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More than twice as many women (6.7 million) as men (3.2 million) suffer from major depressive disorder each year. Major depression can occur at any age including childhood, the teenage years and adulthood. All ethnic, racial and socioeconomic groups suffer from depression. About three-fourths of those who experience a first episode of depression will have at least one other episode in their lives. Some individuals may have several episodes in the course of a year. If untreated, episodes commonly last anywhere from six months to a year. Left untreated, depression can lead to suicide. Natural medicines for depression often help alleviate many of these symptoms.

Major depression, also known as clinical depression or unipolar depression, is only one type of depressive disorder. Other depressive disorders include dysthymia (chronic, less severe depression) and bipolar depression (the depressed phase of bipolar disorder or manic depression). People who have bipolar disorder experience both depression and mania. Mania involves abnormally and persistently elevated mood or irritability, elevated self-esteem, and excessive energy, thoughts, and talking. Natural cures are available to alleviate symptoms of depression.

Source NAMI.

Common symptoms of depression are:

• Feeling sad, blue, incapable of feeling pleasure.
• Change in appetite. Eating too much or not enough.
• Sleep disturbance, sleeping too much or too little.
• Feeling hopeless, worthless, guilty, low self esteem.
• Loss of energy, no motivation, no interest or pleasure in activities.
• Persistent physical symptoms such as aches, pains, headaches, stomach aches, and pain which no physical cause can be found can also be a form of depression.
• Thoughts of death and suicide.

Depression Self-Test

This quick, simple depression self-test can help distinguish between clinical depression and the normal fluctuations of mood experienced from time to time by most people. Sadness is a normal part of life, but sometimes when sadness persists, it becomes what mental health authorities call the nation's leading psychological problem, clinical depression, also known as major depression.
If you answer "yes" to more than two of the following questions, you may well be clinically depressed. Consult your physician or a mental health professional for a thorough assessment and treatment.

1) Much of the time do you feel...
Sad?
Lethargic?
Pessimistic?
Hopeless?
Worthless?
Helpless?

2) Much of the time do you...
Have difficulty making decisions?
Have trouble concentrating?
Have memory problems?

3) Lately have you...
Lost interest in things that used to give you pleasure?
Had problems at work or in school?
Had problems with your family or friends?
Isolated yourself from others? Or wanted to?

4) Lately have you...
Felt like you have low energy?
Felt restless and irritable?
Had trouble falling asleep, staying asleep, or getting up in the morning?
Lost your appetite? Or gained weight?
Been bothered by persistent headaches, stomach aches or back aches? Muscle or joint pains?

5) Lately have you...
Been drinking more alcohol than you used to?
Been taking more mood-altering drugs than you used to?
Engaged in risky behavior? (e.g., not wearing a seat belt, crossing streets without looking, driving faster than normal)

6) Lately, have you been thinking about...
Death?
Hurting yourself?
Your funeral?
Killing yourself?

Source:Adapted from materials created by the National Institute of Mental Health's Depression Awareness, Recognition, and Treatment (D/ART) Program, Rockville, MD  
 

Causes of Depression

Depression can be triggered by traumatic life events, poor diet, nutritional deficiencies, blood sugar imbalances, allergies, medical illness, lack of exercise, drug and alcohol use, and digestive difficulties. These triggers are known to cause or contribute to neurotransmitter imbalances and depletion.
Finding the cause of depression means addressing the biochemistry of the brain.

This can require testing such as Neurotransmitter testing , blood chemistry panels, digestive testing, thyroid testing, and hormone testing.

Take our Neurotransmitter Imbalance Questionnaire to see if you have symptoms of an imbalance.

Candidiasis and Intestinal Parasites

An overgrowth of yeast or intestinal parasites in the gut has been linked to Depression and other emotional symptoms due to a disruption of the brains chemistry. Consuming too much sugar or refined carbohydrates can stimulate overgrowth of Candida.

Food Allergies

Be aware to check for food allergies as they can be one of the main causes of many mental and emotional problems. Although an individual could be allergic to any food, such as fruits, vegetables, and meats, there are eight foods that account for 90% of all food-allergic reactions. These are: milk, egg, peanut, tree nut (walnut, cashew, etc.), fish, shellfish, soy, and wheat. Wheat or gluten intolerance has been shown to contribute to a depressed mood.

Hormonal Imbalance    

Hormones may also play a role in causing depression. Hormone imbalances are being studied by researchers and may be the link to why depression is more prevalent in women than in men. Hormone testing can provide helpful information.

Neurotransmitter Imbalance

Depression can result from imbalances in the levels of chemical messengers in the brain called neurotransmitters. The emotions we feel are based on the release of neurotransmitters in the brain. Prolonged periods of stress can deplete neurotransmitters levels. Our fast paced, fast food society greatly contributes to these imbalances. Scientists have determined that many people who have symptoms of depression may suffer from a neurotransmitter imbalance. Addressing neurotransmitter imbalances is the key to eliminating symptoms of depression. Complete the Neurotransmitter Questionnaire to see if you have symptoms of an imbalance.

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Different neurotransmitters have different actions. Some neurotransmitters are inhibitory and tend to calm, while others are excitatory and stimulate the brain. This observation has led to the conclusion that some neurotransmitter imbalances are more likely to underlie certain conditions. Specifically, deficiencies involving the central nervous system's inhibitory neurotransmitters, gamma-amino-butyric acid (GABA) and glycine, appear to be involved in the development of anxiety disorders, while other neurotransmitters like serotonin and norepinephrine have been more closely linked to depression.

A single neurotransmitter imbalance can result in multiple symptoms. By identifying these chemical imbalances with neurotransmitter tests and understanding how neurotransmitters function and interact in anxiety disorders, it is possible to better match therapies to the patient's chemical imbalance.

The function of a neurotransmitter is to properly relay messages across the synaptic cleft from one neuron to the next. The excitatory neurotransmitters increase the likelihood that a neuron's signals are sent and the inhibitory neurotransmitters decrease the likelihood that a neuron's signals are sent. This balance ensures that unimportant signals are terminated or ignored and that important signals are relayed and acted upon.

If the levels of the excitatory neurotransmitters are in excess, this balance is disturbed and the ability to discern between what is important and what is not can be impaired. This can result in excessive excitation and lead to seizures, insomnia, anxiety, and hyper-excitability.

Causes of Neurotransmitter Imbalance

• Poor Diet. Neurotransmitters are made in the body from certain amino acids derived from proteins. Also required are certain vitamins and minerals called "cofactors". If your nutrition is poor and you do not take in enough protein, vitamins, or minerals to build the neurotransmitters, a neurotransmitter imbalance develops. We really do think and feel what we eat.
• Genetic factors, faulty metabolism, and digestive issues can impair absorption and breakdown of our food which reduces are ability to build neurotransmitters.
• Toxic substances like heavy metals, pesticides, drug and alcohol use, and some prescription drugs can cause permanent damage to the nerve cells that make neurotransmitters.
  Certain drugs and substances such as caffeine, alcohol, nicotine, NutraSweet, antidepressants, and some cholesterol lowering medications deplete neurotransmitter levels leading to neurotransmitter imbalances.
• Hormone changes such as thyroid, adrenal, male and female sex hormones, can cause neurotransmitter imbalances.
• Medical conditions such as food and chemical allergy, blood sugar imbalance, inflammatory conditions, GI disorders, and head injury.
  Nutritional deficiencies

Poor diet can lead to depression. When under emotional stress, the need for nutrients is much greater. Often as part of the imbalance we can have intense carbohydrate cravings. Carbohydrates, when excessive in the diet, can make mood swings worse due to fluctuating blood sugar levels. Diets low in protein, and vitamins may also create deficiencies in neurotransmitter levels, and inadequate or poor quality water affects oxygenation of the tissues.

Street Drugs and Certain Prescription Drugs Can Cause Depression

Prescription drugs, such as antihistamines, anti-hypertensives, anti-inflammatory agents, birth control pills, cholesterol lowering medications, corticosteriods, tranquilizers, sedatives and antidepressants, have all been found to cause depression in susceptible individuals. Alcohol is a depressant, increases adrenal hormone output, interferes with many brain processes, and disrupts normal sleep cycles. Nicotine stimulates adrenal hormone secretion, including cortisol. Caffeine causes anxiety, panic disorders, depression, nervousness, palpitations, irritability and recurrent headache in sensitive individuals. Drugs like Ecstasy damage the serotonin transporters.

Natural Cures For Depression

Many Natural Cures for Depression act by strengthening the same biochemical pathways that medicines use to treat depression.  St. John's Wort has been shown to act in part by increasing the activity of brain neurotransmitters such as serotonin and norepinephrine. Other natural cures for depression work on metabolic pathways that conventional medications do not utilize. These include catecholamine, methylation, and serotonin pathways, omega-3 fatty acids, and second messengers such as Inositol. Other natural depression cures include lifestyle changes such as improving nutritional status, exercise, stress reduction, improving sleep, and limiting exposure to food additives, pesticides and other toxins in our environment.

Find out more about the Natural Depression Supplements we have available!

If you are taking an antidepressant, don't stop taking it on your own. Supplements can be used to reduce dosages of prescription medication or provide an alternative, but this should be done in consultation with your prescribing practitioner.

Targeted Amino Acid Therapy (TAAT)
NeuroScience has developed a program of optimizing neurotransmitters levels. Targeted Amino Acid Therapy or TAAT  is designed to address neurotransmitter deficiencies or imbalances. Neurotransmitters are synthesized from various amino acid precursors. Serotonin, for example, is synthesized from 5-HTP, and oral doses of 5-HTP have been shown to significantly elevate serotonin levels.

The NeuroScience Targeted Amino Acid Therapy Program is an effective means of addressing hormones and neurotransmitter imbalances. A non-invasive lab test is available to measure your neurotransmitter and hormones levels. This test will determine if an imbalance is present and what products should be used in order to combat the neurotransmitter imbalance that disrupts your body's hormone regulation. 

The program uses a combination of specific amino acids, vitamins, and minerals that will increase your body's production of neurotransmitters. These formulas can be used in conjunction with most other therapies your practitioner may prescribe.  They will optimize your neurotransmitter levels, which will reduce the symptoms of depression. a hormone imbalance. The right balance of these chemicals can set the stage for restoring your health. You brain and nervous system will once again send strong signals to the rest of your body.

Find out more about the  Neurotransmitter Testing, we have available!

5HTP 
5-Hydroxytryptophan (5-HTP) is an amino acid. It is found in high concentrations in the brain and acts as a building block for the brain to make serotonin. Under the proper stimulus the brain will turn 5-HTP into serotonin and/or melatonin. Because of this mechanism, 5-HTP is a very gentle yet powerful product to support mood. 5-HTP may work synergistically with certain nutritional supplements to support mood. This nutritive amino acid may also support a healthy sleep cycle. Serotonin is involved in mood regulation, sleep, and appetite control.

L-Carnitine
L-Carnitine is an amino acid that has been reported to safely alleviate depression in some people in doses of 1000 mg twice a day. Acetyl-L-carnitine is a form of carnitine that has shown superior absorption effects to regular L-carnitine.

L-Tryptophan 
 L-Tryptophan is the precursor to Serotonin, a neurotransmitter in the brain, which is deficient in depression. L-Tryptophan is a natural relaxant and helps alleviate insomnia by inducing normal sleep. L-Tryptophan reduces anxiety & depression; helps in the treatment of migraine headaches; helps the immune system; helps reduce the risk of artery & heart spasms.

SAM-e
SAM-e is involved in more than 35 biochemical reactions involving enzymatic transmethylation. Methylation is the process by which the body rids itself of compounds, synthesizes neurotransmitters, makes components of cartilage, regulates enzyme activity within the cell, and maintains the flexibility of cell membranes. Serotonin and other brain chemicals require methylation to be synthesized. SAM-e promotes healthy joint function and comfort , boosts mood and emotional well-being. The suggested dose of SAMe to treat depression ranges from 400-1600 mg a day.

St. John's Wort  
Numerous scientific studies have addressed the effectiveness and safety of standardized St. John's Wort extract.  There are many biologically active components in St. John's Wort, including: naphthodianthrones (hypericin and pseudohypericin), xanthones, phloroglucinols, and various flavonoids, including flavonols and proanthocyanidins. It is thought to work by inhibiting the reuptake of dopamine, serotonin, norepinephrine, and GABA. Hypericin extract appears to inhibit serotonin uptake by postsynaptic receptors and increase synaptic dopamine concentration. Recommended dosage 300mg three times a day.

Food and Mood

Folic acid
Folic acid is needed to make the neurotransmitter group called the catecholamines including dopamine, norepinephrine, and epinephrine. Research suggests that folic acid depletion may help contribute to depression, anxiety and panic.
Sources: Asparagus, Beets, Brussels sprouts, Bok choy, Peas, fresh, Beans, dried, Chick-peas, Soybeans, Lentils, Oranges, Turkey, Cabbage, Savoy, Spinach, Broccoli, Avocados

Magnesium
Magnesium may be beneficial for depression by helping in the formation if certain neurotransmitters and because it helps muscles to relax.
Sources : Spinach, Avocados, Chocolate, Pumpkin seeds, Oysters, Sunflower seeds, Brazil nuts, Buckwheat, Amaranth, Quinoa, Almonds, Barley.

Niacin
Niacin is needed for nerve cell function. Niacin helps the body to release energy from carbohydrates, control blood sugar, and maintain proper nervous system function.
Sources: Rice, brown, Lamb, Pomegranates, Tuna, Chicken, Turkey, Wheat

Omega-3 fatty acids
Omega-3 fatty acids are involved in the cell signaling, and compose part of the cell membrane making it fluid. It reduces inflammatory processes, and is involved in several aspects of neurotransmitter function. Low levels of omega-3 fatty acids have been found the diet and cell membranes of depressed individuals. Sources: Salmon, Trout, Tuna.

Vitamin B6
Vitamin B6 is a cofactor vitamin required for the manufacture of brain chemicals (neurotransmitters), such as serotonin. Serotonin is one of the neurotransmitters that promotes feelings of wellbeing. Vitamin B6 may also help boost the immune system during times of depression and anxiety.
Sources: Sweet potatoes, Avocados, Bananas, Mangoes, Sunflower seeds, Tuna, Chick-peas, Salmon, Pork, fresh, Potatoes, Turkey, Chicken, Bok choy, Rice, brown, and Barely.

Vitamin B12
Vitamin B12  is involved in the synthesis of neurotransmitters. It works in concert with other B vitamins. B12 supports the nervous system and assists the body in converting food into energy.
Sources: Beef, Yogurt, Tuna, Lamb, Oysters, Trout, Crab, Clams

Have a home environment that provides natural light

Use as much natural lighting in your home as possible. Unnatural florescent lighting can be especially aggravating.  Seasonal affective disorder is a type of depression caused by insufficient natural light. People who live in areas with a prolonged winter are prone to this type of depression. If you are not getting at least 15 minutes of exposure to natural sunlight consider purchasing full spectrum lighting for the rooms you spend most of your time.

Physical Exercise
Exercise can be one of the safest and most effective methods of decreasing depression. Cardiovascular exercise combined with calming exercise such as walking several times per week can be very beneficial. Try walking, swimming, bicycling, jogging, yoga, tai-chi, skiing, and tennis; even golf burns calories.

Sufficient sleep

Many people cannot sleep with depression. A restful night is a key ingredient to help many deal with the daily stresses of life. If you have depression and anxiety getting a good night's sleep is very important. Avoid stimulating activities before going to bed, like reading a book, or exercising. Some dietary supplements that are helpful in establishing sleep are melatonin and kava kava. Alcohol is a depressant, and it can greatly interfere with your sleep patterns. Avoid alcohol and cigarettes before going to bed.

Stress-Reduction Techniques
Stress depletes neurotransmitter levels. Mind/body breathing exercises, physical exercise, yoga, tai chi, self-hypnosis, massage, meditation, and biofeedback are just some of the stress reduction techniques used for depression. Listening to music, relaxation CD's, and visual imagery are also effective stress reducers. Meditation is a great tool to prevent those negative thoughts from taking over.

Traditional Depression Treatments

Many patients are treated with antidepressant medication, psychotherapy or a combination of both rather than natural medications for depression. The best treatment for depression is to find the cause of the depression. To do this you must seek a health care practitioner such as a psychiatrist or psychiatric nurse practitioner that has specialized training in the area of natural cures for depression. We offer e-health visits , office visits, or telephone consultations and would be happy work with you in finding the cause of depression if you are not currently working with someone.

 Psychotherapy

There are several approaches to psychotherapy -- including cognitive-behavioral , interpersonal , psychodynamic and other kinds of 'talk therapy' -- that help depressed individuals recover. Psychotherapy offers people the opportunity to identify the factors that contribute to their depression and to deal effectively with the psychological, behavioral, interpersonal and situational causes. Skilled therapists such as licensed psychologists can work with depressed individuals to:

• pinpoint the life problems that contribute to their depression, and help them understand which aspects of those problems they may be able to solve or improve. A trained therapist can help depressed patients identify options for the future and set realistic goals that enable these individuals to enhance their mental and emotional well-being. Therapists also help individuals identify how they have successfully dealt with similar feelings, if they have been depressed in the past.
• identify negative or distorted thinking patterns that contribute to feelings of hopelessness and helplessness that accompany depression. For example, depressed individuals may tend to overgeneralize, that is, to think of circumstances in terms of 'always' or 'never.' They may also take events personally. A trained and competent therapist can help nurture a more positive outlook on life.
• explore other learned thoughts and behaviors that create problems and contribute to depression. For example, therapists can help depressed individuals understand and improve patterns of interacting with other people that contribute to their depression.
• help people regain a sense of control and pleasure in life. Psychotherapy helps people see choices as well as gradually incorporate enjoyable, fulfilling activities back into their lives.
  Having one episode of depression greatly increases the risk of having another episode . There is some evidence that ongoing psychotherapy may lessen the chance of future episodes or reduce their intensity. Through therapy and natural medication, people can learn skills to avoid unnecessary suffering from later bouts of depression.     Source: Healthyplace.com

Medication

Medications may relieve the symptoms of depression by working with existing neurotransmitter supplies. They do not add any molecules of neurotransmitters, without a adequate supply of neurotransmitters to begin with they may not be effective, may work initially then "poop out" or they may give severe or troubling side-effects. A natural alternative to depression should be considered.

Side effects of antidepressant medications.

Antidepressants may cause mild, and often temporary, side effects (sometimes referred to as adverse effects) in some people. Typically, these are not serious. However, any reactions or side effects that are unusual, annoying, or that interfere with functioning should be reported to the doctor immediately.

The most common side effects of tricyclic antidepressants, and ways to deal with them, are as follows:

• Dry mouth —it is helpful to drink sips of water; chew sugarless gum; brush teeth daily.
• Constipation —bran cereals, prunes, fruit, and vegetables should be in the diet.
• Bladder problems —emptying the bladder completely may be difficult, and the urine stream may not be as strong as usual. Older men with enlarged prostate conditions may be at particular risk for this problem. The doctor should be notified if there is any pain.
• Sexual problems —sexual functioning may be impaired with depression; if this is worrisome, it should be discussed with the doctor.
• Blurred vision —this is usually temporary and will not necessitate new glasses. Glaucoma patients should report any change in vision to the doctor.
• Dizziness —rising from the bed or chair slowly is helpful.
• Drowsiness as a daytime problem —this usually passes soon. A person who feels drowsy or sedated should not drive or operate heavy equipment. The more sedating antidepressants are generally taken at bedtime to help sleep and to minimize daytime drowsiness.
• Increased heart rate —pulse rate is often elevated. Older patients should have an electrocardiogram (EKG) before beginning tricyclic treatment.

The newer antidepressants, including SSRIs, have different types of side effects, as follows:

• Sexual problems —fairly common, but reversible, in both men and women. The doctor should be consulted if the problem is persistent or worrisome.
• Headache —this will usually go away after a short time.
• Nausea —may occur after a dose, but it will disappear quickly.
• Nervousness and insomnia (trouble falling asleep or waking often during the night) —these may occur during the first few weeks; dosage reductions or time will usually resolve them.
• Agitation (feeling jittery) —if this happens for the first time after the drug is taken and is more than temporary, the doctor should be notified.
• Any of these side effects may be amplified when an SSRI is combined with other medications that affect serotonin. In the most extreme cases, such a combination of medications (e.g., an SSRI and an MAOI) may result in a potentially serious or even fatal "serotonin syndrome," characterized by fever, confusion, muscle rigidity, and cardiac, liver, or kidney problems.

The small number of people for whom MAOIs are the best treatment need to avoid taking decongestants and consuming certain foods that contain high levels of tyramine, such as many cheeses, wines, and pickles. The interaction of tyramine with MAOIs can bring on a sharp increase in blood pressure that can lead to a stroke. The doctor should furnish a complete list of prohibited foods that the individual should carry at all times. Other forms of antidepressants require no food restrictions. MAOIs also should not be combined with other antidepressants, especially SSRIs, due to the risk of serotonin syndrome.
Medications of any kind —prescribed, over-the-counter, or herbal supplements— should never be mixed without consulting the doctor; nor should medications ever be borrowed from another person.

Other health professionals who may prescribe a drug—such as a dentist or other medical specialist—should be told that the person is taking a specific antidepressant and the dosage. Some drugs, although safe when taken alone, can cause severe and dangerous side effects if taken with other andi-depression drugs. Alcohol (wine, beer, and hard liquor) or street drugs, may reduce the effectiveness of antidepressants and their use should be minimized or, preferably, avoided by anyone taking antidepressants. Some people who have not had a problem with alcohol use may be permitted by their doctor to use a modest amount of alcohol while taking one of the newer antidepressants. The potency of alcohol may be increased by medications since both are metabolized by the liver; one drink may feel like two.

Although not common, some people have experienced withdrawal symptoms when stopping an antidepressant too abruptly. Therefore, when discontinuing an antidepressant, gradual withdrawal is generally advisable.

FDA Public Health Advisory
Suicidality in Adults Being Treated with Antidepressant Medications
Several recent scientific publications suggest the possibility of an increased risk for suicidal behavior in adults who are being treated with antidepressant medications. Even before these reports became available, the FDA began a complete review of all available data to determine whether there is an increased risk of suicidality (suicidal thinking or behavior) in adults being treated with antidepressant medications. It is expected that this review will take a year or longer to complete. In the meantime, FDA is highlighting that:

• Adults being treated with antidepressant medications, particularly those being treated for depression, should be watched closely for worsening of depression and for increased suicidal thinking or behavior. Close watching may be especially important early in treatment, or when the dose is changed, either increased or decreased.
• Adults whose symptoms worsen while being treated with antidepressant drugs, including an increase in suicidal thinking or behavior, should be evaluated by their health care professional.

These recommendations are consistent with existing warnings for treated adults in the approved labeling (package insert) for antidepressant medications that can be found at: http://www.fda.gov/cder/drug/antidepressants/PI_template.pdf The Healthcare Professional and Patient Information Sheets for the antidepressant indications will be updated to add this information within the week. A list of drugs to be included in this update can be found at: http://www.fda.gov/cder/drug/antidepressants/antidepressantList.htm
FDA is working closely with the manufacturers of all marketed antidepressants to fully evaluate the risk of suicidality in adults treated with these drugs. The FDA has asked these manufacturers to identify all placebo-controlled trials conducted in adults in their development programs for their antidepressant products, regardless of the indication studied, and to provide information from these trials to FDA. Manufacturers are being asked to use a similar approach to assembling this information as was used in evaluating the risk of suicidality in placebo-controlled trials in pediatric patients treated with antidepressant medications. The method used to analyze the data for risk of suicidality in children using antidepressant medications is described in more detail at the following web page: http://www.fda.gov/cder/drug/antidepressants/default.htm . A similar approach will be used for adults.

FDA's comprehensive review will involve many hundreds of individual clinical trials and many thousands of adult patients. It is expected that this review will require a year or more to complete because of the large number of trials and the thousands of adverse events that must be checked for possible evidence of suicidality. The FDA will make the results of its review available to the public once its analyses are complete, and will update this advisory in the meantime if more definitive information becomes available.
Source FDA.gov
Dos and Don'ts When You Are Depressed

Don't isolate yourself. Stay in touch with your loved ones, friends and family.

• Don't make major life decisions (for example, about separation or divorce). Since you may not be thinking clearly these decisions might not be in your best interest.
• Don't blame yourself: you didn't cause your own depression.
• Don't be discouraged about not feeling well right away: be patient with yourself.
• Do practice healthy living habits: exercise every day, eat right, and make sure you get enough sleep.
• Do set small goals for yourself since you may have less energy.
• Do call your physician/practitioner or the local suicide crisis center immediately if you begin thinking about suicide. Source: American Academy of Family Physicians