Finding The Best Depression Treatment For You
When youre depressed, it can feel like youll never get out from under a dark shadow. However, even the most severe depression is treatable. So, if your depression is keeping you from living the life you want to, dont hesitate to seek help. From therapy to medication to healthy lifestyle changes, there are many different treatment options available.
Of course, just as no two people are affected by depression in exactly the same way, neither is there a one size fits all treatment to cure depression. What works for one person might not work for another. By becoming as informed as possible, though, you can find the treatments that can help you overcome depression, feel happy and hopeful again, and reclaim your life.
How Is Depression Diagnosed
To be diagnosed with depression, an individual must have five depression symptoms every day, nearly all day, for at least 2 weeks. One of the symptoms must be a depressed mood or a loss of interest or pleasure in almost all activities. Children and adolescents may be irritable rather than sad.
If you think you may have depression, talk to your health care provider. Primary care providers routinely diagnose and treat depression and refer individuals to mental health professionals, such as psychologists or psychiatrists.
During the visit, your provider may ask when your symptoms began, how long they last, how often they occur, and if they keep you from going out or doing your usual activities. It may help to make some notes about your symptoms before your visit. Certain medications and some medical conditions, such as viruses or a thyroid disorder, can cause the same depression symptoms. Your provider can rule out these possibilities by doing a physical exam, interview, and lab tests.
Read NIMHs Tips for Talking With Your Health Care Provider to help prepare for and get the most out of your visit. For additional resources, visit the Agency for Healthcare Research and Quality website.
Do I Need Health Insurance To Receive This Service
The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.
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What Does Severe Depression Feel Like
Severe depression is classified as having the symptoms of mild to moderate depression, but the symptoms are severe and noticeable, even to your loved ones.
Episodes of major depression last an average of six months or longer. Sometimes severe depression can go away after a while, but it can also be recurrent for some people.
Diagnosis is especially crucial in severe depression, and it may even be time-sensitive.
Major forms of depression may also cause:
- delusions
- hallucinations
- suicidal thoughts or behaviors
Severe depression requires medical treatment as soon as possible. Your doctor will likely recommend an SSRI and some form of talk therapy.
If youre experiencing suicidal thoughts or behaviors, you should seek immediate medical attention. Call your local emergency services or the National Suicide Prevention Lifeline at 800-273-8255 right away.
Therapy And The Big Picture In Depression Treatment
One of the hallmarks of depression is feeling overwhelmed and having trouble focusing. Therapy helps you step back and see what might be contributing to your depression and how you can make changes. Here are some of the big picture themes that therapy can help with:
Relationships.Understanding the patterns of your relationships, building better relationships, and improving current relationships will help reduce isolation and build social support, important in preventing depression.
Setting healthy boundaries. If you are stressed and overwhelmed, and feel like you just cant say no, you are more at risk for depression. Setting healthy boundaries in relationships and at work can help relieve stress, and therapy can help you identify and validate the boundaries that are right for you.
Handling lifes problems. Talking with a trusted therapist can provide good feedback on more positive ways to handle lifes challenges and problems.
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Seeing A Doctor About Depression
Big changes in your life, like bereavement, losing a job, or even having a baby, can cause symptoms of depression. You’re also more likely to experience depression if you have a family history of depression. However, it’s also possible to become depressed without there being an obvious reason.
You can learn more about depression causes here.
How Is Depression Syndrome Treated
Depression can be serious, but its also treatable. Treatment for depression includes:
- Self-help: Regular exercise, getting enough sleep, and spending time with people you care about can improve depression symptoms.
- Counseling: Counseling or psychotherapy is talking with a mental health professional. Your counselor helps you address your problems and develop coping skills. Sometimes brief therapy is all you need. Other people continue therapy longer.
- Alternative medicine: People with mild depression or ongoing symptoms can improve their well-being with complementary therapy. Therapy may include massage, acupuncture, hypnosis and biofeedback.
- Medication: Prescription medicine called antidepressants can help change brain chemistry that causes depression. Antidepressants can take a few weeks to have an effect. Some antidepressants have side effects, which often improve with time. If they dont, talk to your provider. A different medications may work better for you.
- Brain stimulation therapy: Brain stimulation therapy can help people who have severe depression or depression with psychosis. Types of brain stimulation therapy include electroconvulsive therapy , transcranial magnetic stimulation and vagus nerve stimulation .
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Severe Depression Diagnostic Criteria
Below are the signs of severe depression. You must have at least five of the symptoms in a two-week period to be diagnosed with severe depression.
- You feel hopeless, guilty, worthless, or ashamed.
- You worry excessively.
- You cant stay focused on tasks.
- You have thoughts of suicide or that the world would be better off without you in it.
Extreme depression may also include hallucinations, delusions, and feelings of stupor. Some people develop substance use disorder when they start using alcohol or drugs to make themselves feel better or escape the symptoms of severe depression.
What To Expect At A Depression Treatment Center
Before a person begins their stay at a facility that offers treatment for depression, they may go through an admissions process. A staff member may ask questions about their life and symptoms and assess whether they could benefit from the program.
When an individual begins their stay at the treatment center, the medical team will run several psychiatric tests and evaluations. Sometimes, these can uncover an additional underlying condition a person never knew they had.
The medical team at the center may share the results with other healthcare professionals and the individuals support system and will use this information to develop a persons treatment plan.
These psychiatric assessments help doctors create a highly personalized treatment protocol. Usually, this will combine medication and therapy.
The types of therapy a depression treatment center offers depends on their resources and could include:
- feeling too exhausted to take of themselves or others
- thoughts of hurting themselves or others
In these cases, if a persons depression is not responsive to outpatient treatment attempts, a doctor or mental health professional will refer them to a treatment center.
The two main differences between inpatient and outpatient therapy are that outpatient therapy is less intensive, and a person does not stay in the facility where they receive treatment.
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Learn To Recognize Negative Thinking
Sometimes these thoughts can be obvious, such as times when you berate or criticize yourself. Other times, they can be more subtle. You might find yourself engaging in things like catastrophizing or all-or-nothing thinking.
Catastrophizing involves always anticipating negative outcomes. All-or-nothing thinking means that you think of things as either successes or failures with no in-between. Once you get better at recognizing these cognitive patterns, you can start working on some healthier replacements.
Negative Thoughts And Depression
Worrying or thinking negatively is common in people with depression. This affects your ability to focus on getting better and makes you more vulnerable to unhealthy emotions.
Tips to help you control worry and reduce negative thinking include:
- Write down what you are worried about. Go through each concern and think about how realistic your negative thoughts are. Explore alternative thoughts and explanations.
- Try not to focus on the things you cannot change.
- Focus on the present. Accept your thoughts without actively engaging with them.
- Write down your problems and brainstorm solutions. Jot down the pros and cons with each option and choose the one that seems the best. Review whether it worked to overcome the problem.
- Avoid making major decisions about your life at this time.
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What Is Treatment Resistant Depression And Is There Any Help For It
If youve tried at least two different antidepressants and your depression hasnt improved, you may be diagnosed with treatment resistant depression . TRD is a serious condition that has been highly associated with suicidal ideation and suicide attempts. Nearly 33 percent of people with TRD attempt suicide in their lifetime, more than double the rate of their treatment-responsive peers, according to a recent report in Psychiatry Advisor. It is not, however, a hopeless condition. A number of alternative treatment approaches are available, including:
Tap Into Your Spirituality
Religion can be an impactful source of support for many people dealing with depression, but there is no need to join a church, synagogue, or mosque unless you wish to. Simple daily practices such as meditation or adding to a list of things you’re grateful can help boost mood and overall well-being.
Meditation can have a range of beneficial effects such as lowering stress levels and helping people to become more aware of their thoughts and reactions.
Research indicates that an intervention called mindfulness-based cognitive therapy , which combines elements of cognitive behavioral therapy with mindfulness meditation, can be helpful in treating depression and preventing future relapses of symptoms.
Studies also suggest that different types of mindfulness meditative practices can also be effective in the treatment of depression.
There are many different types of meditation, but you can get started with a simple meditative exercise with these steps:
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Depression And Drugs And Alcohol
“Drowning your sorrows” is actually a bad idea when it comes to depression. Alcohol is categorised as a “strong depressant” which can make depression worse, and drinking or taking drugs to cope can lead to a downward spiral by having a negative affect on other parts of your life.
There’s evidence that cannabis can cause depression, particularly in teenagers, even if it helps you relax.
Who Is At Risk For Major Depression
Major depression affects about 6.7% of the U.S. population over age 18, according to the National Institute of Mental Health. Overall, between 20% and 25% of adults may suffer an episode of major depression at some point during their lifetime.
Major depression also affects older adults, teens, and children, but frequently goes undiagnosed and untreated in these populations.
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Should You Worry About Antidepressant Withdrawal
No, but its easy to see why some people might think so, because of a medical condition called antidepressant discontinuation syndrome , which can occur if you abruptly stop taking medication rather than tapering off as is generally advised. ADS is marked by a wide range of responses, including but not limited to flu-like symptoms, insomnia, worsening mood, and stomach distress, according to a March 11, 2019, report in Psychiatric Times.
Current estimates are that about 20 percent of patients whove taken an antidepressant for at least a month will experience ADS symptoms if they abruptly stop their medication instead of lowering their dose gradually. Tapering under the care of a doctor can prevent ADS by allowing the brain to adjust to changes in neurotransmitter levels.
More to the point, while you should slowly stop your antidepressant with the help of your doctor, antidepressants do not cause dependence and withdrawal like other substances. Unlike substances that are known to cause addiction, such as alcohol, , and , people don’t crave antidepressants. You dont get high from them, and they arent intentionally or compulsively overused. Serious reactions like the seizures and agitation that can follow sudden withdrawal from addictive substances are unheard of when these antidepressants are tapered gradually, note the authors of the Psychiatric Times report.
Electroconvulsive Therapy Electric Shock Treatment
If you have severe depression and other treatments, like medication, haven’t worked, ECT might be recommended for you.
When receiving ECT, you will be given an anaesthetic and medication that relaxes your muscles to begin with. Electrodes will be placed on your head that give an electrical “shock” to your brain.
ECT is given over a series of sessions, normally twice a week for three to six weeks.
ECT can cause side effects including nausea, headaches, aches in the muscles and memory problems.
Most people find that ECT is good for relieving severe depression, but the beneficial effects tend to wear off when several months have passed.
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Know That Today Isnt Indicative Of Tomorrow
Todays mood, emotions, or thoughts dont belong to tomorrow.
If you were unsuccessful at getting out of bed or accomplishing your goals today, remember that you havent lost tomorrows opportunity to try again.
Give yourself the grace to accept that while some days will be difficult, some days will also be great. Try to look forward to tomorrows fresh start.
Lifestyle Changes To Treat Depression
Exercise.Regular exercise can be as effective at treating depression as medication. Not only does exercise boost serotonin, endorphins, and other feel-good brain chemicals, it triggers the growth of new brain cells and connections, just like antidepressants do. Best of all, you dont have to train for a marathon in order to reap the benefits. Even a half-hour daily walk can make a big difference. For maximum results, aim for 30 to 60 minutes of aerobic activity on most days.
Social support. Strong social networks reduce isolation, a key risk factor for depression. Keep in regular contact with friends and family, or consider joining a class or group. Volunteering is a wonderful way to get social support and help others while also helping yourself.
Nutrition. Eating well is important for both your physical and mental health. Eating small, well-balanced meals throughout the day will help you keep your energy up and minimize mood swings. While you may be drawn to sugary foods for the quick boost they provide, complex carbohydrates are a better choice. Theyll get you going without the all-too-soon sugar crash.
Sleep. Sleep has a strong effect on mood. When you dont get enough sleep, your depression symptoms will be worse. Sleep deprivation exacerbates irritability, moodiness, sadness, and fatigue. Make sure youre getting enough sleep each night. Very few people do well on less than seven hours a night. Aim for somewhere between seven to nine hours each night.
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Whats The Difference Between Grief And Depression
Given that the primary symptom associated with depression is sadness, it can be easy to think of grief or bereavement as depression. But grief is a natural response to specific experiences, such as the end of a relationship or the death of a loved one. While you might feel regret or remorse, and you might withdraw from usual activities if you are experiencing grief, youre unlikely to feel the overwhelming sense of worthlessness, thoughts of self-harm or suicide, and other symptoms of depression. Another important difference is that in grief, painful feelings usually come in waves and are often mixed with positive memories.
In some cases, however, grief and depression do coexist, or grief can trigger depression, according to experts writing in the journal American Family Physician. Having a mental health professional help you distinguish between them can ensure you get the support you need.
Treatment For Severe And Complex Depression
If your depression is severe and complex, your doctor should refer you to specialist mental health services. They can discuss with you the following options:
- Trying talking therapies and medication again. Your healthcare team may suggest a different medication, or a combination of drugs with other treatments.
- Medication for psychotic symptoms. If you are experiencing depression with psychotic symptoms, your healthcare team may prescribe antipsychotic medication alongside your current treatment plan. See our pages on psychosis and antipsychotics for more information.
- Crisis resolution services. A crisis resolution and home treatment team is a team of mental health professionals who can support you at your home during a mental health crisis, rather than going into hospital. See our page on crisis services for more information.
- Hospital admission. If you are severely depressed and at risk of suicide, self-harm or self-neglect, you may need to be cared for in hospital as an in-patient. A hospital can provide a safe and supportive environment if you are in a state of distress. See our page on hospital admission for more information.
“A majority of the treatments I tried were ineffective but at crisis point, about to be admitted to a psychiatric hospital, I started Interpersonal Psychotherapy and Sertraline. I can honestly say that they saved my life.”
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Key Points About Depression
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Depression is a serious mood disorder that affects your whole body including your mood and thoughts.
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Its caused by a chemical imbalance in the brain. Some types of depression seem to run in families.
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Depression causes ongoing, extreme feelings of sadness, helplessness, hopeless, and irritability. These feelings are usually a noticeable change from whats normal for you, and they last for more than two weeks.
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Depression may be diagnosed after a careful psychiatric exam and medical history done by a mental health professional.
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Depression is most often treated with medicine or therapy, or a combination of both.
Depression: What You Need to Know as You Age
Get the help you or a loved one needs, and get the latest expert insights on coping and preventing this mood disorder.