Though the condition has the power to produce a range of severe symptoms and effects, professionals know how to treat depression with a plan that utilizes a combination of therapy and medications for depression. A person with depression may also benefit from at-home and nonprofessional options like lifestyle changes and self-help techniques to complement the results of other treatments.
No matter how damaging the disorder becomes, treatment options can create the desired change. With therapy, medication, or a combination of both, many people with depression can find relief, with therapy often lasting between eight and sixteen sessions.
Therapy for Depression
Therapy is a safe and effective form of treatment for many mental health conditions, including depressive disorders. Also called talk therapy or psychotherapy, the practice involves a therapist meeting with a person to investigate symptoms, identify possible causes, and find resolutions for the depression.1
A person may consider therapy if they are:
- Experiencing periods of high stress linked to a loss, relationship conflict, or changes at work, home, or school
- Noticing changes in mood, energy, sleep, diet, or motivation
- Hoping to improve the health and well-being of a loved one
- Seeking treatment options after a professional diagnosed them with depression or a related di1sorder
For many, therapy is an accessible and low-risk option to address unwanted symptoms. Even better, health insurances regularly pay for established, evidence-based forms of therapy, and in most situations, the person does not need a prescription or a referral to get started.
One therapy session can look quite different from another based on the location and treatment type. Therapy can occur in a number of settings like offices, schools, or the home. Additionally, therapy can involve only the individual and the therapist, or it could include a group of other people brought together by the same goal.
Therapy sessions also look differently based on the style or type of therapy that the professional uses. Some of the most effective therapy types for depression include:
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is a therapy style backed by extensive research and testing. With CBT, the therapist offers education regarding the connection between thoughts, feelings, and behaviors. By investigating negative, unhealthy thoughts and planning behavioral changes through new coping skills, the individual in treatment can move towards more desirable feelings.2 CBT uses structured sessions to produce helpful outcomes efficiently. This time-limited treatment style may conclude between eight and sixteen sessions.2
Interpersonal therapy (IPT) focuses on a person’s relationships with friends, family, classmates, and coworkers to see how these interactions affect depressive symptoms. With unhealthy relationships making depression worse, IPT hopes to find ways to modify communication when possible and avoid problematic people and relationships. Like CBT, IPT uses a short-term treatment approach to improve symptoms in a limited number of sessions.2
Rather than focusing on the person’s conscious awareness of their actions and thoughts, psychodynamic therapy turns towards the unconscious mind for answers about motivation and symptoms. Psychodynamic therapy helps people understand the impact of past experiences and then work to limit their impact. This therapy type uses two separate modes of treatment with short-term and long-term options.2
Depending on the age of the individual in treatment and their presenting problems, play therapy is another treatment option. With the use of toys, art, and other forms of play, play therapy helps younger people with depression practice changing their views, attitudes, and behavior. Play therapy is especially helpful for children with aggressive, defiant, and attention-seeking behaviors linked to depressive disorders.3
Other Types of Therapy You May Encounter
With people constantly looking for novel ways to diminish their depressive symptoms while improving their happiness, mental health professionals may offer other therapy types. These therapies could be new and groundbreaking while lacking sufficient evidence of their benefit, or they could be completely unhelpful interventions passed off as therapy. People may respond well to these treatments, or the therapies could end with harm.
Anyone seeking treatment for depression should be critical of treatments that include:
- Rebirthing therapy: the act of being symbolically reborn to aid in attachments
- Dream interpretation: analyzing the content of dreams to draw conclusions for life
- Therapeutic touch: the therapist touching, holding, or hugging client to improve relationships and mood
- Hypnotic age regression: prompting the client to access memories while under hypnosis4
There are endless alternatives, but people interested in the best chances of success from psychotherapy for depression should only engage in tested and effective styles.
Medication for Depression
Just like with therapy for depression, there is no one medication universally prescribed to improve symptoms in all people. However, with continued innovation, many available medications can improve symptoms. Because there may be some trial and error involved, people using medications to address their depression should use patience while the prescriber finds the best medication at the best dose.
Medications for depression, called antidepressants, work to increase the amounts of certain chemicals in the brain with the hopes of limiting symptoms.
When taking antidepressants, remember:
- Antidepressants require a prescription and are often covered by health insurances
- It can take a month or more for medications to work
- Never stop taking a medication without consulting with the prescriber
- Do not give up if you need to try more than one medication – prescribers learn a lot about what may help based on what does not help
- Antidepressants have side effects, so consult with the prescriber if they become problematic
- Medications help depression by increasing the amounts of certain chemicals called neurotransmitters, but experts are not exactly sure how they work5
Antidepressants fit into five different classes:
Serotonin Reuptake Inhibitors
This group includes selective serotonin reuptake inhibitors (SSRIs), the most commonly used drugs for depression, and serotonin modulators, a group of newer medications that target more serotonin receptors in the brain. Serotonin reuptake inhibitors have fewer side effects compared to other antidepressants.
Examples of SSRIs include (this is not a comprehensive list):
- citalopram (Celexa)
- escitalopram (Lexapro)
- fluoxetine (Prozac)
- paroxetine (Paxil)
- sertraline (Zoloft)5
Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs)
Like SSRIs, this class of medication helps to encourage more serotonin in the brain. SNRIs also increase norepinephrine, another neurotransmitter related to mood. SNRIs may also trigger some side effects like nausea, anxiety, and dizziness.
Examples of SNRIs include (this is not a comprehensive list):
- desvenlafaxine (Pristiq)
- duloxetine (Cymbalta)
- levomilnacipran (Fetzima)
- venlafaxine (Effexor)5
Atypical antidepressants target dopamine, as well as serotonin and norepinephrine to add another layer of effects on mood. These may have more side effects than the SSRIs and SNRIs, but fewer than the other classes.
Examples of atypical antidepressants include (this is not a comprehensive list):
- bupropion (Wellbutrin)
- mirtazapine (Remeron)
- nefazodone (Serzone)
- trazodone (Desyrel, Oleptro)5
Tricyclics and Tetracyclics
If someone is not responding well to the above medications, a prescriber may trial a tricyclic or tetracyclic. Like other antidepressants, these medicines help to increase the serotonin and norepinephrine in the brain, but these may trigger more serious side effects.
Examples include (this is not a comprehensive list):
- amitriptyline (Elavil)
- clomipramine (Anafranil)
- doxepin (Sinequan)
- imipramine (Tofranil)
- nortriptyline (Pamelor)5
Monoamine Oxidase Inhibitors (MAOIs)
MAOs are older medications that require a special diet to avoid serious side effects. Despite the risks, MAOIs help to slow the breakdown of dopamine, norepinephrine, and serotonin in the brain to manage the effects of depression.
Examples of MAOIs include (this is not a comprehensive list):
- phenelzine (Nardil)
- selegiline (Emsam)
- tranylcypromine (Parnate)5
utside of therapy and medications, there are several additional options for the treatment of depression. These options are available to people who did not respond well to other treatments or for people who seek an alternative path.
Other treatments for depression include:
- Brain stimulation therapies: By using electricity or magnets to stimulate the brain, treatments like electroconvulsive therapy (ECT), repetitive transcranial stimulation (rTMS), and vagus nerve stimulation (VNS) carry unique risks and benefits, so consulting with the treatment team is always recommended.
- Complementary and alternative medicines (CAM): Natural remedies, herbs, and dietary supplements may help with depression. People interested in options like St. John’s wort and folate should always check with their prescriber before trying them as many natural remedies have very serious interactions with medications.
- Experimental treatments: New treatments are always on the horizon. Currently, some researchers are investigating the efficacy of small doses of ketamine for depression, while others are exploring deep brain stimulation that places electrodes in specific areas of the brain.2
Lifestyle Changes & Self-Help Strategies for Depression
Numerous studies show that therapy and medications are effective ways to treat depression, but adding lifestyle changes and self-help strategies can enhance the benefits of professional interventions.
A person with depression can gain additional power and control over their symptoms by completing at-home strategies, such as:
Increasing physical activity will help increase the level of wanted neurotransmitters like serotonin in the brain. Exercise can also help self-esteem, increase feelings of empowerment, and build new social relationships.
Without a steady stream of nutrition, the body cannot form new brain chemicals to fight depression. When rebuilding a diet, plan to eat plenty of healthy foods, drink enough water, avoid sugary beverages, and eat foods with probiotics to support the digestive system.
Focus on Good Sleep
Sleep is essential to restoring a person’s mental and physical health, and people who lack sleep tend to see life in more negative ways. Prioritize sleep by seeking ways to increase the quality and quantity of daily rest.
Limit Alcohol and Other Drugs
Using substances like alcohol, marijuana, and other drugs may seem like helpful ways to manage depression, but their use may increase symptoms in the long-term. Avoid substance abuse and devote energy to healthier coping skills.
Cut the Stres
Though people can see the connection between stress and depression, cutting back on stress can seem impossible at times. To reduce stress, focus on identifying the cause of stress, practicing relaxation techniques, and searching for resolutions.
Cultivate Healthy Relationships
Depression can cause healthy relationships to shrink, so people must devote more time, energy, and attention to finding and strengthening healthy relationships. Joining a team or support group, enrolling in a class, volunteering time, or bonding with a pet can help foster healthy relationships.
Find a Purpose
With the hopelessness linked to depression, having a purpose or feeling useful can be challenging but necessary. To define their purpose, a person can reflect on their strengths and pay attention to what brings joy and happiness.
These lifestyle changes are mostly free and readily accessible to people wanting to improve their depression. Even if they lack the motivation to make physical changes, devoting time to cognitive changes can begin the fight against depression.6
Hospitalization for Depression
At times, symptoms of depression will become so severe the person will require a period of inpatient hospitalization.
Some reasons to seek hospitalization include:
- Thinking about or planning to harm oneself
- Thinking about or planning to harm someone else
- Being unable to care for their health and well-being
- Experiencing extreme paranoia, hallucinations, or delusional thinking due to depression with psychotic features7
People may voluntarily seek inpatient hospitalization by calling a local crisis line or presenting to their nearest emergency department. At other times, people will require involuntary hospitalization because depression is creating such intense symptoms. In either case, the person’s health and safety will be the primary concern.
Inpatient hospitalization involves living in the hospital and receiving treatment from a team of psychiatrists, social workers, therapists, nurses, and other support staff until symptoms improve and safety is reestablished. In most cases, an inpatient stay is brief, and the person can follow up with other levels of care after hospitalization ends.7
Questions to Ask About Depression Treatments
Since treatments vary and affect people differently, anyone considering professional depression services should ask questions of the potential providers. By doing so, the person can gain information about the specific course of treatment as well as the risks and benefits involved.
Questions to Ask about Therapy
Therapists will employ a range of therapy styles with tremendous variability based on their previous experiences and education.
To learn more about the treatments, someone interested in therapy should as questions like:
- What are your credentials? Are you licensed with the state? If so, how were those earned?
- Do you have a specialty?
- What type of therapy do you offer, and do you have any special training in this?
- What goals will you work towards in therapy?
- How will you protect my privacy and confidentiality?
- Can I contact you between sessions? Do you use texting, email, or social media?
- Is there a timeframe that you expect to see an improvement in my symptoms?
- How often will sessions be?
- Do you collaborate with other therapists about treatment or receive supervision about cases?
- Will you accept friends, family members, and other loved ones to attend these sessions?
- What will your role be as a therapist? Will you do more listening or talking?1
Pay attention to the answers to these questions. Each person should have control over their treatment and be a fully involved member of their treatment team. If the responses do not seem in your best interests, it could be time to move on to another therapist.
Questions to Ask About Medications
Like with therapy, people interested in seeking medication for their depression should come prepared with a list of questions to ensure this treatment is a good match for their needs.
Some questions for a prescriber include:
- What is your degree, your education, and your experience? Are you a psychiatrist, a general practitioner, a nurse, or some other type of prescriber?
- Do you treat mental health issues exclusively or only occasionally?
- Do you think these symptoms will be well-managed with one medication or a combination?
- Do you think therapy is an important part of this treatment plan?
- Will you communicate with my therapist if needed?
- Are you available for consultation in between appointments?
- What happens if side effects emerge?
- What happens if I miss a dose?
- Will the appointments always be with you, or will I see various prescribers?
- How will we know treatment is effective?1,5
The use of medications may lead to rare side effects, so establishing a safety plan with the prescriber is critical.
Questions to Ask About Lifestyle & Self Help
It will be the individual’s decision to start lifestyle and self-help strategies for improving their depression, but speaking with other members of the treatment team can help refine plans to increase their effectiveness.
Consider asking your treatment team:
- What types of exercise would be more appropriate for my fitness levels – yoga, running, walking, swimming, tai chi?
- What are some sleep hygiene tips to improve my rest?
- Can you help establish a healthy diet and eating plan that fits my needs?
- Are there available support groups, volunteer opportunities, or community activities that could help with my relationships?
- Is my alcohol or other drug use affecting my depression? How can I improve it?
- What stress reduction and relaxation techniques would be best for me?
- How can I find purpose and meaning in life when my optimism is so low?
Remember, above all else, treatment for depression can work. People may feel discouraged and letdown, but depression will not alleviate without consistent and dedicated treatment. Even if a person feels far from it, they can achieve their goals.
Additional Resources for Depression Treatments
For more information about depression and effective treatments, please browse these professional organizations: