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Treatment options for depression
Tags: Public Health, Family Medicine, Psychiatry
Medications and psychotherapy are effective for most people with depression. Your primary care doctor or psychiatrist can prescribe medications to relieve symptoms. However, many people with depression also benefit from seeing a psychiatrist, psychologist or other mental health professional If you have severe depression, you may need a hospital stay, or you may need to participate in an outpatient treatment program until your symptoms improve.
Here's a closer look at depression treatment options.
Finding the right medication
If a family member has responded well to an antidepressant, it may be one that could help you. Or you may need to try several medications or a combination of medications before you find one that works. This requires patience, as some medications need several weeks or longer to take full effect and for side effects to ease as your body adjusts.
Inherited traits play a role in how antidepressants affect you. In some cases, where available, results of genetic tests (done by a blood test or cheek swab) may offer clues about how your body may respond to a particular antidepressant. However, other variables besides genetics can affect your response to medication.
Psychotherapy
Psychotherapy is a general term for treating depression by talking about your condition and related issues with a mental health professional. Psychotherapy is also known as talk therapy or psychological therapy.
Different types of psychotherapy can be effective for depression, such as cognitive behavioral therapy or interpersonal therapy. Your mental health professional may also recommend other types of therapies. Psychotherapy can help you:
- Adjust to a crisis or other current difficulty
- Identify negative beliefs and behaviors and replace them with healthy, positive ones
- Explore relationships and experiences, and develop positive interactions with others
- Find better ways to cope and solve problems
- Identify issues that contribute to your depression and change behaviors that make it worse
- Regain a sense of satisfaction and control in your life and help ease depression symptoms, such as hopelessness and anger
- Learn to set realistic goals for your life
- Develop the ability to tolerate and accept distress using healthier behaviors
Figure 1. Mean Percentage Symptom Reduction from Un-blinded and Blinded Treatment Arms from Published Depression Trials Compared to Data from Pivotal Registration Depression Trials as Reported by the FDA. (Adapted from Khan et al. 2012)
Alternate formats for therapy
Formats for depression therapy as an alternative to face-to-face office sessions are available and may be an effective option for some people. Therapy can be provided, for example, as a computer program, by online sessions, or using videos or workbooks. Programs can be guided by a therapist or be partially or totally independent.
Before you choose one of these options, discuss these formats with your therapist to determine if they may be helpful for you. Also, ask your therapist if he or she can recommend a trusted source or program. Some may not be covered by your insurance and not all developers and online therapists have the proper credentials or training.
Smartphones and tablets that offer mobile health apps, such as support and general education about depression, are not a substitute for seeing your doctor or therapist.
Mind-body connections
Integrative medicine practitioners believe the mind and body must be in harmony for you to stay healthy. Examples of mind-body techniques that may be helpful for depression include:
- Acupuncture
- Relaxation techniques such as yoga or tai chi
- Meditation
- Guided imagery
- Massage therapy
- Music or art therapy
- Spirituality
- Aerobic exercise
Relying solely on these therapies is generally not enough to treat depression. They may be helpful when used in addition to medication and psychotherapy.
Coping and support
Talk with your doctor or therapist about improving your coping skills, and try these tips:
- Simplify your life. Cut back on obligations when possible, and set reasonable goals for yourself. Give yourself permission to do less when you feel down.
- Write in a journal. Journaling, as part of your treatment, may improve mood by allowing you to express pain, anger, fear or other emotions.
- Read reputable self-help books and websites. Your doctor or therapist may be able to recommend books or websites to read.
- Locate helpful groups. Many organizations, such as the National Alliance on Mental Illness (NAMI) and the Depression and Bipolar Support Alliance, offer education, support groups, counseling and other resources to help with depression. Employee assistance programs and religious groups also may offer help for mental health concerns.
- Don't become isolated. Try to participate in social activities, and get together with family or friends regularly. Support groups for people with depression can help you connect to others facing similar challenges and share experiences.
- Learn ways to relax and manage your stress. Examples include meditation, progressive muscle relaxation, yoga and tai chi.
- Structure your time. Plan your day. You may find it helps to make a list of daily tasks, use sticky notes as reminders or use a planner to stay organized.
- Don't make important decisions when you're down. Avoid decision-making when you're feeling depressed, since you may not be thinking clearly.
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