Treatment for depression
You may successfully manage symptoms with one form of treatment, or you may find that a combination of treatments works best.
It’s common to combine medical treatments and lifestyle therapies, including the following. In this post, Pritish tells you about different treatments and remedies for depression.
Your healthcare professional may prescribe:
Selective serotonin reuptake inhibitors (SSRIs)
SSRIs are the most commonly prescribed antidepressant medications and tend to have few side effects. They treat depression by increasing the availability of the neurotransmitter serotonin in your brain.
SSRIs should not be taken with certain drugs including monoamine oxidase inhibitors (MAOIs) and in some cases thioridazine or Orap (pimozide).
People who are pregnant should talk to their healthcare professionals about the risks of taking SSRIs during pregnancy. You should also use caution if you have narrow-angle glaucoma.
Examples of SSRIs include citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox), paroxetine (Paxil, Paxil XR, Pexeva), and sertraline (Zoloft).
Serotonin and norepinephrine reuptake inhibitors (SNRIs)
SNRIs treat depression by increasing the amount of the neurotransmitters serotonin and norepinephrine in your brain.
SNRIs should not be taken with MAOIs. You should use caution if you have liver or kidney problems, or narrow-angle glaucoma.
Examples of SNRIs include desvenlafaxine (Pristiq, Khedezla), duloxetine (Cymbalta, Irenka), levomilnacipran (Fetzima), milnacipran (Savella), and venlafaxine (Effexor XR).
Tricyclic and tetracyclic antidepressants
Tricyclic antidepressants (TCAs) and tetracyclic antidepressants (TECAs) treat depression by increasing the amount of the neurotransmitters serotonin and norepinephrine in your brain.
TCAs can cause more side effects than SSRIs or SNRIs. Do not take TCAs or TECAs with MAOIs. Use with caution if you have narrow-angle glaucoma.
Examples of tricyclic antidepressants include amitriptyline (Elavil), doxepin (Sinequan), imipramine (Tofranil), trimipramine (Surmontil), desipramine (Norpramin), nortriptyline (Pamelor, Aventyl), and protriptyline (Vivactil).
Noradrenaline and dopamine reuptake inhibitors (NDRIs)
These drugs can treat depression by increasing the levels of dopamine and noradrenaline in your brain.
Examples of NDRIs include bupropion (Wellbutrin).
Monoamine oxidase inhibitors (MAOIs)
MAOIs treat depression by increasing the levels of norepinephrine, serotonin, dopamine, and tyramine
in your brain.
Due to side effects and safety concerns, MAOIs are not the first choice for treating mental health disorders. They are typically used only if other medications are unsuccessful at treating depression.
Examples of MAOIs include isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Emsam), tranylcypromine (Parnate).
N-methyl D-aspartate (NMDA) antagonists
N-methyl-D-aspartate (NDMA) antagonists treat depression by increasing levels of glutamate in the brain. Glutamate is a neurotransmitter believed to be involved in depression.
NMDA antagonists are used only in patients who have not had success with other antidepressant treatments.
The FDA has approved one NDMA medication, esketamine (Spravato), for the treatment of depression.
Esketamine is a nasal spray that is only available through a restricted program called Spravato REMS.
Patients may experience tiredness and dissociation (difficulty with attention, judgment, and thinking) after taking the medication. For this reason, esketamine is administered in a healthcare setting where a healthcare professional can monitor for sedation and dissociation.
Each type of medication that’s used to treat depression has benefits and potential risks.
Speaking with a therapist can help you learn skills to cope with negative feelings.
You may also benefit from family or group therapy sessions.
Psychotherapy, also known as “talk therapy,” is when a person speaks to a trained therapist to identify and learn to cope with the factors that contribute to their mental health condition, such as depression.
Psychotherapy has been shown to be an effective treatment in improving symptoms in people with depression and other psychiatric disorders.
Psychotherapy is often used alongside pharmaceutical treatment. There are many different types of psychotherapy, and some people respond better to one type than another.
Cognitive behavioral therapy (CBT)
In cognitive behavioral therapy (CBT), a therapist will work with you to uncover unhealthy patterns of thought and identify how they may be causing harmful behaviors, reactions, and beliefs about yourself.
Your therapist might assign you “homework” where you practice replacing negative thoughts with more positive thoughts.
Dialectical behavior therapy (DBT)
Dialectical behavior therapy (DBT) is similar to CBT, but puts a specific emphasis on validation, or accepting uncomfortable thoughts, feelings, and behaviors, instead of fighting them.
The theory is that by coming to terms with your harmful thoughts or emotions, you can accept that change is possible and make a recovery plan.
Psychodynamic therapy is a form of talk therapy designed to help you better understand and cope with your day-to-day life. Psychodynamic therapy is based on the idea that your present-day reality is shaped by your unconscious, childhood experiences.
Exposure to doses of white light can help regulate your mood and improve symptoms of depression. Light therapy is commonly used in seasonal affective disorder, which is now called major depressive disorder with seasonal pattern.
Electroconvulsive therapy (ECT)
Electroconvulsive therapy (ECT) uses electrical currents to induce a seizure, and has been shown to help people with clinical depression.
It’s used in people with severe depression or depression that is resistant to other treatments or antidepressant medications.
During an ECT procedure, you’ll receive an anesthetic agent which will put you to sleep for approximately 5 to 10 minutes.
Your healthcare professional will place cardiac monitoring pads on your chest and four electrodes on specific areas of your head. They will then deliver short electrical pulses for a few seconds. You will neither convulse nor feel the electrical current and will awaken about 5 to 10 minutes after treatment.
Side effects include headaches, nausea, muscle aches and soreness, and confusion or disorientation.
Patients may also develop memory problems, but these usually reside in the weeks and months after treatment
Ask your doctor about alternative therapies for depression. Many people choose to use alternative therapies alongside traditional psychotherapy and medication. Some examples include:
Meditation. Stress, anxiety, and anger are triggers of depression, but meditation can help change the way your brain responds to these emotions. Studies show that meditation practices can help improve symptoms of depression and lower your chances of a depression relapse.
Acupuncture. Acupuncture is a form of traditional Chinese medicine that may help ease some symptoms of depression. During acupuncture, a practitioner uses needles to stimulate certain areas in the body in order to treat a range of conditions. Research suggests that acupuncture may help clinical treatments work better and may be as effective as counseling.
Natural remedies and lifestyle tips
Aim for 30 minutes of physical activity 3 to 5 days a week. Exercise can increase your body’s production of endorphins, which are hormones that improve your mood.
Avoid alcohol and substance use
Drinking alcohol or misusing substances may make you feel better for a little bit. But in the long run, these substances can make depression and anxiety symptoms worse.
Learn how to set limits
Feeling overwhelmed can worsen anxiety and depression symptoms. Setting boundaries in your professional and personal life can help you feel better.
Take care of yourself
You can also improve symptoms of depression by taking care of yourself. This includes getting plenty of sleep, eating a healthy diet, avoiding negative people, and participating in enjoyable activities.
Sometimes depression doesn’t respond to medication. Your healthcare professional may recommend other treatment options if your symptoms don’t improve.
These options include electroconvulsive therapy (ECT) or repetitive transcranial magnetic stimulation (rTMS) to treat depression and improve your mood.
Several types of supplements may have some positive effect on depression symptoms.
Some research suggests this compound may ease symptoms of depression. The effects were best seen in people taking SSRIs. However, the results of this research is not conclusive and more research is needed.
5-HTP may raise serotonin levels in the brain, which could ease symptoms. Your body makes this chemical when you consume tryptophan, a building block of protein. However, more studies are needed.
Omega-3 fatty acids
These essential fats are important to neurological development and brain health. Adding omega-3 supplements to your diet may help reduce depression symptoms. However, there is some conflicting evidence and more research is needed.
Always talk to your doctor before taking supplements, as they may interact with other medications or have negative effects.
Vitamins are important to many bodily functions. Research suggests two vitamins are especially useful for easing symptoms of depression:
- Vitamin B: B-12 and B-6 are vital to brain health. When your vitamin B levels are low, your risk for developing depression may be higher.
- Vitamin D: Sometimes called the sunshine vitamin, vitamin D is important for brain, heart, and bone health. There may be a link between vitamin D deficiency and depression, but more research is needed.
Many herbs, supplements, and vitamins claim to help ease symptoms of depression, but most haven’t shown themselves to be effective in clinical research.