Treatments for Depression
The very good news is that depression is both treatable and curable, and the even better news is that seeking help is the first step towards getting better.
Admitting that you are depressed can be very difficult for some people (see our page What is Depression?) but it is unlikely that sufferers can be helped until they do.
Treatments for depression fall into two main categories: those that involve talking to a professional and those involving prescribed drugs. Many sufferers will need both.
Those with severe depression may well need drug treatment to get them feeling well enough to concentrate on talking therapy. Analysis of why they became depressed may be necessary to bring about the lifestyle changes that will keep them feeling better and prevent depression from reoccurring in the long term.
Some other therapies may also be useful, such as art therapy or regular exercise.
There are many different kinds of depression and different treatments will help different individuals: see our page on Types of Depression for details.
Talking Therapy for Depression
Discussing your feelings can help to deal with them.
Sometimes it is a relief just to share the problem; sometimes someone else can help you to sort out what the problem really is. It can take another perspective to see patterns in your own behaviour or to help you understand the behaviour of someone else.
If depression has occurred following an unexpected event, such as bereavement, you may need help to come to terms with this and see how a different life can work.
Often it is easier to share feelings with a stranger and not have to feel guilty about 'burdening' others with the details, or about feeling upset for what others may see as an unacceptably long time.
There are three main types of talking therapists:
Psychiatrists are doctors who have specialised in mental health.
The differences between counsellors and psychotherapists is not quite as clear: psychotherapists are sometimes considered to offer a deeper level of therapy than that of a counsellor, therapy that leads to fundamental changes in behaviour, but not everyone agrees.
Talking therapies can be classified in many different ways: client-centred, cognitive analytical, cognitive behavioural (CBT), dynamical interpersonal, existential, Gestalt, personal construct, psychodynamic, rational-emotive behavioural (REBT), transactional analysis, and transpersonal, to name some of the most common! The Mind website (www.mind.org.uk) provides an excellent overview of these approaches to talking therapy.
Essentially, talking therapies all look at how you work and how you relate to other people. Some of them, such as existential and transpersonal therapy, look at what you want out of life, while others, such as psychodynamic therapy, look at how your past experiences influence you.
The two most common types of talking therapy are:
Client-centred (also known as person-centred).
This is based on the idea that the therapist offers you empathy, warmth and openness and that that in itself is therapeutic. Many therapists incorporate this idea into other, more specialised, types of therapy that they offer.
Cognitive Behavioural Therapy or CBT.
This looks at how your thinking and your inner assumptions affect your perspective on what happens to you. For example, you might believe certain things about yourself (for example, “it's always my fault”) which are not necessarily true and, if you can challenge this assumption, you can feel better. You may choose certain behaviours that are not always positive (for example, being confrontational in every situation) and may find that you feel very much better once you choose to do something else.
Drug Treatments for Depression
As their name implies, 'antidepressants' are the most commonly prescribed drugs for depression and they help millions of people overcome their illness.
Antidepressants Quick Facts
- Antidepressants typically take several weeks to work and patients may need to persist through some initial side effects.
- Antidepressants aren't 'addictive' in the traditional sense but, as powerful drugs, patients need to come off them gradually.
- People with recurrent depression may take antidepressants indefinitely.
- There are many different kinds of antidepressants, some work well for some people and less well for others. Usually, if symptoms of depression persist after about six weeks, patients will be prescribed an alternative.
Exactly how antidepressants work is not always clear, but generally they increase the levels of signalling chemicals called neurotransmitters in the brain.
The most important one of these for mood is called serotonin and thus many drugs work by boosting serotonin levels.
- Selective serotonin reuptake inhibitors (SSRIs). These types of antidepressant are commonly prescribed and include Prozac (fluoxetine), which causes few side effects.
- Serotonin-noradrenaline reuptake inhibitors (SNRIs). This group of antidepressants, including Efexor (venlafaxine) may work better for some people than SSRIs.
- Tricyclic antidepressants (TCAs). These antidepressants are no longer usually recommended as a first-line treatment for depression because of potentially dangerous and unpleasant side effects, especially if an overdose is taken.
- Monoamine oxidase inhibitors (MAOIs). This outdated type of antidepressant is now rarely used due to a higher likelihood of undesirable side effects and the need for a specialised diet while taking them. They may however still be used if other types of antidepressants are not effective. MAOIs should only be taken under the supervision of a psychiatrist.
Anti-psychotic drugs may also be used in cases of severe depression, especially if the patient is anxious or has had any psychotic episodes, such as delusions or hallucinations. These symptoms are more common in other mental health conditions such as schizophrenia, mania or bipolar disorder but may occur in depression too.
Depression is a curable condition.
If the first treatment that you try does not work for you, please keep trying until you find one that does, don't give up. You can feel better.
Although recognising you are depressed and seeking professional help is very important, there are some additional things that you can do to help yourself to feel well again.
Avoid stressful situations. Being depressed is a very stressful experience in itself so try to avoid adding to your stress and avoid stressful situations when possible. You may find our page Avoiding and Managing Stress useful.
Relaxation. Being depressed is exhausting and it can be very difficult to turn off the negative feelings you encounter. You may find it useful to practice some relaxation techniques.
Exercise. You may find it difficult to think about exercise but even taking a short walk can help. See our page The Importance of Exercise for more information.
Diet. It is always important to eat a well-balanced diet, but during times of depression you may find that you eat very little or too much or the wrong types of food. See our page Stress, Nutrition and Diet for further information and some tips.
Sleep. Getting adequate, good quality sleep can be a challenge when you're depressed. Ensure your sleep hygiene is good to maximise your chances of proper sleep. See our page: The Importance of Sleep for help.
Talk. Although talking to a professional is very often an effective treatment for depression, talking to friends and family about how you feel can be equally valuable. It is important, however, that people don't offer advice such as 'just pull yourself together' or 'what have you got to be miserable about?' as such statements can be counterproductive.