Exploring your depression treatment options

Therapy, Medication, and Lifestyle Changes That Can Help

Depression Treatment

When you’re depressed, it can feel like you’ll never get out from under its shadow. But take heart. Even the most severe depression is treatable. With the right help and support, you can and will feel better.

There are many effective ways to deal with depression, including exercise, talk therapy, medication, natural supplements, and lifestyle choices. Learning about the treatment options will help you decide what measures are most likely to work best for your particular situation and needs. There are no quick fixes or instant cures, but if you're willing to work on yourself and stick with treatment, you'll find yourself out from under depression's shadow sooner than you think.
In This Article:

    * Depression treatment options
    * Lifestyle changes
    * Ruling out medical causes
    * Finding the right professional
    * Psychotherapy
    * Medication
    * Alternative and complementary treatments
    * Related links

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Exploring your depression treatment options

Just as no two people are affected the exact same way by depression, there is no “one size fits all” treatment that cures depression. What works for one person might not work for another. The best way to treat depression is to become as informed as possible about the treatment options, and then tailor them to meet your needs.
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 supports that works best for you. For example, it might take a few tries to find a therapist that you click with if you decide to pursue therapy. 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, studies show that other treatments, including exercise and therapy, can be just as effective or even more so. What's more, they don't come with unwanted side effects. If you do decide to try medication, remember that medication works best when you pursue therapy 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. Asking for help is not a weakness but a sign of strength.
    * 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 has its ups and downs.

Lifestyle changes: An essential part of depression treatment

Lifestyle changes are simple but powerful tools in treating depression. Sometimes they might be all you need. Even if you need other treatment, lifestyle changes go a long way towards helping lift depression. And they can help keep depression at bay once you are feeling better.
Lifestyle changes that can treat depression

    * Exercise. Regular exercise is a powerful depression fighter. Not only does it 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 activity on most days.
    * 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 7 hours a night. Aim for somewhere between 7 to 9 hours each night.
    * 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.
    * 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.

Putting lifestyle changes into practicePutting lifestyle changes into practice

It’s easy to talk about lifestyle changes, but it’s more of a challenge to make them part of your daily life—especially if your depression is severe.

For more information and steps on how to make these changes, see Dealing with Depression: Self-Help and Coping Tips.
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 low thyroid, is a particularly common mood buster, especially in women. The more medications you are taking, the more the risk for drug interactions. This is especially important to consider in older adults, who often take many different medications every day.
Finding a therapist to treat your depression

If there is no underlying medical cause for your symptoms of depression, then finding a mental health specialist is the next best step for treatment. Although there are many types of mental health professionals, 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. 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.
How do I know which therapist is best?How do I know which therapist is best?

Don’t be surprised if it takes a few tries to find the right therapist. You want someone that you feel you can trust and that you feel comfortable sharing your thoughts. A good therapist will not pressure you into treatment, and encourages questions about his or her qualifications and patient-therapist compatibility. Make sure that your therapist is licensed and credentialed.

To learn more, see Psychotherapy and Counseling.
Psychotherapy for depression treatment

Talk therapy is an extremely effective treatment for depression. Therapy gives you tools to treat depression from a variety of angles. What you learn in therapy gives you skills and insight to help prevent depression from coming back.

There are many types of therapy available. Three of the more common methods used in depression 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 what boundaries 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 for depression treatment?

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. What are the benefits of each? Both group and individual therapy sessions usually last about an hour. 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.

Don’t rule out group therapy, however. Listening to peers going through the same struggles can be tremendously validating 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. You also can get inspiration and ideas from hearing from others, and are of course increasing your social activities and network.
When the going gets tough in therapy...

Like house remodeling, taking apart things that haven't worked well in one's life 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.
Medication treatment 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 and personal decision about how best to treat your depression.

If you are taking medication for depression, don’t ignore other treatments. Lifestyle changes and therapy not only help speed recovery from depression, but provide skills to help prevent a recurrence.
Should you get antidepressants from your family doctor?

Family doctors might be the first professionals to recognize your depression. However, while they can prescribe antidepressants, it’s a good idea to explore your options with other mental health professionals who specialize in depression. Ask for a referral. You might end up working with a therapist and not needing medication at all. If you do need medication, a psychiatrist has advanced training and experience in depression, treatments, and medications.

See Antidepressants: Understanding Depression Medications
Alternative and complementary treatments for depression
Vitamins and supplements for depression treatment

If you’ve considered alternative treatments such as herbal remedies, vitamins or supplements for your depression, you are not alone. Many people with depression have considered them, and they are widely available over the counter.

The jury is still out on how well these remedies work. While some vitamins and herbal supplements may be promising alternative treatments for depression, research is still ongoing. Their efficacy has not been scientifically proven. If your depression symptoms are in part due to some sort of nutritional deficiency, you may benefit from additional vitamin supplementation, 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 for 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 depression treatments

      Relaxation techniques. Although research is still ongoing, relaxation techniques may not only help relieve symptoms of depression, but 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.