Depression is difficult. It’s a powerful illness that negatively impacts millions of lives.
The good news is that depression treatment works. It’s estimated that 80-90% of people get better with treatment, often seeing significant improvement within just weeks of starting. People beat depression every single day.
That doesn’t mean it’s easy. Depression treatment takes time and consistency and can require taking a close look at some painful and challenging issues in our lives.
If you are unsure if what you are experiencing is depression, you may want to review the Signs and Symptoms of Depression.
What are the typical treatments for depression?
If you have been diagnosed with depression, the first thing your doctor or therapist will likely explain to you is that there are three main treatments for depression: medication, therapy, and self care. Let’s walk through each of them so you have a good understanding of each.
Medication is good at reducing the symptoms of depression and the impact it’s having on your life. Many people find that medication simply makes them feel better. They often feel less sad, less weighed down, and have more energy, allowing them to get back into their life. Antidepressant medication works by affecting the availability of certain neurotransmitters — the brain’s chemical messengers.
One way to think about medication is like a splint for a sprained ankle. Wearing a splint allows your ankle to heal to the point where you could start walking or running on your own again. Medication can provide a similar boost with depression. Many people experience significant benefits in the first 12 weeks and once improvement is sustained for 6 months, the majority of people can begin to wean off their medication without symptoms returning.
Therapy is a time tested treatment for depression. There are multiple pragmatic approaches to depression therapy that have shown to work well in research studies:
- Cognitive Behavioral Therapy (CBT): The core principle of CBT is that there is a fundamental connection between how we think, how we act, and how we feel. It offers simple and useful approaches to help people recognize negative patterns in how they think and act and replace them with healthier ones to improve how they feel.
- Interpersonal Therapy (IPT) helps people understand the way they relate to other people and events, adopting healthy approaches to build connection. IPT focuses on evaluating your perceptions of yourself, improving your communication with family and friends, and enhancing connection and conflict resolution.
- Dialectical Behavioral Therapy (DBT) focuses on the balance between accepting the things we cannot change and taking ownership and action for the things we can change.
- Acceptance and Commitment Therapy (ACT) aims to increase psychological flexibility using mindfulness, acceptance, values exploration, and commitment.
Each of these approaches is designed to last about 12 weeks. Some people prefer in person one-on-one sessions with a therapist, others may opt for online sessions or self paced apps.
Self care consists of lifestyle modifications – making healthy changes to diet, sleep, exercise, stress management, and relationships to reduce depression. Small steps and habits can have a major impact.
According to Brightside’s Chief Medical Officer Dr. Mimi Winsberg, “there is good evidence that modifying behaviors such as sleep, activity levels, and brain wave patterns (through activities like meditation), can influence mood in powerful ways. We also know diet plays a role in mood. There are many ways a person can engage in behavioral change to change the course of their illness”.
The same things that make our bodies healthy are also critical for our mind and mood:
- Eat a healthy diet: Studies have shown that people who eat a Mediterranean diet have 25% to 35% lower risk of depression compared to those who eat a typical Western diet, which is mostly comprised of refined foods and sugars. Eat fresh, whole foods and plenty of vegetables – avoid processed foods. Drink water and reduce sugar, especially by eliminating sugary beverages like soda and juice.
- Be physically active: Make sure you walk or do other exercise for at least 30 minutes per day – everything counts and even a little bit can make a difference
- Get enough sleep: experts recommend 7-9 hours per night on a consistent sleep/wake schedule
- Stop drinking alcohol and smoking: If you can avoid alcohol and tobacco, you’re likely to feel better physically and emotionally
Research shows that certain nutritional supplements may help with the symptoms of depression:
- Fish oil: high in omega-3 fatty acids which can decrease inflammation
- Vitamin D: vitamin D deficiency has been associated with higher incidence of depression
- Vitamin B Complex: includes 11 B vitamins essential for the brain and body to function properly, including precursors to neurotransmitters
- SAMe: some studies suggest SAMe may be as effective as antidepressants
- L-Methylfolate: Can help reduce the symptoms of depression alone or amplify the effect of antidepressant medication
- Probiotics: Most of our serotonin supply is produced in our digestive tract, not in our brains, which means our digestive tract isn’t just helping us to digest foods – it’s also helping to guide our emotions. Keeping a healthy gut requires keeping a healthy microbiome – the good bacteria living in your digestive tract.
- Others believed to benefit depression symptoms include St. John’s Wort, 5-HTP, Saffron, and NAC
Note: Nutritional supplements are not overseen by the FDA like medications are. Before taking any supplements, you should always talk to a doctor about which ones may be right for you
Mindfulness involves taking time out of your day to be present in the moment, doing simple breathing exercises that help you let go of worries and preoccupations. It’s easy to learn and you can do it anytime, anywhere.
It’s also important to develop and maintain meaningful connections to people in your life. Spending social time isn’t just for fun – feeling connected protects against depression and builds resilience. Put yourself out there.
What about combining depression treatments?
Depression tends to have biological, psychological, and social/environmental influences. Because of this, the best outcomes are often achieved with medication and therapy together, complemented with a self care regimen. This combination helps reduce symptoms of depression in the near term while processing emotions and developing skills and resilience for lasting gains.
According to Mari Kurahashi, MD, MPH, “The combination of medication and therapy is more effective than any one treatment alone. At the same time, a reasonable alternative is either medication or therapy alone as both have been shown to be effective for depression treatment, even when given alone and not in combination. In addition, it is important for someone with depression to also incorporate relaxation, physical exercise and pleasant activities.”
Mimi Winsberg continues, “Almost all effective treatments for depression include a combination of everything above. Combining treatments optimizes outcomes by attacking the problem from multiple angles and modalities. Many of the treatment modalities seek to strengthen a region of the brain called the dorsolateral prefrontal cortex. The more ways this brain region is strengthened, the better the results.”
Should I get treatment for my depression?
If you are depressed, you should get treatment. Treatment can be relatively easy, affordable, and highly effective. About 80-90% of people get better with depression treatment..
It can sometimes seem easier to live with depression than seek help. But there are serious risks associated with delaying care:
- Increased likelihood that the depression will get worse
- Lowered likelihood of achieving remission
- Physical brain changes, including inflammation
- Negative impact on family, friends, and work relationships
- Increased risk of suicide and substance abuse
- Increased risk of heart disease
So if you’re experiencing depression, get treatment. You can choose the approach that’s right for you – you may want to start by trying CBT, learning meditation, or improving your diet. Or you may find it easier to get guidance, support, and structure from a doctor or therapist. But whatever you do, help is available.
What’s important is choosing the care plan that’s right for you and following through with it.