Treatment Modalities

The most effective treatment for depression usually consists of a combination of modalities. There is no simple solution. Recovery can be a long haul, even if one puts a lot of effort into it. No single treatment, therapy, or lifestyle choice on its own is likely to be fully effective. Working together, each treatment enhances the others.

Talk therapies are designed to change negative thoughts and behaviors and substitute new appropriate thoughts and behaviors. For a description of the various kinds of talk therapies, see Helpguide’s Psychotherapy and Relationship / Marriage Counseling and for help securing strong and supportive intimate love relationships, see Building and Preserving Joy and Excitement in Adult Relationships.

Medical treatments commonly consist of antidepressant medications. Generally, medications should not be thought of as a first line of defense, but they can be used to gain symptomatic relief and improve the mood of a severely depressed person so that he or she will be receptive to talk therapies. For more information, see Helpguide's Medications for Treating Depression and Anxiety: Making Informed Choices.

Electroconvulsive therapy (ECT) is sometimes used for individuals whose depression is severe or life-threatening or who cannot take antidepressant medication. ECT is often prescribed when medications do not provide sufficient relief of symptoms. ECT is recommended only when symptoms are extreme, as it causes a loss of brain cells similar to a stroke.

Complementary treatments include natural substances such as St. John's Wort, SAM-e and omega-3 fatty acids. Because these are less traditional—and often controversial—approaches, their use should be considered carefully and professionally monitored for possible problems.

Lifestyle changes such as yoga and meditation, diet, aerobic exercise, improved sleep patterns, and spiritual or peer support.

Psychotherapy and Medication

Depression is helped most when people are encouraged to be active on their own behalf and to challenge their own thinking. According to an article by Michael D. Yapko, research indicates that psychotherapy outperforms medication in the long run. (See the article The Art of Avoiding Depression on the Psychology Today website.) According to Yapko, in studies comparing drug therapy to psychotherapy for depression:

After about a month, medications are ahead. They reduce symptoms more quickly and more reliably than therapy does.

After a couple of months of treatment, antidepressants and psychotherapy are equal in effectiveness.

At 12 weeks, therapy is slightly ahead in effectiveness.

Medication may dampen core biological emotions, especially those with a distinctive physiological response, and this may inhibit awareness of these primary feelings. Clients feel better about themselves when they’re involved in the healing process. They learn the principles that will help insulate them from later episodes of depression. As a result, relapse occurs 50 percent more often among patients receiving medication alone than among those receiving both drugs and therapy.