Major Depressive Disorder

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    liz111317

    New test story - Trying to Be Heard

    I surround myself with a strong community of family and friends who are there for me in times of joy or hardship. But sometimes I feel alone, like no one can understand what I am going through. In large part, this is because, for years, I tried to hide one very important aspect of my life — my depression. I am a woman of color, and I am a woman of faith. Within the Black and faith communities, mental health issues are stigmatized. I received my diagnosis of Major Depressive Disorder (MDD), a type of depression, nearly 30 years ago when I was in my 20s. Over the years, I have felt shame because as a Black woman of faith, I was expected to pray my depression away and find happiness in the many blessings in my life. I’ve also felt confusion because mental health is not commonly discussed in the Black community. This silence around mental health has made it difficult for me to express how I feel when talking about my MDD. I’ve described my depression as “running in quicksand.” The more I ran, the deeper I sank. I felt sad, fatigued, and had trouble thinking clearly. I lost interest in things I enjoyed doing like spending time with my family, reading, and being out in nature. I began to have suicidal thoughts and recognized that what I was experiencing wasn’t something I could fix on my own. If you are thinking about suicide, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). MDD manifests as a complicated set of symptoms including (but not limited to) depressed mood, loss of interest or pleasure in things once enjoyed, trouble thinking clearly, being tired often, and being restless or moving slowly. The tricky part about MDD is that each person’s experience can be different. Only a healthcare professional can diagnose and treat MDD. I started my treatment journey with my primary care physician. She discussed treatment plan options that included prescription medications and talk therapy. But I soon realized that I needed someone more specialized who focused on treating MDD, so I got a referral to a psychiatrist. Over the years, I switched psychiatric practices, tried different treatment plans, and experienced a lot of frustration because I felt like I wasn’t being heard. If you knew me, you wouldn’t know that I suffered from depression because I created a positive façade to hide my true feelings. While those around me only saw a strong, intelligent woman with wonderful family and friends, I was struggling inside to manage my MDD. I didn’t recognize who I was anymore. Then, my adult daughter was diagnosed with MDD. It was incredibly difficult to watch her struggle with her symptoms and not be able to find the words to communicate to others what she was experiencing. Yet, I knew what she was going through. Her diagnosis was a wake-up call for me. It was the moment that I knew I had to make a change and commit to prioritizing my own mental health in order to be a good example for my daughter and encourage her to do the same. It took an immense amount of courage, but I finally realized that working to get well and find the right treatment plan for me didn’t mean that I lacked faith, which is what I had been conditioned to believe. It meant that I was taking care of myself. After more than two decades following my original MDD diagnosis, I finally found a psychiatrist who understood my experience and listened to my needs. It was around this time that I remember seeing a commercial on television for an antidepressant called Trintellix ® (vortioxetine) used to treat adults with MDD, and I asked my psychiatrist about this prescription medicine . My psychiatrist helped me understand what I could expect while taking Trintellix and explained all of the risks and benefits, like how Trintellix may increase suicidal thoughts and actions in some people 24 years of age and younger (of note, Trintellix is not approved for children under 18). My doctor also advised that I should call her or get emergency help right away if I have new or worsening depression symptoms, new or sudden changes in mood, behavior, thoughts or feelings, or suicidal thoughts or actions. My doctor also said that I shouldn’t take Trintellix if I’m on a monoamine oxidase inhibitor (MAOI), or if I am allergic to vortioxetine or any other ingredients in Trintellix. Scroll below for additional Important Safety Information, including Full Boxed WARNING for Suicidal Thoughts and Actions. Click here for Medication Guide and discuss with your doctor. Along with safety considerations, my doctor went over the positive treatment results from the clinical trials in adults with MDD. In multiple short-term studies, Trintellix was shown to help reduce the overall symptoms of MDD, based on an overall score on a standardized depression rating scale compared to sugar pill. Also, she explained to me that there were no significant changes in weight seen in clinical trials with Trintellix. Some reports of weight gain have been received since product approval. I really appreciated that my doctor took the time to explain that, while antidepressants are known to be effective based on clinical trials, there are also potential side effects of these types of medications, including nausea, vomiting, weight gain, changes in sleep, treatment-emergent sexual dysfunction (TESD), and suicidal thoughts and actions. The most common side effects of Trintellix are nausea, constipation, and vomiting. Serious potential side effects include serotonin syndrome, abnormal bleeding, hypomania (manic episodes), discontinuation syndrome, visual problems, low levels of salt in your blood, and sexual problems. On my current treatment plan, I feel that my MDD is pretty well managed. I have good days and I have bad days like everyone else. Navigating my depression continues to be a complex journey and never a straight line. But that journey has led me to where I am today. I believe we need to be honest about our mental health and share our experience with those we trust and with whom we feel safe, even if the conversation is difficult. It took a lot of courage to overcome the shame and confusion that I was feeling and to speak up. But in doing so, I found my voice, as well as a doctor who was committed to helping me with my depression. There is power in the sharing of personal experiences around mental health. It’s time to use our voices to help normalize the mental health discussion and break down stigma. I want others who relate to my experience to know that MDD is not a character flaw — it’s a real disorder. I hope that by sharing my story others may realize that they have nothing to be ashamed of and should advocate for themselves to prioritize and manage their mental health. Talk to a doctor if you are experiencing the signs and symptoms of MDD and visit Trintellix.com to hear more stories like mine and learn about other patient resources. *Angie is a paid contributor for Takeda Pharmaceuticals and Lundbeck. Last name withheld to protect personal privacy. IMPORTANT SAFETY INFORMATION (continued from above) Suicidal Thoughts & Actions TRINTELLIX and other antidepressants may increase suicidal thoughts and actions in some people 24 years of age and younger, especially within the first few months of treatment or when the dose is changed. TRINTELLIX is not for use in children under 18. Depression or other mental illnesses are the most important causes of suicidal thoughts or actions. Pay close attention to any changes, especially new or sudden changes in mood, behavior, thoughts, or feelings. Call your doctor or get emergency help right away if you have symptoms such as suicidal thoughts or actions, impulsivity, aggressive or violent actions, depression, anxiety or panic attacks, agitation, restlessness, anger, irritability, trouble sleeping, an increase in activity or talking, or other unusual changes in behavior or mood; especially if they are new, worse, or worry you. Who should not take TRINTELLIX? Do not start or take TRINTELLIX if you: are allergic to vortioxetine or any of the ingredients in TRINTELLIX take a Monoamine Oxidase Inhibitor (MAOI) have stopped taking an MAOI in the last 14 days are being treated with the antibiotic linezolid or intravenous methylene blue Do not start taking an MAOI for at least 21 days after you stop treatment with TRINTELLIX . What should I tell my doctor before taking TRINTELLIX? Before taking TRINTELLIX, tell your doctor: about all your medical and other health conditions if you are pregnant or plan to become pregnant, since TRINTELLIX may harm your unborn baby. Taking TRINTELLIX during your third trimester may cause your baby to have withdrawal symptoms after birth or to be at increased risk for a serious lung problem at birth. Tell your doctor right away if you become or think you are pregnant while taking TRINTELLIX. if you are breastfeeding or plan to breastfeed, since it is not known if TRINTELLIX passes into your breast milk Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements, since TRINTELLIX and some medicines may cause serious side effects (or may not work as well) when taken together. Especially tell your doctor if you take: medicines for migraine headache called triptans; tricyclic antidepressants; opioids (such as fentanyl and tramadol); lithium; tryptophan; buspirone; St. John’s Wort; medicines that can affect blood clotting such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin; and diuretics. What are the possible side effects of TRINTELLIX? TRINTELLIX may cause serious side effects, including: Serotonin syndrome: A potentially life ‐ threatening problem that can happen when you take TRINTELLIX with certain other medicines. Call your doctor or go to the nearest emergency room right away if you have any of the following signs and symptoms of serotonin syndrome: agitation; seeing or hearing things that are not real; confusion; coma; fast heart beat; changes in blood pressure; dizziness; sweating; flushing; high body temperature; shaking, stiff muscles, or muscle twitching; loss of coordination; seizures; nausea, vomiting, diarrhea. Increased risk of bleeding: Taking TRINTELLIX with aspirin, NSAIDs, warfarin or blood thinners may add to this risk. Tell your doctor right away about any unusual bleeding or bruising. Manic episodes: Manic episodes may happen in people with bipolar disorder who take TRINTELLIX. Symptoms may include: greatly increased energy; racing thoughts; unusually grand ideas; talking more or faster than usual; severe problems sleeping; reckless behavior; excessive happiness or irritability. Discontinuation syndrome: Suddenly stopping TRINTELLIX may cause you to have serious side effects including: nausea; sweating; changes in your mood; irritability and agitation; dizziness; electric shock feeling; tremor; anxiety; confusion; headache; tiredness; problems sleeping; hypomania; ringing in your ears; seizures. Eye problems: TRINTELLIX may cause a type of eye problem called angle-closure glaucoma in people with certain other eye conditions. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are. Call your doctor if you have eye pain, changes in your vision, or swelling or redness in or around the eye. Low levels of salt (sodium) in your blood: Low sodium levels in your blood that may be serious and may cause death can happen during treatment with TRINTELLIX. Elderly people and people who take certain medicines may be at a greater risk for developing low sodium levels in your blood. Signs and symptoms may include headache; difficulty concentrating; memory changes; confusion; weakness and unsteadiness on your feet which can lead to falls. In more severe or more sudden cases, signs and symptoms include: seeing or hearing things that are not real; fainting; seizures; coma; stopping breathing. Sexual problems: Taking antidepressants like TRINTELLIX may cause sexual problems. Symptoms in males may include: delayed ejaculation or inability to have an ejaculation, decreased sex drive, or problems getting or keeping an erection. Symptoms in females may include: decreased sex drive, or delayed orgasm or inability to have an orgasm. Talk to your healthcare provider if you develop any changes in your sexual function or if you have any questions or concerns about sexual problems during treatment with TRINTELLIX. The most common side effects of TRINTELLIX include: nausea constipation vomiting These are not all the possible side effects of TRINTELLIX. Tell your doctor if you have any side effect that bothers you or does not go away. What is TRINTELLIX (vortioxetine)? TRINTELLIX is a prescription medicine used in adults to treat a certain type of depression called Major Depressive Disorder (MDD). You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1 ‐ 800 ‐ FDA ‐ 1088. For additional safety information, click here for Medication Guide and discuss with your doctor. ©2021 Takeda Pharmaceuticals U.S.A., Inc. All rights reserved. TAKEDA and the TAKEDA logo are registered trademarks of Takeda Pharmaceutical Company Limited. TRINTELLIX is a trademark of H. Lundbeck A/S registered with the U.S. Patent and Trademark Office and used under license by Takeda Pharmaceuticals America, Inc. US-VOR-0915v1.0 5/22

    Paid content from Takeda Pharmaceuticals and Lundbeck
    Angie M
    Angie M @angie-m
    contributor

    Trying to Be Heard: My Depression As a Woman of Color

    I surround myself with a strong community of family and friends who are there for me in times of joy or hardship. But sometimes I feel alone, like no one can understand what I am going through. In large part, this is because, for years, I tried to hide one very important aspect of my life — my depression. I am a woman of color, and I am a woman of faith. Within the Black and faith communities, mental health issues are stigmatized. I received my diagnosis of Major Depressive Disorder (MDD), a type of depression, nearly 30 years ago when I was in my 20s. Over the years, I have felt shame because as a Black woman of faith, I was expected to pray my depression away and find happiness in the many blessings in my life. I’ve also felt confusion because mental health is not commonly discussed in the Black community. This silence around mental health has made it difficult for me to express how I feel when talking about my MDD. I’ve described my depression as “running in quicksand.” The more I ran, the deeper I sank. I felt sad, fatigued, and had trouble thinking clearly. I lost interest in things I enjoyed doing like spending time with my family, reading, and being out in nature. I began to have suicidal thoughts and recognized that what I was experiencing wasn’t something I could fix on my own. If you are thinking about suicide, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). MDD manifests as a complicated set of symptoms including (but not limited to) depressed mood, loss of interest or pleasure in things once enjoyed, trouble thinking clearly, being tired often, and being restless or moving slowly. The tricky part about MDD is that each person’s experience can be different. Only a healthcare professional can diagnose and treat MDD. I started my treatment journey with my primary care physician. She discussed treatment plan options that included prescription medications and talk therapy. But I soon realized that I needed someone more specialized who focused on treating MDD, so I got a referral to a psychiatrist. Over the years, I switched psychiatric practices, tried different treatment plans, and experienced a lot of frustration because I felt like I wasn’t being heard. If you knew me, you wouldn’t know that I suffered from depression because I created a positive façade to hide my true feelings. While those around me only saw a strong, intelligent woman with wonderful family and friends, I was struggling inside to manage my MDD. I didn’t recognize who I was anymore. Then, my adult daughter was diagnosed with MDD. It was incredibly difficult to watch her struggle with her symptoms and not be able to find the words to communicate to others what she was experiencing. Yet, I knew what she was going through. Her diagnosis was a wake-up call for me. It was the moment that I knew I had to make a change and commit to prioritizing my own mental health in order to be a good example for my daughter and encourage her to do the same. It took an immense amount of courage, but I finally realized that working to get well and find the right treatment plan for me didn’t mean that I lacked faith, which is what I had been conditioned to believe. It meant that I was taking care of myself. After more than two decades following my original MDD diagnosis, I finally found a psychiatrist who understood my experience and listened to my needs. It was around this time that I remember seeing a commercial on television for an antidepressant called Trintellix ® (vortioxetine) used to treat adults with MDD, and I asked my psychiatrist about this prescription medicine . My psychiatrist helped me understand what I could expect while taking Trintellix and explained all of the risks and benefits, like how Trintellix may increase suicidal thoughts and actions in some people 24 years of age and younger (of note, Trintellix is not approved for children under 18). My doctor also advised that I should call her or get emergency help right away if I have new or worsening depression symptoms, new or sudden changes in mood, behavior, thoughts or feelings, or suicidal thoughts or actions. My doctor also said that I shouldn’t take Trintellix if I’m on a monoamine oxidase inhibitor (MAOI), or if I am allergic to vortioxetine or any other ingredients in Trintellix. Scroll below for additional Important Safety Information, including Full Boxed WARNING for Suicidal Thoughts and Actions. Click here for Medication Guide and discuss with your doctor. Along with safety considerations, my doctor went over the positive treatment results from the clinical trials in adults with MDD. In multiple short-term studies, Trintellix was shown to help reduce the overall symptoms of MDD, based on an overall score on a standardized depression rating scale compared to sugar pill. Also, she explained to me that there were no significant changes in weight seen in clinical trials with Trintellix. Some reports of weight gain have been received since product approval. I really appreciated that my doctor took the time to explain that, while antidepressants are known to be effective based on clinical trials, there are also potential side effects of these types of medications, including nausea, vomiting, weight gain, changes in sleep, treatment-emergent sexual dysfunction (TESD), and suicidal thoughts and actions. The most common side effects of Trintellix are nausea, constipation, and vomiting. Serious potential side effects include serotonin syndrome, abnormal bleeding, hypomania (manic episodes), discontinuation syndrome, visual problems, low levels of salt in your blood, and sexual problems. On my current treatment plan, I feel that my MDD is pretty well managed. I have good days and I have bad days like everyone else. Navigating my depression continues to be a complex journey and never a straight line. But that journey has led me to where I am today. I believe we need to be honest about our mental health and share our experience with those we trust and with whom we feel safe, even if the conversation is difficult. It took a lot of courage to overcome the shame and confusion that I was feeling and to speak up. But in doing so, I found my voice, as well as a doctor who was committed to helping me with my depression. There is power in the sharing of personal experiences around mental health. It’s time to use our voices to help normalize the mental health discussion and break down stigma. I want others who relate to my experience to know that MDD is not a character flaw — it’s a real disorder. I hope that by sharing my story others may realize that they have nothing to be ashamed of and should advocate for themselves to prioritize and manage their mental health. Talk to a doctor if you are experiencing the signs and symptoms of MDD and visit Trintellix.com to hear more stories like mine and learn about other patient resources. *Angie is a paid contributor for Takeda Pharmaceuticals and Lundbeck. Last name withheld to protect personal privacy. IMPORTANT SAFETY INFORMATION (continued from above) Suicidal Thoughts & Actions TRINTELLIX and other antidepressants may increase suicidal thoughts and actions in some people 24 years of age and younger, especially within the first few months of treatment or when the dose is changed. TRINTELLIX is not for use in children under 18. Depression or other mental illnesses are the most important causes of suicidal thoughts or actions. Pay close attention to any changes, especially new or sudden changes in mood, behavior, thoughts, or feelings. Call your doctor or get emergency help right away if you have symptoms such as suicidal thoughts or actions, impulsivity, aggressive or violent actions, depression, anxiety or panic attacks, agitation, restlessness, anger, irritability, trouble sleeping, an increase in activity or talking, or other unusual changes in behavior or mood; especially if they are new, worse, or worry you. Who should not take TRINTELLIX? Do not start or take TRINTELLIX if you: are allergic to vortioxetine or any of the ingredients in TRINTELLIX take a Monoamine Oxidase Inhibitor (MAOI) have stopped taking an MAOI in the last 14 days are being treated with the antibiotic linezolid or intravenous methylene blue Do not start taking an MAOI for at least 21 days after you stop treatment with TRINTELLIX . What should I tell my doctor before taking TRINTELLIX? Before taking TRINTELLIX, tell your doctor: about all your medical and other health conditions if you are pregnant or plan to become pregnant, since TRINTELLIX may harm your unborn baby. Taking TRINTELLIX during your third trimester may cause your baby to have withdrawal symptoms after birth or to be at increased risk for a serious lung problem at birth. Tell your doctor right away if you become or think you are pregnant while taking TRINTELLIX. if you are breastfeeding or plan to breastfeed, since it is not known if TRINTELLIX passes into your breast milk Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements, since TRINTELLIX and some medicines may cause serious side effects (or may not work as well) when taken together. Especially tell your doctor if you take: medicines for migraine headache called triptans; tricyclic antidepressants; opioids (such as fentanyl and tramadol); lithium; tryptophan; buspirone; St. John’s Wort; medicines that can affect blood clotting such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin; and diuretics. What are the possible side effects of TRINTELLIX? TRINTELLIX may cause serious side effects, including: Serotonin syndrome: A potentially life ‐ threatening problem that can happen when you take TRINTELLIX with certain other medicines. Call your doctor or go to the nearest emergency room right away if you have any of the following signs and symptoms of serotonin syndrome: agitation; seeing or hearing things that are not real; confusion; coma; fast heart beat; changes in blood pressure; dizziness; sweating; flushing; high body temperature; shaking, stiff muscles, or muscle twitching; loss of coordination; seizures; nausea, vomiting, diarrhea. Increased risk of bleeding: Taking TRINTELLIX with aspirin, NSAIDs, warfarin or blood thinners may add to this risk. Tell your doctor right away about any unusual bleeding or bruising. Manic episodes: Manic episodes may happen in people with bipolar disorder who take TRINTELLIX. Symptoms may include: greatly increased energy; racing thoughts; unusually grand ideas; talking more or faster than usual; severe problems sleeping; reckless behavior; excessive happiness or irritability. Discontinuation syndrome: Suddenly stopping TRINTELLIX may cause you to have serious side effects including: nausea; sweating; changes in your mood; irritability and agitation; dizziness; electric shock feeling; tremor; anxiety; confusion; headache; tiredness; problems sleeping; hypomania; ringing in your ears; seizures. Eye problems: TRINTELLIX may cause a type of eye problem called angle-closure glaucoma in people with certain other eye conditions. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are. Call your doctor if you have eye pain, changes in your vision, or swelling or redness in or around the eye. Low levels of salt (sodium) in your blood: Low sodium levels in your blood that may be serious and may cause death can happen during treatment with TRINTELLIX. Elderly people and people who take certain medicines may be at a greater risk for developing low sodium levels in your blood. Signs and symptoms may include headache; difficulty concentrating; memory changes; confusion; weakness and unsteadiness on your feet which can lead to falls. In more severe or more sudden cases, signs and symptoms include: seeing or hearing things that are not real; fainting; seizures; coma; stopping breathing. Sexual problems: Taking antidepressants like TRINTELLIX may cause sexual problems. Symptoms in males may include: delayed ejaculation or inability to have an ejaculation, decreased sex drive, or problems getting or keeping an erection. Symptoms in females may include: decreased sex drive, or delayed orgasm or inability to have an orgasm. Talk to your healthcare provider if you develop any changes in your sexual function or if you have any questions or concerns about sexual problems during treatment with TRINTELLIX. The most common side effects of TRINTELLIX include: nausea constipation vomiting These are not all the possible side effects of TRINTELLIX. Tell your doctor if you have any side effect that bothers you or does not go away. What is TRINTELLIX (vortioxetine)? TRINTELLIX is a prescription medicine used in adults to treat a certain type of depression called Major Depressive Disorder (MDD). You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1 ‐ 800 ‐ FDA ‐ 1088. For additional safety information, click here for Medication Guide and discuss with your doctor. ©2021 Takeda Pharmaceuticals U.S.A., Inc. All rights reserved. TAKEDA and the TAKEDA logo are registered trademarks of Takeda Pharmaceutical Company Limited. TRINTELLIX is a trademark of H. Lundbeck A/S registered with the U.S. Patent and Trademark Office and used under license by Takeda Pharmaceuticals America, Inc. US-VOR-0915v1.0 5/22

    Paid content from

    Navigating My Depression as a Woman of Color and Faith

    I surround myself with a strong community of family and friends who are there for me in times of joy or hardship. But, sometimes I feel alone, like no one can understand what I am going through. In large part, this is because, for years, I tried to hide one very important aspect of my life — my depression. I am a woman of color, and I am a woman of faith. Within the black and faith communities, mental health issues are stigmatized. My diagnosis of Major Depressive Disorder (MDD), a type of depression, almost 30 years ago when I was in my 20s triggered a series of doctor appointments and treatment plans. Over the years, I felt shame because as a black woman of faith, I was expected to pray my depression away and find happiness in the many blessings in my life. I’ve also felt confusion because mental health is not commonly discussed in the black community; therefore, it’s difficult to find the words to fully express how I feel. I’ve described my depression as “running in quicksand.” The more I ran, the deeper I sank. I felt sad, fatigued and had trouble thinking clearly. I lost interest in things I enjoyed doing like spending time with my family, reading and being out in nature. I began to have suicidal thoughts and knew that what I was experiencing wasn’t something I could fix on my own. If you are thinking about suicide, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). MDD manifests as a complicated set of symptoms including (but not limited to) depressed mood, loss of interest or pleasure in things once enjoyed, trouble thinking clearly, being tired often, and being restless or moving slowly. The tricky part about MDD is that each person’s experience can be different. Only a healthcare professional can diagnose and treat MDD. I started my treatment journey with my primary care physician. She discussed treatment plan options that included prescription medications and talk therapy. But I soon realized that I needed someone more specialized who focused on treating MDD, so I got a referral to a psychiatrist. Over the years, I switched psychiatric practices, tried different treatment plans, and throughout it all experienced frustration because I felt like I wasn’t being heard. To see me, you wouldn’t know that I suffered from depression because I created a positive façade to hide my true feelings. While those around me only saw a strong, intelligent woman with wonderful family and friends, I was struggling inside to manage my MDD. I didn’t recognize who I was anymore. Then one day, my adult daughter was diagnosed with MDD. It was incredibly difficult to watch her struggle with her symptoms and not be able to find the words to communicate to others what she was experiencing. Yet, I knew what she was going through. This was a wake-up call for me. It was the moment that I knew I had to make a change and commit to prioritizing my own mental health in order to be a good example for my daughter and encourage her to do the same. It took an immense amount of courage, but I finally realized that working to get well and find the right treatment plan for me didn’t mean that I lacked faith, which is what I had been conditioned to believe. It meant that I was taking care of myself. After more than two decades following my original MDD diagnosis, I finally found a psychiatrist who understood my experience and listened to my needs. It was around this time that I remember seeing a commercial on television for an antidepressant called Trintellix ® (vortioxetine) used to treat adults with MDD and I asked my psychiatrist about this prescription medicine . My psychiatrist helped me understand what I could expect while taking Trintellix and explained all of the risks and benefits, like how Trintellix may increase suicidal thoughts and actions in some people 24 years of age and younger (of note, Trintellix is not approved for children under 18). My doctor also advised that I should call her or get emergency help right away if I have new or worsening depression symptoms, new or sudden changes in mood, behavior, thoughts or feelings, or suicidal thoughts or actions. My doctor also said that I shouldn’t take Trintellix if I’m on a monoamine oxidase inhibitor (MAOI), or if I am allergic to vortioxetine or any other ingredients in Trintellix. Scroll below for additional Important Safety Information, including Full Boxed WARNING for Suicidal Thoughts and Actions. Click here for Medication Guide and discuss with your doctor. Along with safety considerations, my doctor went over the positive treatment results from the clinical trials in adults with MDD. In multiple short-term studies, Trintellix was shown to help reduce the overall symptoms of MDD, based on an overall score on a standardized depression rating scale compared to sugar pill. Also, she explained to me that there were no significant changes in weight seen in clinical trials with Trintellix. Some reports of weight gain have been received since product approval. I really appreciated that my doctor took the time to explain that, while antidepressants are known to be effective based on clinical trials, there are also potential side effects of these types of medications, including nausea, vomiting, weight gain, changes in sleep, treatment-emergent sexual dysfunction (TESD), and suicidal thoughts and actions. The most common side effects of Trintellix are nausea, constipation, and vomiting. Serious potential side effects include serotonin syndrome, abnormal bleeding, hypomania (manic episodes), discontinuation syndrome, visual problems, low levels of salt in your blood, and sexual problems. On my current treatment plan, I feel that my MDD is pretty well managed. I have good days and I have bad days like everyone else. Navigating my depression continues to be a complex journey and never a straight line. But that journey has led me to where I am today. I believe we need to be honest about our mental health and share our experience with those we trust and with whom we feel safe, even if the conversation is difficult. It took a lot of courage to overcome the shame and confusion that I was feeling. But in doing so, I found my voice, as well as a doctor who was committed to helping me with my depression. There is power in the sharing of personal experiences around mental health. It’s time to use our voices to help normalize the mental health discussion and break down stigma. I want others who relate to my experience to know that MDD is not a character flaw – it’s a real disorder. I hope that by sharing my story others may realize that they have nothing to be ashamed of and should advocate for themselves to prioritize and manage their mental health. Talk to a doctor if you are experiencing the signs and symptoms of MDD and visit Trintellix.com to hear more stories like mine and learn about other patient resources. *Angie is a paid contributor for Takeda Pharmaceuticals and Lundbeck. Last name withheld to protect personal privacy. IMPORTANT SAFETY INFORMATION (continued from above) Suicidal Thoughts & Actions TRINTELLIX and other antidepressants may increase suicidal thoughts and actions in some people 24 years of age and younger, especially within the first few months of treatment or when the dose is changed. TRINTELLIX is not for use in children under 18. Depression or other mental illnesses are the most important causes of suicidal thoughts or actions. Pay close attention to any changes, especially new or sudden changes in mood, behavior, thoughts, or feelings. Call your doctor or get emergency help right away if you have symptoms such as suicidal thoughts or actions, impulsivity, aggressive or violent actions, depression, anxiety or panic attacks, agitation, restlessness, anger, irritability, trouble sleeping, an increase in activity or talking, or other unusual changes in behavior or mood; especially if they are new, worse, or worry you. Who should not take TRINTELLIX? Do not start or take TRINTELLIX if you: are allergic to vortioxetine or any of the ingredients in TRINTELLIX take a Monoamine Oxidase Inhibitor (MAOI) have stopped taking an MAOI in the last 14 days are being treated with the antibiotic linezolid or intravenous methylene blue Do not start taking an MAOI for at least 21 days after you stop treatment with TRINTELLIX . What should I tell my doctor before taking TRINTELLIX? Before taking TRINTELLIX, tell your doctor: about all your medical and other health conditions if you are pregnant or plan to become pregnant, since TRINTELLIX may harm your unborn baby. Taking TRINTELLIX during your third trimester may cause your baby to have withdrawal symptoms after birth or to be at increased risk for a serious lung problem at birth. Tell your doctor right away if you become or think you are pregnant while taking TRINTELLIX. if you are breastfeeding or plan to breastfeed, since it is not known if TRINTELLIX passes into your breast milk Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements, since TRINTELLIX and some medicines may cause serious side effects (or may not work as well) when taken together. Especially tell your doctor if you take: medicines for migraine headache called triptans; tricyclic antidepressants; opioids (such as fentanyl and tramadol); lithium; tryptophan; buspirone; St. John’s Wort; medicines that can affect blood clotting such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin; and diuretics. What are the possible side effects of TRINTELLIX? TRINTELLIX may cause serious side effects, including: Serotonin syndrome: A potentially life ‐ threatening problem that can happen when you take TRINTELLIX with certain other medicines. Call your doctor or go to the nearest emergency room right away if you have any of the following signs and symptoms of serotonin syndrome: agitation; seeing or hearing things that are not real; confusion; coma; fast heart beat; changes in blood pressure; dizziness; sweating; flushing; high body temperature; shaking, stiff muscles, or muscle twitching; loss of coordination; seizures; nausea, vomiting, diarrhea. Increased risk of bleeding: Taking TRINTELLIX with aspirin, NSAIDs, warfarin or blood thinners may add to this risk. Tell your doctor right away about any unusual bleeding or bruising. Manic episodes: Manic episodes may happen in people with bipolar disorder who take TRINTELLIX. Symptoms may include: greatly increased energy; racing thoughts; unusually grand ideas; talking more or faster than usual; severe problems sleeping; reckless behavior; excessive happiness or irritability. Discontinuation syndrome: Suddenly stopping TRINTELLIX may cause you to have serious side effects including: nausea; sweating; changes in your mood; irritability and agitation; dizziness; electric shock feeling; tremor; anxiety; confusion; headache; tiredness; problems sleeping; hypomania; ringing in your ears; seizures. Eye problems: TRINTELLIX may cause a type of eye problem called angle-closure glaucoma in people with certain other eye conditions. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are. Call your doctor if you have eye pain, changes in your vision, or swelling or redness in or around the eye. Low levels of salt (sodium) in your blood: Low sodium levels in your blood that may be serious and may cause death can happen during treatment with TRINTELLIX. Elderly people and people who take certain medicines may be at a greater risk for developing low sodium levels in your blood. Signs and symptoms may include headache; difficulty concentrating; memory changes; confusion; weakness and unsteadiness on your feet which can lead to falls. In more severe or more sudden cases, signs and symptoms include: seeing or hearing things that are not real; fainting; seizures; coma; stopping breathing. Sexual problems: Taking antidepressants like TRINTELLIX may cause sexual problems. Symptoms in males may include: delayed ejaculation or inability to have an ejaculation, decreased sex drive, or problems getting or keeping an erection. Symptoms in females may include: decreased sex drive, or delayed orgasm or inability to have an orgasm. Talk to your healthcare provider if you develop any changes in your sexual function or if you have any questions or concerns about sexual problems during treatment with TRINTELLIX. The most common side effects of TRINTELLIX include: nausea constipation vomiting These are not all the possible side effects of TRINTELLIX. Tell your doctor if you have any side effect that bothers you or does not go away. What is TRINTELLIX (vortioxetine)? TRINTELLIX is a prescription medicine used in adults to treat a certain type of depression called Major Depressive Disorder (MDD). You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1 ‐ 800 ‐ FDA ‐ 1088. For additional Important Safety Information, click here for Medication Guide and discuss with your doctor. ©2022 Takeda Pharmaceuticals U.S.A., Inc. All rights reserved. TAKEDA and the TAKEDA logo are registered trademarks of Takeda Pharmaceutical Company Limited. TRINTELLIX is a trademark of H. Lundbeck A/S registered with the U.S. Patent and Trademark Office and used under license by Takeda Pharmaceuticals America, Inc. Angie M. is a paid contributor for Takeda Pharmaceuticals and Lundbeck. She is a wife, mother and person living with Major Depressive Disorder, a type of depression. US-VOR-0915v1.0 03/22

    Community Voices

    Living With Treatment-Resistant Depression

    <p>Living With Treatment-Resistant <a href="https://dev.themighty.info/topic/depression/?label=Depression" class="tm-embed-link  tm-autolink health-map" data-id="5b23ce7600553f33fe991123" data-name="Depression" title="Depression" target="_blank">Depression</a></p>
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    Community Voices

    Living With Treatment Resistant Depression

    <p>Living With Treatment Resistant <a href="https://dev.themighty.info/topic/depression/?label=Depression" class="tm-embed-link  tm-autolink health-map" data-id="5b23ce7600553f33fe991123" data-name="Depression" title="Depression" target="_blank">Depression</a></p>
    liz111317

    Test post for video mental illness mother

    I’ve wanted to be a mom since I was a kid. I can’t explain it, I’ve just always loved babies and kids, and I have always wanted to raise a whole bunch of them. So when my mental health started going south, I got really nervous. I started researching obsessively, looking for positive stories about moms with mental illness who could successfully manage their illness and take care of their kids at the same time. All I found were horror stories. The internet was overflowing with reasons mentally ill women should not have babies, and maybe shouldn’t be mothers at all. There’s the risk of passing your illness onto your child, and the increased risk of postpartum depression, anxiety or psychosis, or the risk of your hormones shifting and making your illness even worse than it was before. And even if none of that happens, a lot of people on the internet seem convinced that being mentally ill would make it impossible for me to take care of my kids “the way they deserved.” I was young, I was depressed, I was scared — and so I believed them. I couldn’t help but wonder if it was ethical for me to have kids. Wasn’t it selfish to have kids just to fulfill my own wishes if I was just destined to wreak havoc on their lives with my illness? I panicked and panicked and panicked, obsessing over everything that could go wrong, grieving my childhood dream of being a mom that had stuck with me through the years. But then my mental health started improving. I got on the right medication, found healthier coping mechanisms and actually used them. I thought maybe things would be OK if I had kids, eventually. Then, bam, pregnant. My fears went into overdrive. I was certain I would experience debilitating postpartum depression. I suspected I would be a terrible mother, unable to take care of my baby. But I still wanted to be a mom so bad. It was a confusing time. I was excited and fearful and confident and so, so unsure. When my son was born, I was so unbelievably happy. I didn’t even mind when he cluster fed for seven hours the second night. He was finally here and I loved him so much. But I was still ready for the postpartum depression to hit soon enough. But it just…didn’t. Don’t get me wrong, it hasn’t been all rainbows and butterflies. Those first few weeks were incredibly hard, but they were also so beautiful, and I was able to appreciate that beauty. And month by month, I have continued taking excellent care of my son. I’m not perfect (I accidentally let him get a little sunburned the other day, the poor thing) but I hold him and sing to him and change him and love on him all the time. I’m a good mom, regardless of my mental illness. If anything, having a baby has actually helped my mental health. I’m not sure if my hormones changed for the better rather than for the worse, or if I just feel like I have more of a sense of purpose now that I have to get up in the morning to feed him and change him and snuggle with him, but I am definitely happier now than I have been in a long time. This is the story I needed to read when I was younger. I needed an account of a mentally ill mom who didn’t make her own health or her baby’s worse simply by being who she was. But I couldn’t find it anywhere, so I assumed it never happened. It happens sometimes, I promise. I’m living proof. I had my son four months ago, and I’m nearly symptom-free for the first time in years. I want to be sure to add that this may not be the case for you. You might experience postpartum depression or anxiety or psychosis, and having a baby might make your mental health worse, and you may struggle to take care of your child on your own. But there is nothing wrong with that either. None of those things mean you will be a bad mom, or that you’re selfish for wanting to be a mom at all. Guess what? I don’t take care of my baby all on my own. No one does. Family, friends, even neighbors are always happy to help out if you’re having a bad brain day and just need a little help. And even though it’s scary when our illnesses worsen, it is possible to continue treating them. You will try a new med, or go to therapy more often, or reach out to your support system more, and you will get through it. When I was younger, it felt like there was no hope for me as a mom. I want to be that hope for someone else out there. Mentally ill moms can be absolutely wonderful mothers, no matter what the rest of the internet has to say about it. Follow this journey on Megan Writes Everything

    Paid content from Takeda Pharmaceuticals and Lundbeck
    Ruth J.
    Ruth J. @ruth-j
    contributor

    Depression and the Holidays: Reflecting on My Journey

    The holiday season is my favorite time of year; a time of joy and celebration! Yet, as a person living with depression, the holidays are also a time that I dread because they can bring about challenges and triggers for me. In any season, I have good days and bad days, of course. But there’s something about the holidays that seem to heighten my feelings and conjure up memories from my past. It’s naturally a reflective time, as we say goodbye to the old and hello to the New Year. This holiday season, I thought a lot about how far I’ve come on my journey with depression. As a young adult, I struggled with my mental health but didn’t fully understand that what I was feeling could be a mental illness, as this was just not something we discussed in my household. It wasn’t until my late 20s and early 30s that I fully realized that something wasn’t right. I had just started to grow my family. It was an exciting time, yet I felt like I was just going through the motions each day. Particularly around the holidays, I started to withdraw socially and just kind of felt “ down in the dumps. ” I remember thinking to myself, I’m so invisible. I often described it as a rain cloud over my head that followed me around everywhere I went. I had trouble thinking clearly and lost interest in the things I really enjoyed doing, like completing puzzles and reading. I knew something had to change and I needed to speak to a doctor about what I was feeling. When I finally decided to make an appointment to see a doctor, he diagnosed me with Major Depressive Disorder (MDD), a form of depression. MDD manifests as a complicated set of symptoms including (but not limited to) depressed mood, loss of interest or pleasure in things once enjoyed, trouble thinking clearly, being tired often, and being restless or moving slowly. The tricky part about MDD is that each person’s experience can be different. Only a healthcare professional can diagnose and treat MDD. My doctor discussed treatment plan options with me that included antidepressant medications and talk therapy. Roughly 10 years after being diagnosed, I felt I needed to see a new doctor. I was frustrated that after all this time, I still found myself struggling with my MDD symptoms. I started thinking that maybe this is how life is supposed to be and I just had to deal with what I was feeling. I shared what I was experiencing with my twin sister, as she too was diagnosed with MDD by a healthcare provider. My sister encouraged me to be open and honest with my psychiatrist about what I was feeling and not lose hope in finding the right treatment plan. I realized that perhaps I had not been as candid with my doctor as I could have been because sometimes it’s hard to have difficult conversations. But I knew this had to change. I met with my psychiatrist and was honest about what I was experiencing. When discussing treatment options, I asked about an antidepressant called Trintellix ® (vortioxetine) . Trintellix is a prescription medicine used in adults to treat MDD. She helped me understand what I could expect while taking Trintellix and explained all of the risks and benefits, like how Trintellix may increase suicidal thoughts and actions in some people 24 years of age and younger (of note, Trintellix is not approved for children under 18). My doctor also advised that I should call her or get emergency help right away if I have new or worsening depression symptoms, new or sudden changes in mood, behavior, thoughts or feelings, or suicidal thoughts or actions. My doctor also said that I shouldn’t take Trintellix if I’m on a monoamine oxidase inhibitor (MAOI), or if I am allergic to vortioxetine or any other ingredients in Trintellix. Scroll below for additional Important Safety Information, including Full Boxed WARNING for Suicidal Thoughts and Actions. Click here for Medication Guide and discuss with your doctor. Along with safety considerations, my doctor went over the positive treatment results from the clinical trials in adults with MDD. In multiple short-term studies, Trintellix was shown to help reduce the overall symptoms of MDD, based on an overall score on a standardized depression rating scale versus sugar pill. Also, she explained to me that there were no significant changes in weight seen in clinical trials with Trintellix. Some reports of weight gain have been received since product approval. I really appreciated that my doctor took the time to explain that, while antidepressants are known to be effective based on clinical trials, there are also potential side effects of these types of medications, including nausea, vomiting, weight gain, changes in sleep, treatment-emergent sexual dysfunction (TESD), and suicidal thoughts and actions. The most common side effects of Trintellix are nausea, constipation, and vomiting. Serious potential side effects include serotonin syndrome, abnormal bleeding, hypomania (manic episodes), discontinuation syndrome, visual problems, low levels of salt in your blood, or sexual problems. My doctor worked with me to find the dose of Trintellix that was right for me, and I feel like my MDD symptoms are pretty well managed. Looking back, I see that my feelings during the holidays played a part in my seeking professional help for my MDD. This New Year, I am setting intentions to spend more time with my family, especially my two sons, and take time for myself. I know I will still have bad days, just like everybody else, but my overall outlook is positive. My advice to others struggling with MDD is to not give up and be your own health advocate by working with your doctor and asking about your treatment plan. It is okay if you need to go back to your doctor or even find a new doctor – someone with whom you might feel more comfortable with discussing your experiences. I’ve learned that it is so important to prioritize your own health and well-being, especially during the holiday season. Note that medication may not be right for every person with MDD. As people focus on resolutions for the New Year, I hope that my story will inspire other people living with MDD to advocate for their health – by having an open and honest conversation with a doctor, and working with the doctor to find a treatment plan that’s right for you. Visit Trintellix.com to hear more stories like mine and learn about other patient resources. * Ruth is a paid contributor for Takeda and Lundbeck. Last name withheld to protect subject’s privacy. IMPORTANT SAFETY INFORMATION (continued from above) Suicidal Thoughts & Actions TRINTELLIX and other antidepressants may increase suicidal thoughts and actions in some people 24 years of age and younger, especially within the first few months of treatment or when the dose is changed. TRINTELLIX is not for use in children under 18. Depression or other mental illnesses are the most important causes of suicidal thoughts or actions. Pay close attention to any changes, especially new or sudden changes in mood, behavior, thoughts, or feelings. Call your doctor or get emergency help right away if you have symptoms such as suicidal thoughts or actions, impulsivity, aggressive or violent actions, depression, anxiety or panic attacks, agitation, restlessness, anger, irritability, trouble sleeping, an increase in activity or talking, or other unusual changes in behavior or mood; especially if they are new, worse, or worry you. Who should not take TRINTELLIX? Do not start or take TRINTELLIX if you: are allergic to vortioxetine or any of the ingredients in TRINTELLIX take a Monoamine Oxidase Inhibitor (MAOI) have stopped taking an MAOI in the last 14 days are being treated with the antibiotic linezolid or intravenous methylene blue Do not start taking an MAOI for at least 21 days after you stop treatment with TRINTELLIX . What should I tell my doctor before taking TRINTELLIX? Before taking TRINTELLIX, tell your doctor: about all your medical and other health conditions if you are pregnant or plan to become pregnant, since TRINTELLIX may harm your unborn baby. Taking TRINTELLIX during your third trimester may cause your baby to have withdrawal symptoms after birth or to be at increased risk for a serious lung problem at birth. Tell your doctor right away if you become or think you are pregnant while taking TRINTELLIX. if you are breastfeeding or plan to breastfeed, since it is not known if TRINTELLIX passes into your breast milk Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements, since TRINTELLIX and some medicines may cause serious side effects (or may not work as well) when taken together. Especially tell your doctor if you take: medicines for migraine headache called triptans; tricyclic antidepressants; opioids (such as fentanyl and tramadol); lithium; tryptophan; buspirone; St. John’s Wort; medicines that can affect blood clotting such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs), warfarin; and diuretics. What are the possible side effects of TRINTELLIX? TRINTELLIX may cause serious side effects, including: Serotonin syndrome: A potentially life ‐ threatening problem that can happen when you take TRINTELLIX with certain other medicines. Call your doctor or go to the nearest emergency room right away if you have any of the following signs and symptoms of serotonin syndrome: agitation; seeing or hearing things that are not real; confusion; coma; fast heart beat; changes in blood pressure; dizziness; sweating; flushing; high body temperature; shaking, stiff muscles, or muscle twitching; loss of coordination; seizures; nausea, vomiting, diarrhea. Increased risk of bleeding: Taking TRINTELLIX with aspirin, NSAIDs, warfarin or blood thinners may add to this risk. Tell your doctor right away about any unusual bleeding or bruising. Manic episodes: Manic episodes may happen in people with bipolar disorder who take TRINTELLIX. Symptoms may include: greatly increased energy; racing thoughts; unusually grand ideas; talking more or faster than usual; severe problems sleeping; reckless behavior; excessive happiness or irritability. Discontinuation syndrome: Suddenly stopping TRINTELLIX may cause you to have serious side effects including: nausea; sweating; changes in your mood; irritability and agitation; dizziness; electric shock feeling; tremor; anxiety; confusion; headache; tiredness; problems sleeping; hypomania; ringing in your ears; seizures. Eye problems: TRINTELLIX may cause a type of eye problem called angle-closure glaucoma in people with certain other eye conditions. You may want to undergo an eye examination to see if you are at risk and receive preventative treatment if you are. Call your doctor if you have eye pain, changes in your vision, or swelling or redness in or around the eye. Low levels of salt (sodium) in your blood: Low sodium levels in your blood that may be serious and may cause death can happen during treatment with TRINTELLIX. Elderly people and people who take certain medicines may be at a greater risk for developing low sodium levels in your blood. Signs and symptoms may include headache; difficulty concentrating; memory changes; confusion; weakness and unsteadiness on your feet which can lead to falls. In more severe or more sudden cases, signs and symptoms include: seeing or hearing things that are not real; fainting; seizures; coma; stopping breathing. Sexual problems: Taking antidepressants like TRINTELLIX may cause sexual problems. Symptoms in males may include: delayed ejaculation or inability to have an ejaculation, decreased sex drive, or problems getting or keeping an erection. Symptoms in females may include: decreased sex drive, or delayed orgasm or inability to have an orgasm. Talk to your healthcare provider if you develop any changes in your sexual function or if you have any questions or concerns about sexual problems during treatment with TRINTELLIX. The most common side effects of TRINTELLIX include: nausea constipation vomiting These are not all the possible side effects of TRINTELLIX. Tell your doctor if you have any side effect that bothers you or does not go away. What is TRINTELLIX (vortioxetine)? TRINTELLIX is a prescription medicine used in adults to treat a certain type of depression called Major Depressive Disorder (MDD). You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1 ‐ 800 ‐ FDA ‐ 1088. For additional safety information, click here for Medication Guide and discuss with your doctor. ©2021 Takeda Pharmaceuticals U.S.A., Inc. All rights reserved. TAKEDA and the TAKEDA logo are registered trademarks of Takeda Pharmaceutical Company Limited. TRINTELLIX is a trademark of H. Lundbeck A/S registered with the U.S. Patent and Trademark Office and used under license by Takeda Pharmaceuticals America, Inc.

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    Grace K
    Grace K @grace-k
    contributor

    How I Found the Right Treatment Plan for My Challenging to Treat Depre

    Growing up, I always felt a little off and sort of sad, but it wasn’t until I reached junior high that I realized I needed to talk to my doctor. With medication, good friends, snowboarding and lacrosse, I was able to have a pretty normal high school experience. College, however, was a different story. What I had expected to be the best years of my life were plagued with ever-worsening depression. I had watched my two sisters thrive in their four years attending universities, making lifelong friends, and traveling to far-off countries, all while maintaining good grades. I couldn’t understand why I was so miserable when I had done everything the exact same way. There was one pillar of the perfect college experience that I did excel at: partying. I found myself going out more and more, and self-medicating – doing anything I could to escape the reality I had created for myself. Although my grades didn’t suffer, my state of mind, outlook, and friendships did. Eventually, it was all too much; I was drowning. I withdrew from all my classes and moved back home. I tried to keep going as best I could and enrolled in courses at a college in my hometown, but my depression made me feel like I could barely keep my head above water. Most people may not realize that depression can rob you of the different pieces of your life, big and small. Depression takes things little by little, so slowly that you don’t even notice at first. Then suddenly everything is gone: hobbies, passions, a sense of belonging, even family.  What used to bring you happiness, the things you loved most, have all been stripped away. Eventually, you reach the point where you can’t do the most basic things. You can’t get out of bed or take care of yourself. It becomes more than you can handle. Everything is a colossal challenge. Every day is so exhausting, and it takes everything in you just to survive. That’s how I felt, day in and day out, for the better part of a decade. Then two years ago, amid the worst depression I’ve ever experienced, I made a promise to myself that I would do everything in my power, try every medication, every type of therapy and every treatment I could find to save myself: for me, this included 16 different antidepressants, acupuncture, reiki, transcranial magnetic stimulation on the left and right sides of my skull, and 12 courses of electroconvulsive therapy. After electroconvulsive therapy failed, I gave up. I was out of options. With nothing left in my arsenal, I started to accept that there had to be something wrong with me. It was the only conclusion that made sense. Maybe I was just meant to be unhappy, and overwhelming depression was going to be my life forever. Grace was diagnosed with major depressive disorder (MDD) with suicidal thoughts or actions after years of battling her depressive symptoms. It is not known if SPRAVATO ® (esketamine) CIII nasal spray is safe and effective for use in preventing suicide or in reducing suicidal thoughts or actions. If you or someone you know is struggling emotionally or has concerns about their mental health, please call 1-800-273-TALK (8255). Then I came across an article about SPRAVATO ® (esketamine) CIII nasal spray. It immediately piqued my interest. The most well-known and most commonly prescribed treatments for depression focus on the same neurotransmitters in the brain and have for decades. This medication is believed to take a different approach, and while the way it works is not completely understood, it is thought to act on a different neurotransmitter, called glutamate. After hours of research and speaking with my doctor, I decided to make an appointment with a certified provider to learn more. They warned me that SPRAVATO ® has risks and benefits and explained that this treatment’s risks and potential side effects included the potential for suicidal ideation, abuse or misuse. Dissociation and sedation can also occur while using the medication, so it is essential to have medical supervision during treatment. (Please see Important Safety Information including BOXED WARNINGS and a list of side effects below. Click here). And while this medication may not work for everyone, combined with my oral antidepressant, it was the right choice for me and has become an essential part of my treatment plan, which also includes talking with my therapist and loved ones, getting outside on a hike or finding a creative outlet in art. Treating depression is difficult because it’s hard to see any effect in the short term. It takes months for traditional antidepressants to build up in your system, and if a dosage increase is necessary, it can be months until you feel true progress. When I am struggling with depression, days feel like months, and months feel like years. There were so many times when I felt like I was taking one step forward and two steps back. At first, I didn’t see a difference in myself, but I think a good gauge of how your treatment is going is by talking to those around you. While I didn’t notice a difference right away, my family and my boyfriend did. I remember watching a movie with my mom, and I looked over at her and she said, “You’re laughing! You’re actually laughing again!” Within a month and a half, I felt my depressive symptoms had improved. I noticed a difference in wanting to be a part of things, engaging in conversation, going to family events and even to the store. Then, I eventually started painting, writing and taking care of myself again. Just doing more than surviving was huge, and I felt like a weight was beginning to lift off my shoulders. For so long, my only concern was getting through to the next day, so when I started to make plans and my future wasn’t so blank, I began feeling optimistic about the future again. It was slow at first, like planning a hike for the upcoming weekend, but now I’m finally able to imagine where I want to be in five years and have hope and faith in myself that I will be able to accomplish my goals. And yes, I still have bad days. But I’ve learned new strategies to deal with them. One thing that helps me is to list five things I am grateful for and five things I like about myself. It sounds simple but sometimes all you need is a reminder that you are worth it. The days, weeks and months can be long and hard, but keep trying. Finding the right treatment plan is hard. During the process, it’s easy to blame yourself and feel like you must be the problem. But now looking back, I know that simply isn’t true. I’m in a place that I never thought I would be in. I want to do more with my life, and I now know that I can. INDICATIONS What is SPRAVATO ® (esketamine) CIII nasal spray? SPRAVATO ® is a prescription medicine, used along with an antidepressant taken by mouth to treat: Adults with treatment-resistant depression (TRD) Depressive symptoms in adults with major depressive disorder (MDD) with suicidal thoughts or actions SPRAVATO ® is not for use as a medicine to prevent or relieve pain (anesthetic). It is not known if SPRAVATO ® is safe or effective as an anesthetic medicine. It is not known if SPRAVATO ® is safe and effective for use in preventing suicide or in reducing suicidal thoughts or actions. SPRAVATO ® is not for use in place of hospitalization if your healthcare provider determines that hospitalization is needed, even if improvement is experienced after the first dose of SPRAVATO ® . It is not known if SPRAVATO ® is safe and effective in children. IMPORTANT SAFETY INFORMATION What is the most important information I should know about SPRAVATO ®? SPRAVATO ® can cause serious side effects, including: Sedation and dissociation. SPRAVATO ® may cause sleepiness (sedation), fainting,  dizziness, spinning sensation, anxiety, or feeling disconnected from yourself, your  thoughts, feelings, space and time (dissociation). Tell your healthcare provider right away if you feel like you cannot stay awake or if  you feel like you are going to pass out. Your healthcare provider must monitor you for serious side effects for at least 2  hours after taking SPRAVATO ®. Your healthcare provider will decide when you are  ready to leave the healthcare setting. Abuse and misuse. There is a risk for abuse and physical and psychological dependence  with SPRAVATO ® treatment. Your healthcare provider should check you for signs of  abuse and dependence before and during treatment with SPRAVATO ®. Tell your healthcare provider if you have ever abused or been dependent on alcohol,  prescription medicines, or street drugs. Your healthcare provider can tell you more about the differences between physical and psychological dependence and drug addiction. SPRAVATO ® Risk Evaluation and Mitigation Strategy (REMS). Because of the risks for sedation, dissociation, and abuse and misuse, SPRAVATO ® is only available through a  restricted program called the SPRAVATO ® Risk Evaluation and Mitigation Strategy (REMS)  Program. SPRAVATO ® can only be administered at healthcare settings certified in the  SPRAVATO ® REMS Program. Patients treated in outpatient healthcare settings (e.g.,  medical offices and clinics) must be enrolled in the program. Increased risk of suicidal thoughts and actions. Antidepressant medicines may increase  suicidal thoughts and actions in some people 24 years of age and younger, especially within the first few months of treatment or when the dose is changed. SPRAVATO ® is not for use in children Depression and other serious mental illnesses are the most important causes of  suicidal thoughts and actions. Some people may have a higher risk of having  suicidal thoughts or actions. These include people who have (or have a family  history of) depression or a history of suicidal thoughts or actions. How can I watch for and try to prevent suicidal thoughts and actions in myself or a  family member? Pay close attention to any changes, especially sudden changes, in mood, behavior,  thoughts, or feelings, or if you develop suicidal thoughts or actions. Tell your healthcare provider right away if you have any new or sudden changes  in mood, behavior, thoughts, or feelings. Keep all follow-up visits with your healthcare provider as scheduled. Call your  healthcare provider between visits as needed, especially if you have concerns  about symptoms. Tell your healthcare provider right away if you or your family member have any of the  following symptoms, especially if they are new, worse, or worry you: suicide attempts thoughts about suicide or dying worsening depression other unusual changes in behavior or mood Do not take SPRAVATO ® if you: have blood vessel (aneurysmal vascular) disease (including in the brain, chest, abdominal  aorta, arms and legs) have an abnormal connection between your veins and arteries (arteriovenous  malformation) have a history of bleeding in the brain are allergic to esketamine, ketamine, or any of the other ingredients in SPRAVATO ®. If you are not sure if you have any of the above conditions, talk to your healthcare provider before taking SPRAVATO ®. Before you take SPRAVATO ®, tell your healthcare provider about all of your medical  conditions, including if you: have heart or brain problems, including: high blood pressure (hypertension) slow or fast heartbeats that cause shortness of breath, chest pain, lightheadedness,  or fainting history of heart attack history of stroke heart valve disease or heart failure history of brain injury or any condition where there is increased pressure in the brain have liver problems have ever had a condition called “psychosis” (see, feel, or hear things that are not there, or  believe in things that are not true). are pregnant or plan to become pregnant. SPRAVATO ® may harm your baby. You should not  take SPRAVATO ® if you are pregnant. Tell your healthcare provider right away if you become pregnant during treatment  with SPRAVATO ®. If you are able to become pregnant, talk to your healthcare provider about methods  to prevent pregnancy during treatment with SPRAVATO ®. There is a pregnancy registry for women who are exposed to SPRAVATO ® during  pregnancy. The purpose of the registry is to collect information about the health of  women exposed to SPRAVATO ® and their baby. If you become pregnant during  treatment with SPRAVATO ®, talk to your healthcare provider about registering with  the National Pregnancy Registry for Antidepressants at 1-844-405-6185 or online at  https://womensmentalhealth.org/clinical-and-research-programs/pregnancyregistry/antidepressants/. are breastfeeding or plan to breastfeed. You should not breastfeed during treatment with SPRAVATO ®. Tell your healthcare provider about all the medicines that you take , including prescription and  over-the-counter medicines, vitamins and herbal supplements. Taking SPRAVATO ® with certain  medicine may cause side effects. Especially tell your healthcare provider if you take central nervous system (CNS) depressants,  psychostimulants, or monoamine oxidase inhibitors (MAOIs) medicines. Keep a list of them to show to your healthcare provider and pharmacist when you get a new medicine. How will I take SPRAVATO ®? You will take SPRAVATO ® nasal spray yourself, under the supervision of a healthcare  provider in a healthcare setting. Your healthcare provider will show you how to use the  SPRAVATO ® nasal spray device. Your healthcare provider will tell you how much SPRAVATO ® you will take and when you  will take it. Follow your SPRAVATO ® treatment schedule exactly as your healthcare provider tells you  to. During and after each use of the SPRAVATO ® nasal spray device, you will be checked by a  healthcare provider who will decide when you are ready to leave the healthcare setting. You will need to plan for a caregiver or family member to drive you home after taking  SPRAVATO ®. If you miss a SPRAVATO ® treatment, your healthcare provider may change your dose and  treatment schedule. Some people taking SPRAVATO ® get nausea and vomiting. You should not eat for at least 2  hours before taking SPRAVATO ® and not drink liquids at least 30 minutes before taking  SPRAVATO ®. If you take a nasal corticosteroid or nasal decongestant medicine take these medicines at  least 1 hour before taking SPRAVATO ®. What should I avoid while taking SPRAVATO ®? Do not drive, operate machinery, or do anything where you need to be completely alert after  taking SPRAVATO ®. Do not take part in these activities until the next day following a restful  sleep. See “What is the most important information I should know about SPRAVATO ®?” What are the possible side effects of SPRAVATO ®? SPRAVATO ® may cause serious side effects including: See “What is the most important information I should know about SPRAVATO ®?” Increased blood pressure. SPRAVATO ® can cause a temporary increase in your blood  pressure that may last for about 4 hours after taking a dose. Your healthcare provider will  check your blood pressure before taking SPRAVATO ® and for at least 2 hours after you take SPRAVATO ®. Tell your healthcare provider right away if you get chest pain, shortness of  breath, sudden severe headache, change in vision, or seizures after taking SPRAVATO ®. Problems with thinking clearly. Tell your healthcare provider if you have problems thinking  or remembering. Bladder problems. Tell your healthcare provider if you develop trouble urinating, such as a  frequent or urgent need to urinate, pain when urinating, or urinating frequently at night. The most common side effects of SPRAVATO ® when used along with an antidepressant taken  by mouth include: feeling disconnected from yourself, your thoughts, feelings and things  around you dizziness nausea feeling sleepy spinning sensation decreased feeling of sensitivity (numbness) feeling anxious lack of energy increased blood pressure vomiting feeling drunk feeling very happy or excited If these common side effects occur, they usually happen right after taking SPRAVATO ® and go  away the same day. These are not all the possible side effects of SPRAVATO ®. Call your doctor for medical advice about side effects. You may report side effects to FDA at  1-800-FDA-1088. Please see full Prescribing Information , including Boxed WARNINGS, and Medication Guide for SPRAVATO ® and discuss any questions you may have with your healthcare provider. cp-170363v1 For more information about SPRAVATO ®, please visit www.spravato.com. This information is intended for the use of patients and caregivers in the United States and its territories only. Laws, regulatory requirements and medical practices for pharmaceutical products vary from country to country. The Prescribing Information included here may not be appropriate for use outside the United States and its territories. cp-266083v1