Treatments for Depression

WebMD Medical Reference

The good news about depression is that you have a number of excellent treatments to choose from. More than 80% of people who get treatment for depression say that it helps them feel better.

Here's a rundown of some of the most common approaches. Many people use a mix. For instance, you might try medicine and therapy at the same time. Some studies show that using both together is better than using either one alone.

Talk Therapy

Talking with a trained therapist is one of the best treatments for depression. Many studies show that it helps. Some people choose to be in therapy for several months to work on a few key issues. Other people prefer to stay in therapy for years, gradually working through larger problems. The choice is up to you. Here are some common types of therapy.

  • Cognitive behavioral therapy helps you see how behaviors -- and the way you think about things -- play a role in your depression. Your therapist will help you change some of these unhealthy patterns. This is a very hands-on approach.
  • Interpersonal therapy focuses on your relationships with other people and how they affect you. Your therapist will also help you identify and change unhealthy behaviors.
  • Psychodynamic therapy is a more traditional form of therapy. It focuses on the deeper roots of your problems. Your therapist might encourage you to talk about hard things in your past, especially your childhood. This type of therapy is often done during a longer period.

Medicines

Medicines are the other key treatment for depression. There are now dozens of antidepressants that your health care provider can choose from. They include:

  • SSRIs (selective serotonin reuptake inhibitors.) These common medicines include some well-known names, like Lexapro , Paxil, Prozac, and Zoloft. Side effects are generally mild. They include stomach upset, sexual problems, insomnia, dizziness, weight change, and headaches.
  • Newer types. Researchers have developed many new types of antidepressants in recent years. These include drugs like Wellbutrin, Cymbalta, and Effexor . Cymbalta and Effexor may also ease chronic pain in people with depression. Side effects are usually mild. They include stomach upset, sleep problems, sexual problems, dizziness, and weakness.
  • Older antidepressants. Tricyclic antidepressants and Monoamine Oxidase Inhibitors (MAOIs) were some of the first medicines used to treat depression. While they work well, they can cause serious side effects and interact with some drugs and foods. Because newer medicines work just as well, these drugs aren't used as often anymore. But if you can't take newer medicines for some reason, your health care provider may suggest these.

ECT (electroconvulsive therapy)

This is a safe and effective treatment for people with serious depression. It's typically used on people who haven't been helped by medicines or therapy.

In ECT, your doctor will use electric charges to create a controlled seizure. These seizures seem to change the chemical balance of the brain. It may sound scary. But during the procedure, you'll be unconscious, so you won't feel anything.

ECT tends to work very quickly. It also works well -- about 80%-90% of people who receive it show improvement. The most common side effect is temporary memory loss.

You might have up to 12 sessions over a few weeks. Some people get "maintenance" therapy with ECT to prevent depression from returning.

Experimental Treatments

Other treatments are being tested right now. Vagus Nerve Stimulation (VNS) is a treatment for epilepsy that researchers are trying with depression. It involves implanting a small device in your chest, like a pacemaker. But instead of sending electrical charges to the heart, it sends them to a nerve in your neck. These charges may change the balance of chemicals in your brain and relieve depression.

Other treatments involve powerful magnets to change the levels of brain chemicals. None of these approaches have been approved for people with depression. But they may be in the future.

Alternative Treatments

Some people use herbs, supplements, and other alternative therapies for depression. However, none of these approaches has been proven to work. Herbs and supplements -- like St. John's Wort -- can have side effects and cause interactions with other medicines. Never start taking an herb or supplement without talking to your doctor first.

Other unproven alternative treatments -- like acupuncture, hypnosis, and meditation -- may help some people with their symptoms. Since they have few risks, you might want to try them, provided that your health care provider says it's OK.


Published April 2005.

Reviewed by Charlotte E. Grayson, MD.

SOURCES: American Psychiatric Association: "Practice Guideline for the Treatment of Patients With Major Depression," 2000. Fochtmann, L. and Gelenberg, A. Guideline Watch: Practice Guideline for the Treatment of Patients With Major Depressive Disorder, 2nd Edition. Focus, Winter 2005: vol 3: pp 34-42. Compton M. "Depression and Bipolar Disorder," ACP Medicine, Psychiatry II, 2003. DeRubeis, R. Archives of General Psychiatry, April, 2005; vol 62: pp 409-416. Glass R. The Journal of the American Medical Association, March 14, 2001; vol 285: pp 1346-1348. Depression and Bipolar Support Alliance: "What You Need to Know About Dietary Supplements." Depression and Bipolar Support Alliance: "Psychotherapy: How It Works and How It Can Help." Depression and Bipolar Support Alliance: "New Technologies in the Treatment of Mood Disorders." Depression and Bipolar Support Alliance: "Finding Peace of Mind: Treatment Strategies for Depression and Bipolar Disorder." Depression and Bipolar Support Alliance: "Healthy Lifestyles." Depression and Bipolar Support Alliance: "Guide to Depression and Bipolar Disorder," 2002. National Institutes of Mental Health: "Depression," Reprinted 2002. National Institute of Mental Health: "Medications," Revised 2002. National Institute of Mental Health: "The Numbers Count: Mental Disorders in America." ©1996-2005

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Last Editorial Review: 11/8/2005