Major Depressive Disorder Treatments

Major depressive disorder, also known as depression and clinical depression, is a medical condition that affects over 8% of people in the United States.

Classified as a mood disorder, depression can affect the way you think and feel. It can cause severe symptoms, to the point where it can make it difficult for you to function on a daily basis. You may feel low for weeks or months, and lose interest in things you previously enjoyed.

If you or a loved one have been diagnosed with major depressive disorder, you may wonder what the treatment options are and what the prognosis for this condition is.

Major Depressive Disorder Treatments

This article explores the treatment options for depression, which can include:

• Psychotherapy
• Medication
• Brain stimulation

Mild cases of depression are often treated with psychotherapy. Moderate to severe cases of depression may be treated with a combination of medication and psychotherapy. If the depression persists, brain stimulation may help.

It’s important to remember that everyone’s symptoms and experience of depression are different and so the best treatment methods for them may vary as well. There is no one-size-fits-all treatment that works for everybody.

Psychotherapy

Listed below are some of the forms of psychotherapy that can help treat major depressive disorder.

Cognitive Behavioral Therapy (CBT)

Cognitive-behavioral therapy involves identifying distorted perceptions or negative thought patterns you may have developed about yourself or the world around you. It helps you develop healthier, more positive thoughts and actions.

Cognitive-behavioral therapy treatment for major depressive disorder may involve the following steps:

• Learning to recognize depressive thoughts and reactions as they occur. Your healthcare provider may ask you to write these down in a journal as they occur during the day.
• Examining these depressive thoughts with your healthcare provider and challenging the assumptions they are based on.
• Doing homework that involves testing assumptions against reality in order to find different responses. As you do this, you will start to understand that the assumptions and beliefs that are causing you to feel depressed are untrue.
• Substituting negative thoughts with positive ones and developing coping skills.

According to a 2012 study, cognitive-behavioral therapy is an effective form of treatment for depression, and its effects last even after treatment is completed.

Interpersonal Therapy (IPT)

Interpersonal therapy is a form of psychodynamic therapy that explores unresolved issues and internal conflicts you may be struggling with. It focuses on resolving issues from the past as well as treating current issues and symptoms. 

The goal of interpersonal therapy is to reduce symptoms of depression, build communication and interpersonal skills, and improve your interactions with family, friends, and colleagues.

Interpersonal therapy may be particularly helpful if the depression stems from issues such as:

• Childhood abuse or trauma
• Delayed or distorted mourning
• Suppressed conflicts with partners, close friends, or family members
• Major life changes
• Isolation

Interpersonal therapy is generally a short-term form of treatment that lasts a few months. Unlike cognitive-behavioral therapy, which often involves homework, interpersonal therapy doesn’t typically require you to do any homework; all the work is done with the healthcare provider during the session. 

Other Forms of Therapy

Cognitive therapy and interpersonal therapy are typically conducted on an individual basis. However, depending on the circumstances, it may also be helpful to participate in therapy involving others. These forms of therapy may include:

• Group therapy: This type of therapy is conducted in a group setting, with others who are going through the same thing you are. Group members can share experiences, advice, and inspiration that can be helpful to you.
• Family therapy: Family therapy can help you work out conflicts and issues as a family, with guidance from a mental healthcare provider.
• Couples therapy: A couples therapist can help you and your partner identify and resolve issues in your relationship that may be contributing to the depression you’re experiencing.

Medication

Antidepressants are medications that treat depression by improving the balance of certain brain chemicals known as neurotransmitters.

Since there are many different types of antidepressant medications, it may take a few tries for you to find the type that works best for you. A psychiatrist may start you with an antidepressant that has worked for you in the past or helped one of your family members.

These are some of the most common types of antidepressants:

• Selective serotonin reuptake inhibitors (SSRIs): SSRIs are commonly used antidepressant medications. They work by targeting the neurotransmitter serotonin. 
• Serotonin and norepinephrine reuptake inhibitors (SNRIs): SNRIs work by targeting the neurotransmitters norepinephrine and serotonin. They may be helpful for people who don’t respond to SSRIs.
• Tricyclic antidepressants (TCAs): This is an older category of antidepressant medication that is effective, but can cause severe side effects, particularly in older adults. TCAs work by targeting the neurotransmitters norepinephrine, serotonin, and acetylcholine.
• Monoamine oxidase inhibitors (MAOIs): These antidepressants work by targeting the enzyme monoamine oxidase. However, they are only prescribed in specific cases, if other antidepressants don’t work, because they can interact with certain foods and cause severe side effects. Therefore, taking MAOIs requires patients to follow certain dietary restrictions.
• Atypical drugs: In certain cases of severe depression, healthcare providers may prescribe atypical antidepressants or atypical antipsychotic medications.

Brain Stimulation

These are the different brain stimulation techniques:

• Electroconvulsive therapy (ECT): Also known as shock treatment, ECT was first developed in the 1930s. However, it has been refined considerably since then and is now considered a safe and effective procedure to treat depression. During an ECT session, the brain is stimulated using electric impulses, under anesthesia. 
• Repetitive transcranial magnetic stimulation (rTMS): This procedure involves placing an electric coil that delivers high-frequency magnetic pulses near the forehead. rTMS is non-invasive and doesn’t require anesthesia.
• Vagus nerve stimulation (VNS): A procedure that is used to treat epilepsy, VNS can also help some people with treatment-resistant depression. It involves surgically implanting a battery-powered device into the person’s chest. The device delivers pulses of electrical energy to the person’s brain, via the vagus nerve. In a way, it's like a pacemaker for the brain.

How to Make Your Treatment Most Effective

These are some steps you can take to make your treatment most effective:

• Seek help as soon as possible: If you suspect you may have major depressive disorder, seek help as soon as possible. The sooner you seek treatment, the more effective it is likely to be.
• Maintain an active, healthy lifestyle: Eat a balanced, nutritious diet and try to get some exercise every day. Build a consistent routine and get enough sleep.
• Don’t isolate yourself: Reach out to loved ones and talk to them about how you’re feeling. Let them know how they can support you. Spend time with them and accept their help.
• Stay in touch with your healthcare provider: Make sure you go to therapy sessions regularly. Report any symptoms or side effects you’re experiencing to your healthcare provider.
• Avoid harmful substances: Avoid alcohol, nicotine, and drugs, as they can make depression worse. Don’t take any medication that has not been prescribed for you.
• Focus on doing what you can: Do as much as you can, when you can. You may not be able to do everything you need to do, and that’s all right. It may be helpful to postpone big decisions and life changes until you’re feeling better.
• Give it time: Depression is not something you snap out of in a moment. It may take some time for you to start feeling better. Expect your mood to get better slowly, with small improvements every day.
• Practice self-care: Do things you enjoy that make you feel better. Go for a walk, watch a movie, do some gardening, cook a meal you enjoy, or learn a new hobby.

A Word From Verywell

Major depressive disorder is a medical condition that needs to be treated as it often doesn’t go away on its own.

If you or someone you know are experiencing depression, it’s important to seek treatment from a qualified mental health professional. The best form of treatment for you may vary depending on several factors, including the severity of the symptoms you're experiencing and your personal and family medical history.