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Most people are quite aware that antidepressants are commonly used to treat depression — but what about depressants, without the "anti"? Do they play any role in the treatment of depression?

The very broad spectrum of antidepressant medications now available represent a primary tool in the depression treatment toolbox, alongside talk therapy. In fact, around 13 percent of United States residents over 12 years old will take antidepressants during any one month; some for other conditions, but most for depression. 

This will make sense to most people. Antidepressants battle depression. "Depressants", without the "anti"? Not so much, right? They'd be more likely to do the opposite, no, and actually induce depression? Yet, that wasn't a typo in the headline. Let's explore this further.

What are depressants?

Depressants are "psychoactive" drugs (meaning they change brain function) that slow the activity of your central nervous system down. In practice, this means they reduce your alertness and also slow your heart rate and reaction time, not that they induce the symptoms of depression. 

While benzodiazepines, barbiturates, and ketamine are the prime examples of medically prescribed depressants, plenty of others can be found on the street — legally and illegally. These include all kinds of alcohol, of course, but also marijuana, GHB, and heroin. 

If your mind is racing, you're overwhelmed, and you just don't want to feel so much any more, depressants (also called sedatives and tranquilizers) seem to be a natural self-medication choice for a large number of people. Research suggests that 11 percent of clinically depressed people are dependent on alcohol (alcoholics, in other words), while 20.5 percent of people dependent on alcohol suffer from depression. Because many alcohol abusers who are depressed never get diagnosed or treated, the true number could be much larger. 

Since alcohol is legal as well as socially acceptable in so many places, and since it's something you're already likely to be familiar with, it's easy to slip into the practice of attempting to self-medicate depression in this way. You may even think it is helping you, for a while. Studies have shown, however, that alcohol dependence actually makes you more likely to stay depressed, and can increase your symptoms. It may even induce or worsen suicidal thoughts.

That doesn't sound like a good idea, then. But are depressants medically prescribed in the treatment of depression? The answer is — sometimes, but under specific circumstances. 

Benzodiazepines to treat depression?

While you won't be prescribed benzodiazepines in the treatment of pure depression, a significant subset of depressed people also suffers from anxiety — for which benzos, like alprazolam, lorazepam, or diazepam​, are often prescribed. If you have anxious depression, you may be prescribed a drug from the benzodiazepine family in addition to an antidepressant.

Can benzodiazepines also work on their own, though? A review of (older) studies on the topic found that antidepressants were not more effective than benzos in treating anxious depression, but that there are advantages and disadvantages to both. While antidepressants often induce side effects that can range from excessive bleeding to sexual dysfunction, weight gain, and gastrointestinal issues, benzos will make you drowsy, impair your brain function, and interfere with your physical abilities. Though benzodiazepines will not, on their own, usually be a first-choice treatment for depression coupled with anxiety, they can be considered.  

Ketamine for depression?

Ketamine, a powerful anesthetic often used on animals as well as a street drug that goes by "special K" and other names, has more recently been hailed as a possible tool in the management of treatment-resistant depression. Single-dose IV ketamine has been shown to alleviate the symptoms of depression in over half of patients it was tried on in as little as two hours, and the effects  of that single dose can last for an amazing two weeks or more. More importantly than anything else, ketamine consistently reduces suicidal thoughts in depressed patients.

This unlikely drug may yet emerge to become a life-saver for the 30 percent of depressed patients who do not respond well to any currently used antidepressant — or at least some of them. 

Can cannabis help you overcome depression?

Maybe. Several studies have found that cannabis has antidepressant effects, while other studies have found that the regular use of marijuana is associated with a slight increase in the risk of developing depression in the first place. Research is still lacking in this area, with no randomized controlled trials showing that marijuana could have a long-term positive effect on the symptoms of depression. Therefore, jurisdictions that have legalized medical marijuana may not make it available to people diagnosed with major depressive disorder. Watch this space, however, as more research will certainly be conducted! 

In conclusion

Depressants, substances that slow the functioning of your central nervous system down, can play a role in the treatment of depression in some circumstances. They aren't a first choice among doctors, however, and turning to available depressants such as alcohol and marijuana on your own as a means of self-medication isn't a good idea either. Alcohol may temporarily help some people with depression feel a little less depressed, and marijuana may actually be beneficial in the treatment of depression, but this doesn't meauiten they are a safe and healthy choice for you. 

In conclusion, safe and effective depression treatments should always be coordinated with a qualified healthcare provider who is fully aware of your circumstances. Instead of self-medicating, seek professional help — and if your doctor wants to prescribe a depressant, ask them why, what it will do, and what the alternatives are. 

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