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 for Depression
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.
1. 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.
2. 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.
3. Problem solving therapy focuses on the specific problems you currently face, and on helping you find solutions to those problems.
Medicines are the other key treatment for depression. There are now dozens of antidepressants that your health care provider can choose from. They include:
1. 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.
2. Researchers have developed many types of antidepressants in recent years. These include drugs like Remeron, 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.
3. 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) for Depression
This is a safe and effective treatment for people with depression that is resistant to medication. 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.
Vagus Nerve Stimulation (VNS) for Depression
Vagus Nerve Stimulation (VNS) is a new option for people with severe, treatment-resistant depression. Approved by the FDA in 2005, it’s used only on people who haven’t been helped by at least four antidepressants.
VNS involves implanting a small electrical generator in your chest, like a pacemaker. The device is attached with wires to the vagus nerve, which runs from the neck into the brain. Once implanted, the device sends electrical pulses to the vagus nerve every few seconds. The pulses are then delivered via the vagus nerve to the area of the brain thought to regulate mood. The electrical charges may change the balance of chemicals in your brain and relieve depression.
The device must be implanted by a surgeon, but patients can usually go home the same day.
Alternative Treatments for Depression
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 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.