Treatments for Depression

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.

Antidepressant 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:

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.

Common Causes of Depression

Health experts’ understanding of depression has come a long way in the last few decades. In many cases, depression doesn’t have only one cause. It often results from a mix of biology, psychology, and stressful or traumatic events.

Reasons for depression include:

1. Biology. Researchers still have a lot to learn about exactly why people become depressed. But some experts say depression often results from an imbalance of certain chemicals in the brain. These chemicals are called neurotransmitters. Antidepressants work by affecting the levels of these chemicals — bringing them back into balance.

There’s also a genetic connection. If depression runs in your family, you have a higher chance of becoming depressed.

Having other general health conditions or diseases can increase your risk of depression. For instance, if you have a heart attack, you have a 65% risk of becoming depressed afterwards. Conditions such as cancer, heart disease, thyroid problems, and many others increase your risk of becoming depressed.

Your gender makes a difference, too. Women are about twice as likely as men to become depressed. No one’s sure why. But the hormonal changes that women go through at different times of their lives may be a factor.

2. Psychology. Studies show that people who have a pessimistic personality are more likely to become depressed. This doesn’t mean that getting a “better attitude” will resolve your depression.

3. Stressful events. Many people become depressed during difficult times. Losing a family member or close friend, being diagnosed with a serious illness, going through a divorce, or any other traumatic event may trigger depression.

4. Medications and substances. Many prescription drugs can cause the symptoms of depression. Alcohol or substance abuse is common in depressed people. It often makes their condition worse.

Some people have a clear sense of why they become depressed. Others don’t. The most important thing to remember is that depression is not your fault. It’s not a flaw in your character. It’s a disease that can affect anyone.

Recognizing the Symptoms of Depression

Common symptoms of depression can make work and daily life almost impossible. Depression can skew your view of the world, making everything seem hopeless. Depression can make you feel utterly alone.

But you’re not. Major depression affects about 14 million American adults or about 6.7% of the population 18 or older in any given year. And the good news is a lot of treatments work to reduce depression symptoms, and some experts claim depression can be “cured” as well. This guide will help you recognize the symptoms of depression and learn how to treat them.

You may already know some of the emotional and psychological effects of depression. They include:

1. Feeling sad, empty, hopeless, or numb. These feelings are with you most of the day, every day.

2. Loss of interest in things you used to enjoy. You might no longer bother with hobbies that you used to love. You might not like being around friends. You might lose interest in sex.

3. Irritability or anxiety. You might be short-tempered and find it hard to relax.

4. Trouble making decisions. Depression can make it hard to think clearly or concentrate. Making a simple choice can seem overwhelming.

5. Feeling guilty or worthless. These feelings are often exaggerated or inappropriate to the situation. You might feel guilty for things that aren’t your fault or that you have no control over. Or you may feel intense guilt for minor mistakes.

6. Thoughts of death and suicide. The types of thoughts vary. Some people wish that they were dead, feeling that the world would be better off without them. Others make very explicit plans to hurt themselves.