Therapy, medication, self-help? If you’re confused by all the different treatment options for depression, here’s how to decide the best approach for you.
Finding the best depression treatment for you
When you’re depressed, it can feel like you’ll never get out from under a dark shadow. However, even the most severe depression is treatable. So, if your depression is keeping you from living the life you want to, don’t hesitate to seek help. From therapy to medication to healthy lifestyle changes, there are many different treatment options available.
Of course, just as no two people are affected by depression in exactly the same way, neither is there a “one size fits all” treatment to cure depression. What works for one person might not work for another. By becoming as informed as possible, though, you can find the treatments that can help you overcome depression, feel happy and hopeful again, and reclaim your life.
Depression treatment tips
Learn as much as you can about your depression. It's important to determine whether your depression symptoms are due to an underlying medical condition. If so, that condition will need to be treated first. The severity of your depression is also a factor. The more severe the depression, the more intensive the treatment you're likely to need.
It takes time to find the right treatment. It might take some trial and error to find the treatment and support that works best for you. For example, if you decide to pursue therapy it may take a few attempts to find a therapist that you really click with. Or you may try an antidepressant, only to find that you don't need it if you take a daily half hour walk. Be open to change and a little experimentation.
Don't rely on medications alone. Although medication can relieve the symptoms of depression, it is not usually suitable for long-term use. Other treatments, including exercise and therapy, can be just as effective as medication, often even more so, but don't come with unwanted side effects. If you do decide to try medication, remember that medication works best when you make healthy lifestyle changes as well.
Get social support. The more you cultivate your social connections, the more protected you are from depression. If you are feeling stuck, don't hesitate to talk to trusted family members or friends, or seek out new connections at a depression support group, for example. Asking for help is not a sign of weakness and it won't mean you're a burden to others. Often, the simple act of talking to someone face-to-face can be an enormous help.
Treatment takes time and commitment. All of these depression treatments take time, and sometimes it might feel overwhelming or frustratingly slow. That is normal. Recovery usually has its ups and downs.
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Lifestyle changes: An essential part of depression treatment
Lifestyle changes are simple but powerful tools in the treatment of depression. Sometimes they might be all you need. Even if you need other treatment as well, making the right lifestyle changes can help lift depression faster—and prevent it from coming back.
Lifestyle changes to treat depression
Exercise. Regular exercise can be as effective at treating depression as medication. Not only does exercise boost serotonin, endorphins, and other feel-good brain chemicals, it triggers the growth of new brain cells and connections, just like antidepressants do. Best of all, you don't have to train for a marathon in order to reap the benefits. Even a half-hour daily walk can make a big difference. For maximum results, aim for 30 to 60 minutes of aerobic activity on most days.
Social support. Strong social networks reduce isolation, a key risk factor for depression. Keep in regular contact with friends and family, or consider joining a class or group. Volunteering is a wonderful way to get social support and help others while also helping yourself.
Nutrition. Eating well is important for both your physical and mental health. Eating small, well-balanced meals throughout the day will help you keep your energy up and minimize mood swings. While you may be drawn to sugary foods for the quick boost they provide, complex carbohydrates are a better choice. They'll get you going without the all-too-soon sugar crash.
Sleep. Sleep has a strong effect on mood. When you don't get enough sleep, your depression symptoms will be worse. Sleep deprivation exacerbates irritability, moodiness, sadness, and fatigue. Make sure you're getting enough sleep each night. Very few people do well on less than seven hours a night. Aim for somewhere between seven to nine hours each night.
Stress reduction. Make changes in your life to help manage and reduce stress. Too much stress exacerbates depression and puts you at risk for future depression. Take the aspects of your life that stress you out, such as work overload or unsupportive relationships, and find ways to minimize their impact.
Ruling out medical causes of depression
If you suspect that you may be depressed, and lifestyle changes haven't worked, make an appointment to see your primary care doctor for a thorough checkup. If your depression is the result of medical causes, therapy and antidepressants will do little to help. The depression won't lift until the underlying health problem is identified and treated.
Your doctor will check for medical conditions that mimic depression, and also make sure you are not taking medications that can cause depression as a side effect. Many medical conditions and medications can cause symptoms of depression, including sadness, fatigue, and the loss of pleasure. Hypothyroidism, or underactive thyroid, is a particularly common mood buster, especially in women. Older adults, or anyone who takes many different medications each day, are at risk for drug interactions that cause symptoms of depression. The more medications you are taking, the greater the risk for drug interactions.
Psychotherapy for depression treatment
If there is no underlying medical cause for your symptoms of depression, talk therapy can be an extremely effective treatment. What you learn in therapy gives you skills and insight to feel better and help prevent depression from coming back.
There are many types of therapy available. Three of the more common methods used in depression treatment include cognitive behavioral therapy, interpersonal therapy, and psychodynamic therapy. Often, a blended approach is used.
Some types of therapy teach you practical techniques on how to reframe negative thinking and employ behavioral skills in combating depression. Therapy can also help you work through the root of your depression, helping you understand why you feel a certain way, what your triggers are for depression, and what you can do to stay healthy.
Therapy and “the big picture” in depression treatment
One of the hallmarks of depression is feeling overwhelmed and having trouble focusing. Therapy helps you step back and see what might be contributing to your depression and how you can make changes. Here are some of the “big picture” themes that therapy can help with:
Relationships. Understanding the patterns of your relationships, building better relationships, and improving current relationships will help reduce isolation and build social support, important in preventing depression.
Setting healthy boundaries. If you are stressed and overwhelmed, and feel like you just can't say no, you are more at risk for depression. Setting healthy boundaries in relationships and at work can help relieve stress, and therapy can help you identify and validate the boundaries that are right for you.
Handling life's problems. Talking with a trusted therapist can provide good feedback on more positive ways to handle life's challenges and problems.
Individual or group therapy?
When you hear the word “therapy” you might automatically think of one-on-one sessions with a therapist. However, group therapy can be very useful in depression treatment as well. Both group and individual therapy sessions usually last about an hour. What are the benefits of each? In individual therapy, you are building a strong relationship with one person, and may feel more comfortable sharing some sensitive information with one person than with a group. You also get individualized attention.
In group therapy, listening to peers going through the same struggles can validate your experiences and help build self-esteem. Often group members are at different points in their depression, so you might get tips from both someone in the trenches and someone who has worked through a challenging problem. As well as offering inspiration and ideas, attending group therapy can also help increase your social activities and network.
When the going gets tough in therapy…
As with remodeling a house, when you take apart things that haven't worked well in your life, it often makes them seem worse before they get better. When therapy seems difficult or painful, don't give up. If you discuss your feelings and reactions honestly with your therapist, it will help you move forward rather than retreat back to your old, less effective ways. However, if the connection with your therapist consistently starts to feel forced or uncomfortable, don't be afraid to explore other options for therapy as well. A strong trusting relationship is the foundation of good therapy.
Finding a therapist
One of the most important things to consider when choosing a therapist is your connection with this person. The right therapist will be a caring and supportive partner in your depression treatment and recovery.
There are many ways to find a therapist:
- Word of mouth is one of the best ways to find a good therapist. Your friends and family may have some ideas, or your primary care doctor may be able to provide an initial referral.
- National mental health organizations can also help with referral lists of licensed credentialed providers.
- If cost is an issue, check out local senior centers, religious organizations, and community mental health clinics. Such places often offer therapy on a sliding scale for payment.
Medication for depression
Depression medication may be the most advertised treatment for depression, but that doesn't mean it is the most effective. Depression is not just about a chemical imbalance in the brain. Medication may help relieve some of the symptoms of moderate and severe depression, but it doesn't cure the underlying problem, and it's usually not a long-term solution. Antidepressant medications also come with side effects and safety concerns, and withdrawal can be very difficult. If you're considering whether antidepressant medication is right for you, learning all the facts can help you make an informed decision.
Even if you decide to take medication for depression, don't ignore other treatments. Lifestyle changes and therapy not only help speed recovery from depression, but also provide skills to help prevent a recurrence.
TMS therapy for depression
If you’re suffering from major depression that has been resistant to therapy, medication, and self-help, then TMS therapy may be an option. Transcranial magnetic stimulation (TMS) therapy is a noninvasive treatment that directs recurring magnetic energy pulses at the regions of the brain that are involved in mood. These magnetic pulses pass painlessly through the skull and stimulate brain cells which can improve communication between different parts of the brain and ease depression symptoms.
While TMS may be able to improve treatment-resistant depression, that doesn’t mean it’s a cure for depression or that your symptoms won’t return. However, it could provide sufficient improvements in your energy and drive to enable you to begin talk therapy or make the lifestyle changes—such as improving your diet, exercising, and building your support network—that can help preserve your depression recovery in the long term.
ECT for depression
Electroconvulsive therapy (ECT) is another noninvasive procedure that may help with depression that's resistant to psychotherapy, medication, and self-help. During ECT, electrodes deliver mild electrical pulses to parts of your brain. This triggers a brief seizure and flurry of brain cell activity. The procedure results in short-term relief from depression, but researchers aren’t entirely sure why. The therapeutic effect could be due to factors like changes in blood flow in the brain or the growth of new neurons.
Research indicates that ECT may be more effective than TMS in treating depression in the short term. However, ECT also seems to come with a higher risk of side effects, including memory impairment and headaches.
To learn more about the potential benefits and drawbacks to ECT, read Electroconvulsive Therapy (ECT): How it Works and What to Expect.
Alternative and complementary treatments
Alternative and complementary treatments for depression may include vitamin and herbal supplements, acupuncture, and relaxation techniques, such as mindfulness meditation, yoga, or tai chi.
Vitamins and supplements for depression
The jury is still out on how well herbal remedies, vitamins, or supplements work in treating depression. While many supplements are widely available over the counter, in many cases their efficacy has not been scientifically proven. If your depression symptoms are in part due to nutritional deficiency, you may benefit from vitamin supplements, but this should be on the advice of your healthcare professional.
If you decide to try natural and herbal supplements, remember that they can have side effects and drug or food interactions. For example, St. John's Wort—a promising herb used for treatment of mild to moderate depression—can interfere with prescription drugs such as blood thinners, birth control pills, and prescription antidepressants. Make sure your doctor or therapist knows what you are taking.
Other alternative treatments
Relaxation techniques. As well as helping to relieve symptoms of depression, relaxation techniques may also reduce stress and boost feelings of joy and well-being. Try yoga, deep breathing, progressive muscle relaxation, or meditation.
Acupuncture. Acupuncture, the technique of using fine needles on specific points on the body for therapeutic purposes, is increasingly being investigated as a treatment for depression, with some research studies showing promising results. If you decide to try acupuncture, make sure that you find a licensed qualified professional.
Authors: Melinda Smith, M.A., Lawrence Robinson, and Jeanne Segal, Ph.D.
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Last updated: December 30, 2022