There are several different depression treatments that are available. Most require a doctor’s approval, but certain herbs and supplements are available over the counter. The best option for you depends on the type of depression you have, the severity of your depression and how well you respond to any given treatment. The following is a summary of the many types of depression treatments which may be available to you.
Antidepressants are the most common depression treatments.
Antidepressants fall into several different classes, depending upon how they affect brain chemistry or their chemical structure.
The best antidepressant type for you will depend on several factors, such as how well it is working for you. how well you are able to tolerate its side effects and whether your insurance will cover it.
Selective Serotonin Reuptake Inhibitors (SSRIs) are a popular first choice for treating depression due to the fact that they have fewer side effects and work well.
If your antidepressant is working, but not well enough, your doctor may opt to add a second antidepressant or other medications, such as mood stabilizers or antipsychotics, to enhance its effect. Drugs such as stimulants or anti-anxiety medications might also we used in conjunction with your antidepressant.
Psychotherapy is a type of treatment which involves the patient sitting in a room with a therapist and talking. It’s not just having a conversation, however. Psychotherapists are trained in techniques which can help you discover insights into your depression and effect change in your life.
Psychotherapy can take place in a variety of formats, depending on your needs. You might have therapy alone, with a partner, with your family or even in a group setting.
There are a variety of therapeutic approaches to psychotherapy, but Cognitive Behavioral Therapy (CBT) is one of the best for treating depression. CBT involves becoming aware of faulty patterns of thinking that you might be engaging in, called cognitive distortions. Once you become aware of those thoughts, you can reframe them in a more accurate, positive manner. Better thinking then leads to better moods.
Brain stimulation is not as commonly used for treating depression, but it does hold great promise for treating cases of depression which have not responded to medications and psychotherapy.
This method of treatment involves either inhibiting or activating the brain with electricity. The application of electricity can be done through electrodes placed on the scalp (electroconvulsive therapy) or directly to the brain (deep brain stimulation). Magnetic fields can also be used to induce electricity (repetitive transcranial magnetic stimulation or magnetic seizure therapy). Or, a pacemaker-like implant may be used to provide nerve stimulation (vagus nerve stimulation). Finally, a pulsed, weak electrical current may be applied to the ear lobes, maxilla-occiptal junction, mastoid process or temples (cranial electrotherapy stimulation).
The oldest and best-studied brain stimulation method for depression is electroconvulsive therapy (ECT). ECT can be a quick and effective treatment for patients who are feeling suicidal. It can also be helpful for those who may not have benefited from other treatments. In addition, it is useful for patients who may not be able to use other treatments, due to side effects or a medical condition. Unfortunately, ECT does have certain undesirable side effects, such as memory loss.
A type of depression called seasonal affective disorder (SAD) is especially responsive to light therapy. SAD occurs during the winter when the days are shorter. This reduced exposure to sunlight can throw off the circadian rhythm in sensitive individuals, causing them to become depressed. By sitting in front of a light box with the correct color, timing and intensity of light, the body clock can be reset.
Researchers say that antidepressants, psychotherapy and supplementation with a hormone called melatonin can also help SAD.
The jury is still out at the time of this writing on whether marijuana is a viable alternative for treating depression.
One thing we do know about marijuana use and depression is that they often occur together. We don’t know what this means, however. Some have suggested that marijuana causes depression. Others say people with existing depression are simply using it to self-medicate. At this time, it doesn’t appear that marijuana causes depression, but a definitive answer is simply not known.
As to whether it helps depression, there is some evidence, both in research studies and in anecdotal accounts, that it does help. At least one study found that dose seemed to be the determining factor in whether it helped. Low doses seemed to improve symptoms, while higher ones made them worse.
Until the time comes that we know for certain whether marijuana helps depression, the choice whether to use it remains between you, your doctor and your state.
Over-the-Counter Depression Treatments
If your depression is only mild to moderate in intensity, you may wish to use one of several over-the-counter depression treatments such as herbs and supplements. Please consult with your doctor, a pharmacist or a reliable health information website for for more information if you intend to use any over-the-counter herb or supplement. Just like with prescription medications, there may be side effects or interactions if they are used improperly.
If your diet is poor, consider supplementing with a good quality vitamin and mineral supplement and/or improving your diet. There are several vitamin and mineral deficiencies which may cause you to feel depressed. In additional, low levels of omega-3 fatty acids have been associated with depression. You can increase these in your diet by eating fatty fish like salmon or mackerel or by taking fish oil supplements.
Another supplement which may have some utility in treating depression is 5-HTP. In the body, 5-HTP can be converted to serotonin, a chemical which is thought to be involved in mood regulation. Low levels of serotonin have been associated with depression. It is believed that 5-HTP may be able to help depression by increasing serotonin production. If 5-HTP is taken as directed, it is believed to be safe to use. 5-HTP should not be taken with antidepressants or other drugs with interact with serotonin as this may lead to a dangerous buildup of serotonin.
Among herbals, St. John’s wort if your best choice. Strong evidence exists supporting its use in the treatment of mild to moderate depression. You should be aware, however, that it does have some potential for side effects, such as sun sensitivity and interactions with certain prescription drugs. It should not be combined with any other antidepressant in order to avoid the risk of having too much serotonin building up in your brain. This buildup, called serotonin syndrome, can potentially be fatal.
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Nancy Schimelpfening has a master’s degree in community health education from Old Dominion University in Norfolk, VA.
She was the About.com (now Verywell.com) expert in depression for 18 years, providing her readers with reliable, evidence-based answers to their many questions and concerns about their illness.
Nancy is the founder of the non-profit organization Depression Sanctuary, which provides a free, online peer support group for those with depression. She has served as its president since 2016.
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