Treatments for Depression
Learn about the various treatments available to help with depression.
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Exploring treatments for depression is a crucial step towards recovery. This guide covers various options, including medication, talking therapies, and more. Remember, the right treatment is personal and best determined with professional guidance.
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Self-help resources
When dealing with depression, your doctor might suggest self-help resources as a starting point for treatment. These options are typically more accessible and quicker to start than other treatments, potentially improving your mood without the need for additional interventions. Your GP may recommend trying the following:
- Guided Self-Help Programme: This approach focuses on the interaction between your thoughts, feelings, beliefs, and behaviours, offering skills to better manage your emotional state. A healthcare professional will support you throughout the programme, with support available online, in person, or via phone.
- Physical Activity Programme: Group exercise classes specifically designed for individuals with depression can be beneficial. Depending on your location and financial situation, your GP might also provide access to free or low-cost exercise programmes. Discuss with your GP to explore available options.
These self-help strategies offer immediate access to support and empower you to take an active role in your recovery journey.
Talking therapies
The National Institute for Health and Care Excellence (NICE) suggests various talking therapies for treating depression, recognising their effectiveness in addressing the condition. Here are the recommended therapies:
- Cognitive Behavioural Therapy (CBT): Focuses on changing negative thought patterns and behaviours.
- Group CBT: CBT is in a group setting and offers peer support.
- Behavioural Activation (BA): Encourages engagement in meaningful activities to improve mood.
- Group BA: BA practised within a group environment.
- Group Mindfulness-Based Therapy: Uses mindfulness techniques to reduce stress and improve mood in a group setting.
- Interpersonal Psychotherapy (IPT): Addresses problems in personal relationships contributing to depression.
- Counselling: Provides a supportive environment to discuss feelings and solutions.
- Short-term Psychodynamic Psychotherapy (STPP): Explores unconscious patterns affecting current behaviour and mood.
- Problem-Solving Therapy: Develops skills to manage life’s problems effectively.
- Behavioural Couples Therapy: Involves your partner in therapy if relationship issues are affecting your depression.
It’s important to note that waiting times for NHS talking therapies can be lengthy in many areas. However, your doctor is there to assist you. They can inform you about the options available locally and help you choose the right therapy for you, based on your specific needs and circumstances.
Self-referral for Therapy in England:
In England, you might have the option to refer yourself for therapy through the NHS Talking Therapies for Anxiety and depression programme, formerly known as Improving Access to Psychological Therapies (IAPT). The NHS website offers a therapy finder tool to locate a service near you for self-referral.
Should I stop therapy if I start to feel better?
If therapy is making you feel better, that’s great news! But feeling better doesn’t mean you must stop therapy right away. It’s a good idea to chat with your therapist about how you’re feeling. You might decide together that you could keep going for a bit longer, try meeting less often, or maybe even try a different kind of therapy to help keep you feeling good.
NICE suggests trying group therapy or a course on mindfulness if you’ve felt down before. These can be really helpful, even if you haven’t tried talking therapy before. Remember, the best plan is one you and your therapist make together, based on how you’re doing.
Medication
Your GP might suggest medication like antidepressants for your depression, especially if it’s severe or other treatments haven’t worked. You could be offered medication alone or alongside talking therapy.
Some commonly prescribed medications include:
- SSRIs (Selective Serotonin Reuptake Inhibitors)
- SNRIs (Serotonin and Norepinephrine Reuptake Inhibitors)
- Tricyclics
- MAOIs (Monoamine Oxidase Inhibitors)
- Other types
In some cases, if your depression is very severe or keeps coming back, your doctor might add lithium to your treatment. If you’re experiencing psychotic symptoms with depression, antipsychotic medication might also be prescribed.
Finding the right medication can be immediate or take some time. You might need to try different ones to see what works best for you. If medication doesn’t seem to help, there are other options. Always feel free to discuss these with your doctor.
How long do I need to take medication for?
According to NICE guidelines, it’s recommended to continue taking antidepressants for at least 6 months after your depression symptoms have improved. However, if you’ve experienced multiple episodes of depression in the past, you might choose to stay on medication longer to help prevent future episodes.
This decision is based on your personal experience and health history, and it’s something you can discuss with your healthcare provider to determine the best course of action for you.
Coming off medication
When considering stopping your depression medication, it’s crucial not to stop abruptly. Suddenly stopping can lead to withdrawal symptoms or pose health risks with certain medications.
Here’s what to do if you’re thinking about coming off medication:
- Consult with a Healthcare Professional: Talk to the person who prescribed your medication or someone knowledgeable about the process.
- Understand the Risks: Learn about potential withdrawal symptoms and how to reduce them.
- Gradually Reduce Dosage: Taper off the medication slowly, following a plan agreed upon with your healthcare provider.
Deciding to continue or stop medication is usually up to you. You have the right to refuse or discontinue medication, although there are exceptions, such as being under certain sections of the Mental Health Act or lacking the mental capacity to make healthcare decisions.
For more detailed guidance on safely discontinuing psychiatric medication, it’s best to seek specific advice from healthcare professionals or look into resources designed to help with this process.
Additional treatments for depression
Besides medication and talking therapies, there are various treatments you can explore to help manage depression. These can be tried on their own or in combination with other treatments:
- Arts and Creative Therapies: Engaging in art, music, or dance to express and explore feelings.
- Complementary and Alternative Therapies: Such as acupuncture, massage, or herbal supplements.
- Mindfulness: Practicing being present and fully engaged in the moment which can help reduce stress and improve mood.
- Ecotherapy: Activities in nature, like gardening or walking, to boost mental well-being.
- Peer Support: Sharing experiences and support with others who have faced similar challenges.
Your doctor might refer you to services that offer these treatments, or you might be able to try some of them on your own. Additionally, contacting your local Mind organisation can provide information on what’s available in your area.
What if medication or therapy doesn’t work?
If medication or therapy hasn’t been effective in treating your depression, your doctor might discuss alternative options with you. Initially, they may suggest trying different types of therapy or medication to see if another approach works better for you.
However, for severe depression that doesn’t respond to these treatments, there are less common methods that may be considered:
Electroconvulsive Therapy (ECT)
Electroconvulsive therapy (ECT) is a treatment that involves sending an electrical current through your brain.
NICE guidelines say that doctors should only offer this in certain, rare situations. For example, if you’re experiencing a long and severe period of depression and other treatments haven’t worked. Or you’re in a life-threatening situation.
If you feel like you’re in this situation, you could discuss ECT with your doctor. They should make sure you have clear and accessible information about ECT, so you understand it before deciding whether to have it.
See our pages on ECT for more information about this treatment and when it can be performed. And see our legal pages on consent to treatment and the Mental Capacity Act 2005 for information about your legal rights regarding treatment.
Repetitive Transcranial Magnetic Stimulation (rTMS)
Repetitive transcranial magnetic stimulation (rTMS) is a treatment where your brain is stimulated using magnetic fields. NICE guidelines say that doctors can offer this treatment for severe depression, if it hasn’t responded to other treatments.
Neurosurgery, VNS, and DBS
- Neurosurgery for Mental Disorder (NMD): Very rarely performed, and only when all other treatments haven’t worked. Consent is absolutely necessary.
- Deep Brain Stimulation (DBS) and Vagus Nerve Stimulation (VNS): Less invasive than NMD and reversible, these treatments are also considered rare and are used for severe depression.
These alternative treatments are generally considered only in extreme cases where conventional therapies haven’t led to improvement. It’s important to fully understand these treatments’ implications, benefits, and risks, which a healthcare professional can provide along with information on legal rights regarding consent to treatment.
Get support
Talk with a trained professional about your thoughts and feelings with out free counselling and private counselling service for people over the age of 18.