Excessive anxiety causes very unpleasant symptoms: dizziness or light-headedness, sweating, pounding heart, vomiting, diarrhea, shaking, muscle tension, inability to sleep. Many of these symptoms can be controlled by antianxiety drugs. All of these drugs can lead to psychological dependence when they are used regularly over periods of time that vary with the person and the medication. For this reason, they are normally used for short periods, often at the beginning of psychotherapy. {231} The most commonly prescribed antianxiety drugs include these (trade names): Atarax Ativan Centrax Clonopin Dalmane Doriden Equanil Librium Loxitane Paxipam Restoril Serax Tranxene Tybatran Valium Valmid Xanax Although relatively small percentages of patients experience them, as with most drugs, there may be side effects, including drowsiness, impaired judgment and performance, nausea/vomiting, ataxia (loss of voluntary muscle coordination), and agitation (paradoxical restlessness). Patients who have taken an antianxiety drug for a period of time are often instructed to reduce their dosage gradually to avoid mild, infrequently severe, withdrawal symptoms. Antianxiety drugs can reduce agitation and produce a relative sense of calm. But, unfortunately, patients usually develop a tolerance to any antianxiety drug after three to four months, and then the drug loses its effectiveness. Antianxiety drugs are usually limited, then, to short-term treatment. Long-term recovery from the symptoms of anxiety is the task of psychotherapy: to help clients change their attitudes, behavior, or way of life. _Depression_ Depression can be a seriously incapacitating emotional disorder. Depression can range from a lingering sense of sadness or grief to a feeling of utter hopelessness, guilt, despondency, uncontrollable crying, and suicidal thoughts. The following symptoms are typical: insomnia or early waking, loss of appetite and loss of interest in sex, inability to concentrate, great difficulty in making decisions, and a reduced desire and ability to assume job and family responsibilities. Though depression is called "the common cold of emotional illness," it is not to be taken lightly, since severe depression is life-threatening, as many {232} suicides testify. Depression affects one out of five people during their lifetimes; more women suffer from depression than men. At the time of this writing,[2] the most widely prescribed antidepressants are the tricyclics. They are most effective in treating endogenous depressions; MAO inhibitors (see below) are more useful in cases of "atypical" depression, which frequently is associated with a situation the patient cannot come to terms with, such as the loss of a job or of a loved one.