Therapy, medications, brain stimulation, and self-help strategies are just some of the many approaches to depression treatment.
There’s a wide variety of treatment options available for depression, but it can take some trial and error to find one — or a combo — that works for you.
While the cause of depression isn’t entirely known, it’s believed to be a blend of biological, social, and psychological factors. Treatment that focuses on only one of these factors may not be as helpful as an approach that addresses multiple aspects.
In fact, a combo of therapy and medication may lead to some of the best results.
Finding the right treatments can be tricky, though. Just because something works for some people, doesn’t mean it’ll work for you.
As you or a loved one seeks depression treatment, keep in mind that the first treatment isn’t always the right one. It’s normal for it to take some time to find the best treatment options.
Depression treatment is often a journey rather than a sprint. With patience and self-compassion, you can find methods that help you keep depression symptoms at bay.
Many types of therapy can help you manage depression and its symptoms.
While some types have undergone more rigorous research than others, approaches that help you identify thoughts, behaviors, and beliefs that add to depression are often considered the most effective.
Some helpful forms of therapy for depression include:
- cognitive behavioral therapy (CBT)
- interpersonal therapy (IPT)
- behavioral activation therapy (BA)
- acceptance and commitment therapy (ACT)
- problem-solving therapy (PST)
- short-term psychodynamic psychotherapy (STPP)
- couples or family therapy
Check out some more details on these therapy types below:
Cognitive behavioral therapy (CBT)
CBT is one of the most popular and commonly used therapies for depression. Hundreds of studies have verified its safety and effectiveness.
In CBT, the focus is on changing thoughts and behaviors that can worsen or encourage depression. These thoughts often contribute to:
- feelings of worthlessness
- frustration with yourself
- feelings of being “stuck” or “in a rut”
A therapist will usually work with you one-on-one to help you learn to replace these thoughts with more realistic thoughts that support your well-being and goals.
You don’t usually focus on your past in CBT. Instead, you’ll focus on changing your thoughts, feelings, and behaviors right now.
Interpersonal therapy (IPT)
In IPT, you address your social relationships and how to improve them.
Stable social support is often considered key to overall well-being. When relationships falter, it can negatively impact the people in them.
The aim of IPT is to improve a person’s relationship skills, such as:
- communicating effectively
- expressing emotions clearly
- being assertive in personal and professional situations
Like CBT, IPT usually takes place with a therapist one-on-one but also can be done in a group setting.
Behavioral activation therapy (BA)
BA therapy can help people change behaviors, which in turn may help change their moods.
Research has found BA to be just as effective as cognitive therapy in managing depression.
In BA, you might learn:
- to identify when you start to feel depressed
- how to engage in activities that line up with your beliefs and values
- replace behaviors that contribute to depression with ones that don’t
A BA therapist can help you identify your goals and achieve them. Recent
Acceptance and commitment therapy (ACT)
In ACT, acceptance and mindfulness are key. One of the main goals of ACT is to help people live according to their values while coping with uncomfortable thoughts and feelings.
If you live with depression, ACT may help you:
- focus on the present
- observe and accept uncomfortable thoughts and feelings
- identify what’s most meaningful and important to you
- act on your values
One study found that ACT’s emphasis on value-based action helped people reduce symptoms of depression.
Problem-solving therapy (PST)
In some cases, depression can cause people to view problems as threats or believe they’re incapable of solving the problem.
In PST, your therapist may help you:
- define the problem
- brainstorm alternative realistic solutions
- select a helpful solution
- put that solution in place and evaluate it
Short-term psychodynamic psychotherapy (STPP)
STPP focuses on interpersonal relationships and unconscious thoughts and feelings.
The primary goal of STPP is to reduce your depression symptoms. The secondary goal is to decrease your vulnerability to depression and increase your resilience.
Family or couples therapy
Family or couples therapy can help if depression is impacting your family dynamic or the health of your relationships.
These therapies tend to focus on:
- interpersonal relationships of family members
- clear and straightforward communication
- the roles of family members in managing your depression
- education about depression and mental health
Therapy is an active collaboration between you and your therapist (and sometimes loved ones).
Whatever therapy you choose, taking a proactive approach can help. This means keeping up with assignments between sessions and letting your therapist know if you have any concerns.
Antidepressants are the most commonly prescribed medications for depression.
Most antidepressants prescribed today are both safe and effective when taken according to your healthcare professional’s directions.
In the United States, antidepressants are often prescribed by family doctors or general practitioners. But many people find it most helpful to work with a psychiatrist or other mental health professional, as they may have extensive knowledge of medication types and side effects.
Your doctor will recommend a medication based on factors such as:
- your past experiences with meds
- side effects you experienced with any other medications
- co-occurring medical or mental health conditions
- any other meds you’re taking
- your personal preference
- the medication’s short and long-term side effects
- the toxicity of overdose
- any history your relatives have had with the medication
- financial constraints
It can take up to 6 to 8 weeks to start getting results with most antidepressants, so you may need to give it some time. If you experience side effects, many will go away before this point.
Keep in mind that you might not feel better with the first medication you try — sometimes you might need to try a few different types before finding the meds that work for you.
Selective serotonin reuptake inhibitors (SSRIs)
SSRIs are some of the most prescribed antidepressants for depression.
SSRIs increase the amount of serotonin in the brain. Researchers aren’t exactly sure why an increase in serotonin helps relieve depression, but decades’ worth of
Some of the most common SSRIs are:
- fluoxetine (Prozac)
- paroxetine (Paxil)
- sertraline (Zoloft)
- fluvoxamine (Luvox)
- citalopram (Celexa)
While SSRIs are usually well-tolerated, most people experience some side effects while taking them. These might include:
- lowered sex drive
- weight gain
For most people, these initial side effects dissipate within 3 to 4 weeks. Some side effects, such as tremors cause by serotonin syndrome or weight gain, are long-term side effects of taking SSRIs.
Serotonin syndrome occurs when you have too much serotonin in your body. This can cause mild to severe side effects and can be fatal if you don’t receive quick treatment.
If you take an antidepressant and notice symptoms like tremors, rapid heartbeat, or hallucinations, it’s important to let your doctor know right away.
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
SNRIs work by boosting the levels of two neurotransmitters — serotonin and norepinephrine — in your brain. These chemicals play an essential role in your mood.
Some commonly prescribed SNRIs include:
- venlafaxine (Effexor)
- duloxetine (Cymbalta)
SNRIs can cause many of the same side effects as SSRIs.
They can also cause:
- lack of energy
If an SSRI isn’t working for you, your doctor might prescribe an SNRI. If you also have anxiety, an SNRI may be a better option since some are used to treat anxiety disorders.
Tricyclic antidepressants (TCAs)
TCAs are older antidepressants, and while they’re not prescribed as often as SSRIs and SNRIs, they still help some people manage depression.
Some common TCAs include:
- doxepin (Adapin)
- clomipramine (Anafranil)
- amitriptyline (Elavil)
- imipramine (Tofranil)
Some common side effects of TCAs include:
- weight gain
- heart problems
- blurred vision
Since TCAs generally cause more side effects than newer antidepressants, they’re usually considered an option only if newer antidepressants don’t work for you.
Monoamine oxidase inhibitors (MAOIs)
MAOIs aren’t prescribed as frequently as other types of antidepressants anymore. This is because they’ve been known to cause severe side effects and have unwanted interactions with many foods and other drugs.
A few examples of MAOIs include:
- tranylcypromine (Parnate)
- phenelzine (Nardil)
- isocarboxazid (Marplan)
Side effects of MAOIs include:
- dry mouth
MAOIs can interact with other drugs and antidepressants, some supplements and herbs, and certain foods (especially those that contain high levels of tyramine).
Your doctor may only prescribe an MAOI if other types of medications aren’t working for you.
Atypical antidepressants don’t fall into any of the other antidepressant classes. They’re often prescribed when a person hasn’t improved with a common SSRI.
Examples of atypical antidepressants include:
- nefazodone (Serzone)
- trazodone (Desyrel)
- bupropion (Wellbutrin)
Sometimes these meds are prescribed when others cause severe side effects, or in combination with other antidepressants.
Mood stabilizers and antipsychotics
Your doctor might also prescribe an atypical antipsychotic to boost the effectiveness of your antidepressant.
The following atypical antipsychotics are sometimes used to add to your treatment:
- aripiprazole (Abilify)
- quetiapine XR (Seroquel XR)
- olanzapine-fluoxetine (Symbyax)
- brexpiprazole (Rexulti)
Lithium, a mood stabilizer commonly used to treat bipolar disorder, is also sometimes used to treat major depressive disorder.
Ketamine is one of the newest treatments for severe forms of depression.
In 2019, the FDA approved a prescription nasal spray called esketamine (Spravato). It’s a fast-acting drug derived from ketamine and can be taken along with an antidepressant to treat severe depression.
Spravato must be taken at a doctor’s office or clinic. Because Spravato can have severe side effects, including sedation and dissociation, people are monitored by their doctor for 2 hours after taking the med.
While apparently effective for many people who try it, the long-term effects of ketamine haven’t been studied yet. Since it’s so new, it may also be harder to obtain and is only recommended for treatment-resistant depression.
Brain stimulation therapies help treat depression with electricity acting on the brain.
While therapy and meds are used much more often than brain stimulation therapies, they may be effective for reducing depression in some people.
Electroconvulsive therapy (ECT)
ECT is considered an effective treatment option for severe, chronic, or treatment-resistant depression.
ECT isn’t typically an initial treatment for depression, though. This is because you’re placed under general anesthesia, may need to take time off work or school, and it can come with side effects like memory loss.
Repetitive transcranial magnetic stimulation (rTMS)
rTMS is a newer type of brain stimulation that may be an alternative to and more accessible than ECT.
In rTMS, a technician places an electromagnet on the scalp that generates magnetic field pulses roughly to the strength of an MRI scan. These pulses pass readily through the skull and may stimulate the cerebral cortex.
Potential benefits of rTMS that have been observed include:
- no systemic side effects such as: weight gain, sexual dysfunction, sedation, nausea, or dry mouth
- no adverse effects on concentration or memory
- reduced risk of device-drug interactions
Seizures are also much less likely to occur as a side effect compared to other brain therapies.
The most common adverse event related to treatment was mild to moderate scalp pain or discomfort during treatments, which lessened after the first week of treatment.
In some cases, hospitalization may be the best way to keep someone safe if their depression is severe. But hospitalization is typically only necessary if someone poses a danger to themselves or others.
Hospitalization for depression requires a lot of care. It’s usually best when someone can check themselves into a hospital. This way, they’re able to give their full consent to treatment.
Involuntary hospitalization to a psychiatric hospital is fairly rare, and there are legal requirements involved. In order for someone to be placed in hospitalization against their will, it typically has to be very clear that it’s the best way to help that person.
Hospitalization is usually relatively short — often until you’re stabilized and have a treatment plan. In some cases, you may only need a partial hospitalization plan.
Are you or a loved one in crisis?
If you believe you or a loved one is in crisis and may need hospitalization, there are many options available for immediate help:
- Call a suicide prevention hotline. You can call the National Suicide Prevention Hotline in the U.S. at 800-273-8255 or find a helpline through Befrienders Worldwide.
- Text “HOME” to the Crisis Text Line at 741741.
- Call or visit a local emergency room or psychiatric care center to speak with a mental health professional.
A variety of self-help strategies, including home remedies and lifestyle changes, can empower you with tools to manage your depression.
It’s not uncommon to want to try home remedies — such as supplements and teas — either before starting prescription meds or in combination with your current treatment.
While some of these remedies can be helpful, before you start anything, reach out to a healthcare professional. Some remedies interact with antidepressants or other meds, or may only work for mild symptoms.
Like anything else, home remedies may or may not work for you, but most are generally safe to try.
St. John’s wort
St. John’s wort is a popular herbal remedy for depression — though it does come with its fair share of interactions.
Research suggests that St. John’s wort can help people with mild and moderate depression. A
However, St. John’s wort interacts (sometimes dangerously) with several medications:
- birth control pills
- warfarin, a blood thinner
- other medications for the heart, HIV, or cancer
It may also make you more sensitive to sunlight, and cause interactions with certain foods.
Recent research has found some evidence that saffron may be effective in treating mild to moderate depression.
Green and black tea
Tea contains compounds — L-theanine and catechins, to name a couple — that may have antidepressant effects.
Omega-3 fatty acids
Omega-3 fatty acids are essential fats found in many fish, nuts, and seeds.
To get more omega-3s in your diet, you can add foods rich in them like salmon, mackerel, and chia seeds. You might also take a supplement if you’re not getting enough from diet alone.
Most people are lacking in vitamin D, and
While more research is needed to understand the link between depression and vitamin D, most doctors will support supplementing with vitamin D to help with mood and depression symptoms.
Probiotics often bring to mind gut health — but depression doesn’t just affect your thoughts.
In many cases, making lifestyle changes can help you reduce and manage depression symptoms.
While the ways you might choose to adjust your lifestyle are endless, below are a few tried-and-true strategies that have been used to help with depression.
For some people, one of the most effective strategies is to join a depression-focused support group.
You can find a variety of depression support groups online. These groups may give you the opportunity to:
- develop healthy relationships
- talk with people who have similar experiences and feelings
Mental Health America has a popular support group for people with depression, and the Depression and Bipolar Support Alliance has an online support group for people with depression and bipolar disorder.
Another excellent strategy is to read self-help books or workbooks on overcoming depression. Some examples include:
- “The Feeling Good Handbook”
- “Cognitive Behavioral Workbook for Depression: A Step-by-Step Program”
- “Mind Over Mood: Change How You Feel By Changing the Way You Think”
Some books emphasize a cognitive behavioral approach, which is similar to those used in many types of therapy. So these books can be helpful whether or not you’re currently working with a therapist (or in between sessions if you can’t access one frequently).
Engaging in physical activity and getting outdoors can be incredibly helpful in improving mood. Both sunlight and exercise have been well-established to boost mood and reduce depression symptoms.
If you’re currently not experiencing much sunshine where you live, consider trying a light therapy box. This can especially help if you experience seasonal symptoms of depression, like in seasonal affective disorder.
While saying that exercise can help with depression is one thing, actually doing it is another.
Depression often causes fatigue or lack of motivation — so be gentle with yourself. You don’t need to join a gym or start a daily workout program. Any movement and time spent outdoors can be a step in the right direction.
One way or the other, food affects mood.
In particular, people who ate higher amounts of fish (omega-3s!) and veggies were less likely to have depressive symptoms.
So if you want to give your mood a boost, try adding some more foods that support well-being into your diet.
If there’s one thing you can take away, let it be this: You’ve got endless options when it comes to managing your depression.
While it can feel overwhelming to some people, the more options means better opportunities to find the right treatments that work for you.
Depression treatment is often determined by how severe your symptoms are. One question you might ask yourself is, “How much does depression affect my everyday life?”
If your depression is severe — you find it hard to do much at all — talking with a doctor is a good first step. In many cases, a doctor will refer you to a mental health specialist who can connect you with treatments, like therapy or medication, to manage your symptoms.
If you consider your depression mild, it might help to start by implementing some lifestyle changes or home remedies to see if they work for you. Keep in mind that if you need it, more help is available.