Treatment for depression usually involves a combination of self-help, talking therapies and medicines. The treatment recommended will be based on the type of depression you have. If you have mild depression, the following treatments may be recommended. If a GP diagnoses you with mild depression, they may suggest waiting a short time to see if it gets better by itself. In this case, you'll be seen again by the GP after 2 weeks to monitor your progress. This is known as watchful waiting. There's evidence that exercise can help depression, and it's one of the main treatments for mild depression. You may be referred to a group exercise class. Find out more about walking for health and exercise for depression. Talking through your feelings can be helpful. You could talk to a friend or relative, or you
could ask a GP or local psychological therapies service if there are any self-help groups for people with depression in your area. You could try
self-help books or online cognitive behavioural therapy (CBT). If you have mild
to moderate depression that is not improving, or moderate depression, you may find a talking therapy helpful. There are different types of talking therapies for depression, including cognitive behavioural therapy (CBT) and
counselling. A GP can refer you for talking treatment, or you can refer yourself directly to an NHS psychological therapies service (IAPT) without a referral from a GP. Find an NHS psychological therapies
service (IAPT) If you have moderate to severe depression, the following treatments may be recommended. Antidepressants are medicines that
treat the symptoms of depression. There are many different types of antidepressant. They have to be prescribed by a doctor, usually for depression that's moderate or severe. A GP may recommend that you take a course of antidepressants plus talking therapy,
particularly if your depression is quite severe. A combination of an antidepressant and CBT usually works better than having just one of these treatments. If you have severe depression, you may be referred to a mental health team made up of psychologists, psychiatrists, specialist nurses and occupational therapists. These teams often provide intensive specialist talking treatments as well as prescribed medicine. Talking treatmentsCognitive behavioural therapy (CBT)Cognitive behavioural therapy (CBT) aims to help you understand your thoughts and behaviour, and how they affect you. CBT recognises that events in your past may have shaped you, but it concentrates mostly on how you can change the way you think, feel and behave in the present. It teaches you how to overcome negative thoughts – for example, being able to challenge hopeless feelings. CBT is available on the NHS for people with depression or any other mental health problem it's been shown to help. If CBT is recommended, you'll usually have a session with a therapist once a week or once every 2 weeks. The course of treatment usually lasts for between 5 and 20 sessions, with each session lasting 30 to 60 minutes. In some cases, you may be offered group CBT. Online CBTOnline CBT is a type of CBT delivered through a computer, rather than face to face with a therapist. You'll have a series of weekly sessions and should receive support from a healthcare professional. Interpersonal therapy (IPT)Interpersonal therapy (IPT) focuses on your relationships with others and problems you may be having in your relationships, such as difficulties with communication or coping with bereavement. There's some evidence that IPT can be as effective as antidepressants or CBT, but more research is needed. Psychodynamic psychotherapyIn psychodynamic (psychoanalytic) psychotherapy, a psychoanalytic therapist will encourage you to say whatever is going through your mind. This will help you become aware of hidden meanings or patterns in what you do or say that may be contributing to your problems. CounsellingCounselling is a form of therapy that helps you think about the problems you're experiencing in your life so you can find new ways of dealing with them. Counsellors support you in finding solutions to problems, but do not tell you what to do. You can talk in confidence to a counsellor, who supports you and offers practical advice. On the NHS, you may be offered a single session of counselling, a short course of sessions over a few weeks or months, or a longer course that lasts for several months or years. It's ideal for people who are generally healthy but need help coping with a current crisis, such as anger, relationship issues, bereavement, redundancy, infertility or a serious illness. Getting helpSee a GP for more information about accessing NHS talking treatments. They can refer you for local talking treatments for depression. You also have the option of self-referral. This means that if you prefer not to talk to a GP, you can go directly to a psychological therapies service. Video: psychological therapies for stress, anxiety and depressionAnimated video explaining self-referral to psychological therapies services for stress, anxiety or depression. Media last reviewed: 14 March 2022 AntidepressantsAntidepressants are medicines that treat the symptoms of depression. There are many different types available. Most people with moderate or severe depression benefit from antidepressants, but not everybody does. You may respond to 1 antidepressant but not to another, and you may need to try 2 or more treatments before you find one that works for you. The different types of antidepressant work about as well as each other. But side effects vary between different treatments and people. When you start taking antidepressants, you should see a GP or specialist nurse every week or 2 for at least 4 weeks to assess how well they're working. If they're working, you'll need to continue taking them at the same dose for at least 4 to 6 months after your symptoms have eased. If you have had episodes of depression in the past, you may need to continue to take antidepressants for up to 5 years or more. Antidepressants are not addictive, but you may get some withdrawal symptoms if you stop taking them suddenly or you miss a dose. Selective serotonin reuptake inhibitors (SSRIs)If a GP thinks you'd benefit from taking an antidepressant, you'll usually be prescribed a modern type called a selective serotonin reuptake inhibitor (SSRI). Examples of commonly used SSRI antidepressants are paroxetine (Seroxat), fluoxetine (Prozac) and citalopram (Cipramil). They help increase the level of a natural chemical in your brain called serotonin, which is thought to be a "good mood" chemical. SSRIs work just as well as older antidepressants and have fewer side effects, although they can cause nausea, headaches, a dry mouth and problems having sex. But these side effects usually improve over time. Some SSRIs are not suitable for children and young people under 18 years of age. Research shows that the risk of self-harm and suicidal behaviour may increase if they're taken by under-18s. Fluoxetine is the only SSRI that can be prescribed for under-18s and, even then, only when a specialist has given the go-ahead. Tricyclic antidepressants (TCAs)Tricyclic antidepressants (TCAs) are a group of antidepressants used to treat moderate to severe depression. TCAs, including imipramine (Imipramil) and amitriptyline, have been around for longer than SSRIs. They work by raising the levels of the chemicals serotonin and noradrenaline in your brain. These both help lift your mood. They're generally quite safe, but it's a bad idea to smoke cannabis if you're taking TCAs because it can cause your heart to beat rapidly. Side effects of TCAs vary from person to person but may include a dry mouth, blurred vision, constipation, problems passing urine, sweating, feeling lightheaded and excessive drowsiness. The side effects usually ease within 10 days as your body gets used to the medicine. VortioxetineVortioxetine (Brintellix or Lundbeck) is recommended by the National Institute for Health and Care Excellence (NICE) for treating adults who are having a first or recurrent major depressive episode, if the current episode has not responded to 2 other antidepressants. Common side effects associated with vortioxetine include abnormal dreams, constipation, diarrhoea, dizziness, itching, nausea and vomiting. Other antidepressantsNew antidepressants, such as venlafaxine (Efexor), duloxetine (Cymbalta or Yentreve) and mirtazapine (Zispin Soltab), work in a slightly different way from SSRIs and TCAs. Venlafaxine and duloxetine are known as serotonin-noradrenaline reuptake inhibitors (SNRIs). Like TCAs, they change the levels of serotonin and noradrenaline in your brain. Studies have shown that an SNRI can be more effective than an SSRI, but they're not routinely prescribed because they can lead to a rise in blood pressure. Withdrawal symptomsAntidepressants are not addictive in the same way that illegal drugs and cigarettes are, but you may have some withdrawal symptoms when you stop taking them. These include:
In most cases, these are quite mild and last no longer than 1 or 2 weeks, but occasionally they can be quite severe. They seem to be most likely to occur with paroxetine (Seroxat) and venlafaxine (Efexor). Withdrawal symptoms occur very soon after stopping the tablets so are easy to distinguish from symptoms of depression relapse, which tend to occur after a few weeks. Further information
Other treatmentsMindfulnessMindfulness involves paying closer attention to the present moment, and focusing on your thoughts, feelings, bodily sensations and the world around you to improve your mental wellbeing. The aim is to develop a better understanding of your mind and body, and learn how to live with more appreciation and less anxiety. Mindfulness is recommended by NICE as a way of preventing depression in people who have had 3 or more bouts of depression in the past. Read more about mindfulness St John's wortSt John's wort is a herbal treatment that some people take for depression. It's available from health food shops and pharmacies. There's some evidence that it may help mild to moderate depression, but it's not recommended by doctors. This is because the amount of active ingredients varies among individual brands and batches, so you can never be sure what sort of effect it'll have on you. Taking St John's wort with other medicines, such as anticonvulsants, anticoagulants, antidepressants and the contraceptive pill, can also cause serious problems. You should not take St John's wort if you're pregnant or breastfeeding, as we do not know for sure that it's safe. Also, St John's wort can interact with the contraceptive pill, reducing its effectiveness. Brain stimulationBrain stimulation is sometimes used to treat severe depression that has not responded to other treatments. Electromagnetic currents can be used to stimulate certain areas of the brain to try to improve the symptoms of depression. There are a number of different types of brain stimulation that can be used to treat depression. These include:
NICE has more information about the different types of brain stimulation, including the benefits and risks. LithiumIf you have tried several different antidepressants and there's been no improvement, your doctor may offer you a medicine called lithium in addition to your current treatment. There are 2 types: lithium carbonate and lithium citrate. Both are usually effective, but if you're taking one that works for you, it's best not to change. If the level of lithium in your blood becomes too high, it can become toxic. You'll therefore need blood tests every 3 months to check your lithium levels while you're on the medicine. You'll also need to avoid eating a low-salt diet because this can also cause the lithium to become toxic. Ask a GP for advice about your diet. Which of the following is seen as an effective treatment for severe depression?Medications and psychotherapy are effective for most people with depression. Your primary care doctor or psychiatrist can prescribe medications to relieve symptoms. However, many people with depression also benefit from seeing a psychiatrist, psychologist or other mental health professional.
What procedure is used to treat severe depression?Electroconvulsive therapy (ECT).
Although there are potential side effects, such as temporary confusion or temporary memory loss, a series of ECT treatments may provide significant relief of severe depression.
Which form of therapy is most effective for major depression?Studies have shown that cognitive therapy is an effective treatment for depression and is comparable in effectiveness to antidepressants and interpersonal or psychodynamic therapy. The combination of cognitive therapy and antidepressants has been shown to effectively manage severe or chronic depression.
What is the most effective treatment for moderate to severe depression?The most commonly prescribed are known as selective serotonin reuptake inhibitors (SSRIs). These include medications like Zoloft (sertraline), Prozac (fluoxetine), and Paxil (paroxetine).
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Which of the following is seen as an effective treatment for severe depression that does not respond to drug therapy?
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