Depression Treatment Depression Guide Depression Guide Types Symptoms Causes Diagnosis Treatment Living With In Children ADA An Overview of the Treatments for Depression By Nancy Schimelpfening Nancy Schimelpfening Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be. Learn about our editorial process Updated on January 19, 2021 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Akeem Marsh, MD Medically reviewed by Akeem Marsh, MD LinkedIn Twitter Akeem Marsh, MD, is a board-certified child, adolescent, and adult psychiatrist who has dedicated his career to working with medically underserved communities. Learn about our Medical Review Board Print Verywell / Cindy Chung Table of Contents View All Table of Contents Psychotherapy Medication Procedures Self-Help Strategies Next in Depression Guide 8 Tips for Living With Depression Depression is treatable and most people see improvements in their symptoms with psychotherapy, medication, or a combination of the two. That said, what works for one person might not necessarily work for another. It's important to talk to your physician and or healthcare provider about which options may be most effective for you. To help with that discussion, here is an overview of the most commonly used treatments for depression. Is There Rehab for Depression? Psychotherapy Psychotherapy is often referred to as "talk therapy." There are various approaches to psychotherapy. Many therapists specialize in a particular type of therapy to treat depression, but sometimes they pull from multiple approaches to create a more individualized therapy that is based on your specific treatment needs. Since many types of psychotherapy are available, one study set out to discover which ones are most effective for depression. Researchers found that all of the following provide good results. Interpersonal Therapy Interpersonal therapy is based on the idea that depression can be related to our relationships. Therefore, the goal of this type of therapy is to help you improve your relationship skills, such as becoming a better communicator and learning how to resolve conflict. Interpersonal therapy sessions are relatively short in duration, usually lasting between 12 and 16 weeks. Cognitive Behavioral Therapy Cognitive behavioral therapy (CBT) is a form of talk therapy designed to help you change any negative thought or behavior patterns that may be contributing to or worsening your depression. This therapy is also generally short-term and focuses on your current problems and learning new coping skills. Social Skills Training Social skills training teaches you how to interact with others more effectively so you can have healthy relationships. The goal is to improve your communication skills and learn how to build a strong social network with others, such as by creating relationships based on honesty and respect. Psychodynamic Therapy Psychodynamic therapy is the type of therapy often portrayed in movies or pop culture. During these therapy sessions, you learn how your depression may be related to past experiences, unresolved conflicts, or unhealed wounds. The therapist will help you address these issues so you can move forward in your life. Supportive Counseling Supportive counseling is less structured than some of the other therapies and mainly involves listening to you share whatever is on your mind. You are invited to talk about any issues you want and the therapist works with you to show understanding and support. Behavioral Activation Behavioral activation teaches you how to set goals and include more pleasant activities in your lifestyle. The goal of this therapy is to avoid isolation and increase the positive interactions you have with your environment. By getting active and engaging in more pleasurable activities, your symptoms of depression may be reduced. Problem-Solving Therapy Problem-solving therapy aims to define your most pressing issues, then guides you to come up with multiple ways to overcome them. The therapist helps you evaluate all of your options and choose the best solution for you. Family or Couples Therapy Family or couples therapy may be considered when depression affects others in the household. This involves looking at each of your roles and expectations. This type of therapy also involves educating your loved ones about depression and how it affects you. Medication There are many different medications that can help reduce the symptoms of depression. Here are some classes of medication that are commonly used. Most studies have found medication is most effective when it is used in conjunction with therapy. Selective Serotonin Reuptake Inhibitors Selective serotonin reuptake inhibitors (SSRIs) are the most-prescribed medications for depression today. Prozac (fluoxetine), Paxil (paroxetine), Zoloft (sertraline), Celexa (citalopram), and Luvox (fluvoxamine) are commonly prescribed brand names. SSRIs have been found helpful for both severe and non-severe depression. They also tend to have fewer side effects compared to other antidepressant types. Note that SSRIs should not be prescribed together with some monoamine oxidase inhibitors (MAOIs). This is due to the potential for a dangerously high serotonin buildup, which can cause serotonin syndrome. Serotonin and Norepinephrine Reuptake Inhibitors Serotonin and norepinephrine reuptake inhibitors (SNRIs) are a newer type of antidepressant that work similarly to SSRIs. The main difference is that they also block the body's reuptake of norepinephrine, another neurotransmitter involved in mood. Common medications in this class are Effexor (venlafaxine), Cymbalta (duloxetine), and Pristiq (deslavenfaxine). Like with SSRIs, the Food and Drug Administration indicates that SNRIs should not be taken with MAOIs, and care should be followed if you have liver or kidney issues or narrow-angle glaucoma. Norepinephrine and Dopamine Reuptake Inhibitors Norepinephrine and dopamine reuptake inhibitors (NDRIs) can help with depression by blocking both norepinephrine and dopamine transporters. NDRI medications include Focalin (dexmethylphenidate), Ritalin (methylphenidate), and Wellbutrin (bupropion). Wellbutrin is sometimes preferred because it is less likely to have the sexual side effects that are common in the other antidepressants. Plus, the side effects that are common this medication, which can include headache, trouble sleeping, and dizziness, generally go away within one to two weeks. Tricyclic Antidepressants Tricyclic antidepressants (TCAs) were among the first antidepressants developed. Research shows that tricyclics are just as effective as SSRIs for treating chronic depression and dysthymia, also known as persistent depressive disorder. Drugs that fall into this category include Elavil (amitriptyline), Tofranil (imipramine), and Pamelor (nortriptyline). Tricyclic antidepressants have more side effects than newer options but can be more effective for certain patients. Monoamine Oxidase Inhibitors Monoamine oxidase inhibitors (MAOIs) are another older type of antidepressant. Like tricyclics, MAOIs are not generally a first-choice treatment, but they can sometimes be helpful for more difficult-to-treat depression. MAOIs include Marplan (isocarboxazid), Nardil (phenelzine), and Parnate (tranylcypromine). If you are taking an MAOI, you will have to follow certain dietary restrictions to prevent a reaction that can cause high blood pressure. You will also have to be careful about interactions with certain other medications. Newer Medication Options Sold under the brand name Spravato, esketamine was FDA approved in March 2019 and is authorized for adults with treatment-resistant depression, meaning that other medication options have not worked. Esketamine is a nasal spray that works within 20 to 40 minutes, compared to the weeks or months that it takes for other medications to help you start feeling better. However, there are some risks associated with this drug. For example, esketamine is a variant of the hallucinogenic drug ketamine and may cause sedation and out-of-body experiences. For this reason, you can only receive the drug at a certified location and will be monitored for several hours after taking it. Esketamine must also be prescribed along with an oral antidepressant. What Happens When Depression Doesn't Respond to Treatment? Procedures Some depression treatment options are more invasive in nature. There are three that are used most often when a patient is not responding to other forms of treatment. Electroconvulsive Therapy Electroconvulsive therapy (ECT) involves using a form of electrical stimulation to the brain to create seizures. It works by changing the brain's chemistry and environment. You are under general anesthesia when the doctor performs ECT, so you don't remember the treatment session. Transcranial Magnetic Stimulation Transcranial magnetic stimulation (TMS) is another form of brain stimulation. However, TMS is less invasive than ECT and works by placing a small device on the skull to stimulate the brain's neurons. This changes their activity, thus decreasing feelings of depression. Vagus Nerve Stimulation Vagus nerve stimulation (VNS) also sends electrical pulses to the brain, this time through the vagus nerve. Yet, one difference between VNS and the other two options is that this often involves implanting a device in the chest. Self-Help Strategies Some self-help activities have also been found useful along with medication and therapy for easing depression. Self-help methods for the treatment of depression may also be helpful for someone who is unable to access professional resources or has mild symptoms. These strategies include the following. Press Play for Advice On Coping With Depression Hosted by Editor-in-Chief and therapist Amy Morin, LCSW, this episode of The Verywell Mind Podcast, featuring NFL host Jay Glazer, shares how to cope with depression. Click below to listen now. Follow Now: Apple Podcasts / Spotify / Google Podcasts Support Groups Support groups allow you to talk to other people who can relate to the issues and symptoms you are experiencing with your depression. Many people report that being a part of these groups helps them realize that they're not alone and provides ideas and resources for feeling better. Online Resources There are also many websites, chat rooms, and online programs that help people with depression. The benefit of this option is that help is available to you at all times of the day and night. Simply go online and the information and support is there. The 7 Best Online Help Resources for Depression Self-Help Books Self-help books can teach many of the same skills that people gain in therapy. The drawback is that this option requires that you be able to apply the information to your own life. Many self-help books are available for free through local libraries. You can also find them in online bookstores, giving you the ability to see which ones have the highest reviews. Lifestyle Changes Making certain lifestyle changes can also help you reduce your feelings of depression. Three of the most important changes you can make include eating a healthy diet, getting regular physical exercise, and getting enough sleep. 8 Tips for Living With Depression If you or a loved one are struggling with depression, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. Major Depressive Disorder Treatments 10 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Barth J, Munder T, Gerger H, et al. Comparative efficacy of seven psychotherapeutic interventions for patients with depression: A network meta-analysis. PLoS Med. 2013;10(5):e1001454. doi:10.1371/journal.pmed.1001454 Hieronymus F, Lisinski A, Nilsson S, Eriksson E. Influence of baseline severity on the effects of SSRIs in depression: an item-based, patient-level post-hoc analysis. The Lancet Psy. 2019;6(9):745-752. doi:10.1016/S2215-0366(19)30216-0 U.S. Food and Drug Administration. Depression medicines. Updated 2019. National Alliance on Mental Illness. Bupropion (Wellbutrin). Updated 2018. Wolff A, Holzel L, Westphal A, Harter M, Kriston L. Selective serotonin reuptake inhibitors and tricyclic antidepressants in the acute treatment of chronic depression and dysthymia: a systematic review and meta-analysis. J Affect Disord. 2013;144(1-2):7-15. doi:10.1016/j.jad.2012.06.007 Bahr R, Lopez A, Rey JA. Intranasal esketamine (Spravato) for use in treatment-resistant depression in conjunction with an oral antidepressant. P T. 2019;44(6):340-375. Food and Drug Administration. Esketamine. Singh A, Kar S. How electroconvulsive therapy works? Understanding the neurobiological mechanisms. Clin Psychopharmacol Neurosci. 2017;15(3);210-221. doi:10.9758/cpn.2017.15.3.210 Pfeiffer PN, Heisler M, Piette JD, Rogers MA, Valenstein M. Efficacy of peer support interventions for depression: a meta-analysis. Gen Hosp Psychiatry. 2011;33(1):29-36. doi:10.1016/j.genhosppsych.2010.10.002 Lopresti A, Hood S, Drummond P. A review of lifestyle factors that contribute to important pathways associated with major depression: diet, sleep and exercise. J Affect Disord. 2013;148(1):12-27. doi:10.1016/j.jad.2013.01.014 Additional Reading Arroll B, Elley CR, Fishman T, et al. Antidepressants versus placebo for depression in primary care. Cochrane Database Syst Rev 2009; (3). doi:10.1002/14651858.CD007954 Barth JCBC, Munder T, Gerger H, et al. Comparative efficacy of seven psychotherapeutic interventions for patients with depression: A network meta-analysis. PLOS. 2013;14(2):229-243. doi:10.1371/journal.pmed.1001454 United States Food and Drug Administration. FDA approves new nasal spray medication for treatment-resistant depression; available only at a certified doctor's office or clinic. Updated March 5, 2019. By Nancy Schimelpfening Nancy Schimelpfening, MS is the administrator for the non-profit depression support group Depression Sanctuary. Nancy has a lifetime of experience with depression, experiencing firsthand how devastating this illness can be. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Speak to a Therapist for Depression Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.