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Therapy, Medication, and Lifestyle Changes That Can Treat Depression

When you're depressed, it can feel like you'll 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, don't hesitate to seek help. Learning about your depression treatment options will help you decide which approach is right for you. From therapy to medication to healthy lifestyle changes, there are many effective treatments that can help you overcome depression, feel happy and hopeful again, and reclaim your life.

What are my depression treatment options?

Just as no two people are affected the exact same way by depression, there is no "one size fits all" treatment that cures depression. What works for one person might not work for another. The best way to treat depression is to become as informed as possible about the treatment options, and then tailor them to meet your needs.

Depression treatment tips

Learn as much as you can about your depression. It's important to determine whether your depression symptoms are due to an underlying medical condition. If so, that condition will need to be treated first. The severity of your depression is also a factor. The more severe the depression, the more intensive the treatment you're likely to need.

It takes time to find the right treatment. It might take some trial and error to find the treatment and support that works best for you. For example, if you decide to pursue therapy it may take a few attempts to find a therapist that you really click with. Or you may try an antidepressant, only to find that you don't need it if you take a daily half hour walk. Be open to change and a little experimentation.

Don't rely on medications alone. Although medication can relieve the symptoms of depression, it is not usually suitable for long-term use. Other treatments, including exercise and therapy, can be just as effective as medication, often even more so, but don't come with unwanted side effects. If you do decide to try medication, remember that medication works best when you make healthy lifestyle changes as well.

Get social support. The more you cultivate your social connections, the more protected you are from depression. If you are feeling stuck, don't hesitate to talk to trusted family members or friends, or seek out new connections at a depression support group, for example. Asking for help is not a sign of weakness and it won't mean you're a burden to others. Often, the simple act of talking to someone face-to-face can be an enormous help.

Treatment takes time and commitment. All of these depression treatments take time, and sometimes it might feel overwhelming or frustratingly slow. That is normal. Recovery usually has its ups and downs.

Lifestyle changes: An essential part of depression treatment

Lifestyle changes are simple but powerful tools in the treatment of depression. Sometimes they might be all you need. Even if you need other treatment as well, making the right lifestyle changes can help lift depression faster-and prevent it from coming back.

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 don't 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. They'll get you going without the all-too-soon sugar crash.

Sleep. Sleep has a strong effect on mood. When you don't get enough sleep, your depression symptoms will be worse. Sleep deprivation exacerbates irritability, moodiness, sadness, and fatigue. Make sure you're 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.

Stress reduction. Make changes in your life to help manage and reduce stress. Too much stress exacerbates depression and puts you at risk for future depression. Take the aspects of your life that stress you out, such as work overload or unsupportive relationships, and find ways to minimize their impact.

Ruling out medical causes of depression

If you suspect that you may be depressed, and lifestyle changes haven't worked, make an appointment to see your primary care doctor for a thorough checkup. If your depression is the result of medical causes, therapy and antidepressants will do little to help. The depression won't lift until the underlying health problem is identified and treated.

Your doctor will check for medical conditions that mimic depression, and also make sure you are not taking medications that can cause depression as a side effect. Many medical conditions and medications can cause symptoms of depression, including sadness, fatigue, and the loss of pleasure. Hypothyroidism, or underactive thyroid, is a particularly common mood buster, especially in women. Older adults, or anyone who takes many different medications each day, are at risk for drug interactions that cause symptoms of depression. The more medications you are taking, the greater the risk for drug interactions.

Psychotherapy for depression treatment

If there is no underlying medical cause for your symptoms of depression, talk therapy can be an extremely effective treatment. What you learn in therapy gives you skills and insight to feel better and help prevent depression from coming back.

There are many types of therapy available. Three of the more common methods used in depression treatment include cognitive behavioral therapy, interpersonal therapy, and psychodynamic therapy. Often, a blended approach is used.

Some types of therapy teach you practical techniques on how to reframe negative thinking and employ behavioral skills in combating depression. Therapy can also help you work through the root of your depression, helping you understand why you feel a certain way, what your triggers are for depression, and what you can do to stay healthy.

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 can't 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 life's problems. Talking with a trusted therapist can provide good feedback on more positive ways to handle life's challenges and problems.

Individual or group therapy for depression treatment?

When you hear the word "therapy" you might automatically think of one-on-one sessions with a therapist. However, group therapy can be very useful in depression treatment as well. Both group and individual therapy sessions usually last about an hour. What are the benefits of each? In individual therapy, you are building a strong relationship with one person, and may feel more comfortable sharing some sensitive information with one person than with a group. You also get individualized attention.

In group therapy, listening to peers going through the same struggles can validate your experiences and help build self-esteem. Often group members are at different points in their depression, so you might get tips from both someone in the trenches and someone who has worked through a challenging problem. As well as offering inspiration and ideas, attending group therapy can also help increase your social activities and network.

When the going gets tough in therapy...

As with remodeling a house, when you take apart things that haven't worked well in your life, it often makes them seem worse before they get better. When therapy seems difficult or painful, don't give up. If you discuss your feelings and reactions honestly with your therapist, it will help you move forward rather than retreat back to your old, less effective ways. However, if the connection with your therapist consistently starts to feel forced or uncomfortable, don't be afraid to explore other options for therapy as well. A strong trusting relationship is the foundation of good therapy.

Finding a therapist

One of the most important things to consider when choosing a therapist is your connection with this person. The right therapist will be a caring and supportive partner in your depression treatment and recovery.

There are many ways to find a therapist:

Word of mouth is one of the best ways to find a good therapist. Your friends and family may have some ideas, or your primary care doctor may be able to provide an initial referral.

National mental health organizations can also help with referral lists of licensed credentialed providers.

If cost is an issue, check out local senior centers, religious organizations, and community mental health clinics. Such places often offer therapy on a sliding scale for payment.

Medication treatment for depression

Depression medication may be the most advertised treatment for depression, but that doesn't mean it is the most effective. Depression is not just about a chemical imbalance in the brain. Medication may help relieve some of the symptoms of moderate and severe depression, but it doesn't cure the underlying problem, and it's usually not a long-term solution. Antidepressant medications also come with side effects and safety concerns, and withdrawal can be very difficult. If you're considering whether antidepressant medication is right for you, learning all the facts can help you make an informed decision.

If you are taking medication for depression, don't ignore other treatments. Lifestyle changes and therapy not only help speed recovery from depression, but also provide skills to help prevent a recurrence.

Should you get antidepressants from your family doctor?

Your family doctor might be the first professionals to recognize your depression. However, while your doctor can prescribe antidepressants, it's a good idea to explore your options with a mental health professional who specializes in depression. Ask for a referral. You might end up working with a therapist and not needing medication at all. If you do need medication, a psychiatrist has advanced training and experience in depression, treatments, and medications.

Alternative and complementary treatments for depression

Alternative and complementary treatments for depression may include vitamin and herbal supplements, acupuncture, and relaxation techniques, such as mindfulness meditation, yoga, or tai chi.

Vitamins and supplements for depression treatment

The jury is still out on how well herbal remedies, vitamins, or supplements work in treating depression. While many supplements are widely available over the counter, in many cases their efficacy has not been scientifically proven. If your depression symptoms are in part due to nutritional deficiency, you may benefit from vitamin supplements, but this should be on the advice of your healthcare professional.

If you decide to try natural and herbal supplements, remember that they can have side effects and drug or food interactions. For example, St. John's Wort-a promising herb used for treatment of mild to moderate depression-can interfere with prescription drugs such as blood thinners, birth control pills, and prescription antidepressants. Make sure your doctor or therapist knows what you are taking.

Other alternative depression treatments

Relaxation techniques. As well as helping to relieve symptoms of depression, relaxation techniques may also reduce stress and boost feelings of joy and well-being. Try yoga, deep breathing, progressive muscle relaxation, or meditation.

Acupuncture. Acupuncture, the technique of using fine needles on specific points on the body for therapeutic purposes, is increasingly being investigated as a treatment for depression, with some research studies showing promising results. If you decide to try acupuncture, make sure that you find a licensed qualified professional.

Authors: Joanna Saisan, M.S.W., Melinda Smith, M.A., and Jeanne Segal, Ph.D. Last updated: December 2018.

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Depression Treatment Therapy, Medication, and Lifestyle Changes That Can Treat DepressionWhen you're depressed, it can feel like you'll never get out from under a dark shadow. However, even the most severe depression is treatable. So, if your depression is keeping you

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Overview

What is depression? A Mayo Clinic expert explains.

Learn more about depression from Craig Sawchuk, Ph.D., L.P., clinical psychologist at Mayo Clinic.

Hi, I'm Dr. Craig Sawchuk, a clinical psychologist at Mayo Clinic. And I'm here to talk with you about depression. Whether you're looking for answers for yourself, a friend, or loved one, understanding the basics of depression can help you take the next step.

What is depression?

Depression is a mood disorder that causes feelings of sadness that won't go away. Unfortunately, there's a lot of stigma around depression. Depression isn't a weakness or a character flaw. It's not about being in a bad mood, and people who experience depression can't just snap out of it. Depression is a common, serious, and treatable condition. If you're experiencing depression, you're not alone. It honestly affects people of all ages and races and biological sexes, income levels and educational backgrounds. Approximately one in six people will experience a major depressive episode at some point in their lifetime, while up to 16 million adults each year suffer from clinical depression. There are many types of symptoms that make up depression. Emotionally, you may feel sad or down or irritable or even apathetic. Physically, the body really slows down. You feel tired. Your sleep is often disrupted. It's really hard to get yourself motivated. Your thinking also changes. It can just be hard to concentrate. Your thoughts tend to be much more negative. You can be really hard on yourself, feel hopeless and helpless about things. And even in some cases, have thoughts of not wanting to live. Behaviorally, you just want to pull back and withdraw from others, activities, and day-to-day responsibilities. These symptoms all work together to keep you trapped in a cycle of depression. Symptoms of depression are different for everyone. Some symptoms may be a sign of another disorder or medical condition. That's why it's important to get an accurate diagnosis.

What causes depression?

While there's no single cause of depression, most experts believe there's a combination of biological, social, and psychological factors that contribute to depression risk. Biologically, we think about genetics or a family history of depression, health conditions such as diabetes, heart disease or thyroid disorders, and even hormonal changes that happen over the lifespan, such as pregnancy and menopause. Changes in brain chemistry, especially disruptions in neurotransmitters like serotonin, that play an important role in regulating many bodily functions, including mood, sleep, and appetite, are thought to play a particularly important role in depression. Socially stressful and traumatic life events, limited access to resources such as food, housing, and health care, and a lack of social support all contribute to depression risk. Psychologically, we think of how negative thoughts and problematic coping behaviors, such as avoidance and substance use, increase our vulnerability to depression.

The good news is that treatment helps. Effective treatments for depression exist and you do have options to see what works best for you. Lifestyle changes that improve sleep habits, exercise, and address underlying health conditions can be an important first step. Medications such as antidepressants can be helpful in alleviating depressive symptoms. Therapy, especially cognitive behavioral therapy, teaches skills to better manage negative thoughts and improve coping behaviors to help break you out of cycles of depression. Whatever the cause, remember that depression is not your fault and it can be treated.

To help diagnose depression, your health care provider may use a physical exam, lab tests, or a mental health evaluation. These results will help identify various treatment options that best fit your situation.

Help is available. You don't have to deal with depression by yourself. Take the next step and reach out. If you're hesitant to talk to a health care provider, talk to a friend or loved one about how to get help. Living with depression isn't easy and you're not alone in your struggles. Always remember that effective treatments and supports are available to help you start feeling better. Want to learn more about depression? Visit mayoclinic.org. Do take care.

Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest. Also called major depressive disorder or clinical depression, it affects how you feel, think and behave and can lead to a variety of emotional and physical problems. You may have trouble doing normal day-to-day activities, and sometimes you may feel as if life isn't worth living.

More than just a bout of the blues, depression isn't a weakness and you can't simply "snap out" of it. Depression may require long-term treatment. But don't get discouraged. Most people with depression feel better with medication, psychotherapy or both.
Depression care at Mayo Clinic
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Symptoms

Although depression may occur only once during your life, people typically have multiple episodes. During these episodes, symptoms occur most of the day, nearly every day and may include:

Feelings of sadness, tearfulness, emptiness or hopelessness

Angry outbursts, irritability or frustration, even over small matters

Loss of interest or pleasure in most or all normal activities, such as sex, hobbies or sports

Sleep disturbances, including insomnia or sleeping too much

Tiredness and lack of energy, so even small tasks take extra effort

Reduced appetite and weight loss or increased cravings for food and weight gain

Anxiety, agitation or restlessness

Slowed thinking, speaking or body movements

Feelings of worthlessness or guilt, fixating on past failures or self-blame

Trouble thinking, concentrating, making decisions and remembering things

Frequent or recurrent thoughts of death, suicidal thoughts, suicide attempts or suicide

Unexplained physical problems, such as back pain or headaches

For many people with depression, symptoms usually are severe enough to cause noticeable problems in day-to-day activities, such as work, school, social activities or relationships with others. Some people may feel generally miserable or unhappy without really knowing why.

Depression symptoms in children and teens

Common signs and symptoms of depression in children and teenagers are similar to those of adults, but there can be some differences.

In younger children, symptoms of depression may include sadness, irritability, clinginess, worry, aches and pains, refusing to go to school, or being underweight.

In teens, symptoms may include sadness, irritability, feeling negative and worthless, anger, poor performance or poor attendance at school, feeling misunderstood and extremely sensitive, using recreational drugs or alcohol, eating or sleeping too much, self-harm, loss of interest in normal activities, and avoidance of social interaction.

Depression symptoms in older adults

Depression is not a normal part of growing older, and it should never be taken lightly. Unfortunately, depression often goes undiagnosed and untreated in older adults, and they may feel reluctant to seek help. Symptoms of depression may be different or less obvious in older adults, such as:

Memory difficulties or personality changes

Physical aches or pain

Fatigue, loss of appetite, sleep problems or loss of interest in sex - not caused by a medical condition or medication

Often wanting to stay at home, rather than going out to socialize or doing new things

Suicidal thinking or feelings, especially in older men

When to see a doctor

If you feel depressed, make an appointment to see your doctor or mental health professional as soon as you can. If you're reluctant to seek treatment, talk to a friend or loved one, any health care professional, a faith leader, or someone else you trust.

When to get emergency help

If you think you may hurt yourself or attempt suicide, call 911 in the U.S. or your local emergency number immediately.

Also consider these options if you're having suicidal thoughts:

Call your doctor or mental health professional.

Contact a suicide hotline.

In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.

U.S. veterans or service members who are in crisis can call 988 and then press "1" for the Veterans Crisis Line. Or text 838255. Or chat online.

The Suicide & Crisis Lifeline in the U.S. has a Spanish language phone line at 1-888-628-9454 (toll-free).

Reach out to a close friend or loved one.

Contact a minister, spiritual leader or someone else in your faith community.

If you have a loved one who is in danger of suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you think you can do so safely, take the person to the nearest hospital emergency room.

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Causes

It's not known exactly what causes depression. As with many mental disorders, a variety of factors may be involved, such as:

Biological differences. People with depression appear to have physical changes in their brains. The significance of these changes is still uncertain, but may eventually help pinpoint causes.

Brain chemistry. Neurotransmitters are naturally occurring brain chemicals that likely play a role in depression. Recent research indicates that changes in the function and effect of these neurotransmitters and how they interact with neurocircuits involved in maintaining mood stability may play a significant role in depression and its treatment.

Hormones. Changes in the body's balance of hormones may be involved in causing or triggering depression. Hormone changes can result with pregnancy and during the weeks or months after delivery (postpartum) and from thyroid problems, menopause or a number of other conditions.

Inherited traits. Depression is more common in people whose blood relatives also have this condition. Researchers are trying to find genes that may be involved in causing depression.

Risk factors

Depression often begins in the teens, 20s or 30s, but it can happen at any age. More women than men are diagnosed with depression, but this may be due in part because women are more likely to seek treatment.

Factors that seem to increase the risk of developing or triggering depression include:

Certain personality traits, such as low self-esteem and being too dependent, self-critical or pessimistic

Traumatic or stressful events, such as physical or sexual abuse, the death or loss of a loved one, a difficult relationship, or financial problems

Blood relatives with a history of depression, bipolar disorder, alcoholism or suicide

Being lesbian, gay, bisexual or transgender, or having variations in the development of genital organs that aren't clearly male or female (intersex) in an unsupportive situation

History of other mental health disorders, such as anxiety disorder, eating disorders or post-traumatic stress disorder

Abuse of alcohol or recreational drugs

Serious or chronic illness, including cancer, stroke, chronic pain or heart disease

Certain medications, such as some high blood pressure medications or sleeping pills (talk to your doctor before stopping any medication)

Complications

Depression is a serious disorder that can take a terrible toll on you and your family. Depression often gets worse if it isn't treated, resulting in emotional, behavioral and health problems that affect every area of your life.

Examples of complications associated with depression include:

Excess weight or obesity, which can lead to heart disease and diabetes

Pain or physical illness

Alcohol or drug misuse

Anxiety, panic disorder or social phobia

Family conflicts, relationship difficulties, and work or school problems

Social isolation

Suicidal feelings, suicide attempts or suicide

Self-mutilation, such as cutting

Premature death from medical conditions

Prevention

There's no sure way to prevent depression. However, these strategies may help.

Take steps to control stress, to increase your resilience and boost your self-esteem.

Reach out to family and friends, especially in times of crisis, to help you weather rough spells.

Get treatment at the earliest sign of a problem to help prevent depression from worsening.

Consider getting long-term maintenance treatment to help prevent a relapse of symptoms.

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Depression (major depressive disorder) - Symptoms and causes

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Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest and can interfere with your daily functioning.

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Diagnosis

Your doctor may determine a diagnosis of depression based on:

Physical exam. Your doctor may do a physical exam and ask questions about your health. In some cases, depression may be linked to an underlying physical health problem.

Lab tests. For example, your doctor may do a blood test called a complete blood count or test your thyroid to make sure it's functioning properly.

Psychiatric evaluation. Your mental health professional asks about your symptoms, thoughts, feelings and behavior patterns. You may be asked to fill out a questionnaire to help answer these questions.

DSM-5. Your mental health professional may use the criteria for depression listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.

Types of depression

Symptoms caused by major depression can vary from person to person. To clarify the type of depression you have, your doctor may add one or more specifiers. A specifier means that you have depression with specific features, such as:

Anxious distress - depression with unusual restlessness or worry about possible events or loss of control

Mixed features - simultaneous depression and mania, which includes elevated self-esteem, talking too much and increased energy

Melancholic features - severe depression with lack of response to something that used to bring pleasure and associated with early morning awakening, worsened mood in the morning, major changes in appetite, and feelings of guilt, agitation or sluggishness

Atypical features - depression that includes the ability to temporarily be cheered by happy events, increased appetite, excessive need for sleep, sensitivity to rejection, and a heavy feeling in the arms or legs

Psychotic features - depression accompanied by delusions or hallucinations, which may involve personal inadequacy or other negative themes

Catatonia - depression that includes motor activity that involves either uncontrollable and purposeless movement or fixed and inflexible posture

Peripartum onset - depression that occurs during pregnancy or in the weeks or months after delivery (postpartum)

Seasonal pattern - depression related to changes in seasons and reduced exposure to sunlight

Other disorders that cause depression symptoms

Several other disorders, such as those below, include depression as a symptom. It's important to get an accurate diagnosis, so you can get appropriate treatment.

Bipolar I and II disorders. These mood disorders include mood swings that range from highs (mania) to lows (depression). It's sometimes difficult to distinguish between bipolar disorder and depression.

Cyclothymic disorder. Cyclothymic (sy-kloe-THIE-mik) disorder involves highs and lows that are milder than those of bipolar disorder.

Disruptive mood dysregulation disorder. This mood disorder in children includes chronic and severe irritability and anger with frequent extreme temper outbursts. This disorder typically develops into depressive disorder or anxiety disorder during the teen years or adulthood.

Persistent depressive disorder. Sometimes called dysthymia (dis-THIE-me-uh), this is a less severe but more chronic form of depression. While it's usually not disabling, persistent depressive disorder can prevent you from functioning normally in your daily routine and from living life to its fullest.

Premenstrual dysphoric disorder. This involves depression symptoms associated with hormone changes that begin a week before and improve within a few days after the onset of your period, and are minimal or gone after completion of your period.

Other depression disorders. This includes depression that's caused by the use of recreational drugs, some prescribed medications or another medical condition.

Treatment

Medications and psychotherapy are effective for most people with depression. Your primary care doctor or psychiatrist can prescribe medications to relieve symptoms. However, many people with depression also benefit from seeing a psychiatrist, psychologist or other mental health professional.

If you have severe depression, you may need a hospital stay, or you may need to participate in an outpatient treatment program until your symptoms improve.

Here's a closer look at depression treatment options.

Medications

Many types of antidepressants are available, including those below. Be sure to discuss possible major side effects with your doctor or pharmacist.

Selective serotonin reuptake inhibitors (SSRIs). Doctors often start by prescribing an SSRI. These drugs are considered safer and generally cause fewer bothersome side effects than other types of antidepressants. SSRIs include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), paroxetine (Paxil, Pexeva), sertraline (Zoloft) and vilazodone (Viibryd).

Serotonin-norepinephrine reuptake inhibitors (SNRIs). Examples of SNRIs include duloxetine (Cymbalta), venlafaxine (Effexor XR), desvenlafaxine (Pristiq, Khedezla) and levomilnacipran (Fetzima).

Atypical antidepressants. These medications don't fit neatly into any of the other antidepressant categories. They include bupropion (Wellbutrin XL, Wellbutrin SR, Aplenzin, Forfivo XL), mirtazapine (Remeron), nefazodone, trazodone and vortioxetine (Trintellix).

Tricyclic antidepressants. These drugs - such as imipramine (Tofranil), nortriptyline (Pamelor), amitriptyline, doxepin, trimipramine (Surmontil), desipramine (Norpramin) and protriptyline (Vivactil) - can be very effective, but tend to cause more-severe side effects than newer antidepressants. So tricyclics generally aren't prescribed unless you've tried an SSRI first without improvement.

Monoamine oxidase inhibitors (MAOIs). MAOIs - such as tranylcypromine (Parnate), phenelzine (Nardil) and isocarboxazid (Marplan) - may be prescribed, typically when other drugs haven't worked, because they can have serious side effects. Using MAOIs requires a strict diet because of dangerous (or even deadly) interactions with foods - such as certain cheeses, pickles and wines - and some medications and herbal supplements. Selegiline (Emsam), a newer MAOI that sticks on the skin as a patch, may cause fewer side effects than other MAOIs do. These medications can't be combined with SSRIs.

Other medications. Other medications may be added to an antidepressant to enhance antidepressant effects. Your doctor may recommend combining two antidepressants or adding medications such as mood stabilizers or antipsychotics. Anti-anxiety and stimulant medications also may be added for short-term use.

Finding the right medication

If a family member has responded well to an antidepressant, it may be one that could help you. Or you may need to try several medications or a combination of medications before you find one that works. This requires patience, as some medications need several weeks or longer to take full effect and for side effects to ease as your body adjusts.

Inherited traits play a role in how antidepressants affect you. In some cases, where available, results of genetic tests (done by a blood test or cheek swab) may offer clues about how your body may respond to a particular antidepressant. However, other variables besides genetics can affect your response to medication.

Risks of abruptly stopping medication

Don't stop taking an antidepressant without talking to your doctor first. Antidepressants aren't considered addictive, but sometimes physical dependence (which is different from addiction) can occur.

Stopping treatment abruptly or missing several doses can cause withdrawal-like symptoms, and quitting suddenly may cause a sudden worsening of depression. Work with your doctor to gradually and safely decrease your dose.

Antidepressants and pregnancy

If you're pregnant or breast-feeding, some antidepressants may pose an increased health risk to your unborn child or nursing child. Talk with your doctor if you become pregnant or you're planning to become pregnant.

Antidepressants and increased suicide risk

Most antidepressants are generally safe, but the Food and Drug Administration (FDA) requires all antidepressants to carry a black box warning, the strictest warning for prescriptions. In some cases, children, teenagers and young adults under age 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed.

Anyone taking an antidepressant should be watched closely for worsening depression or unusual behavior, especially when starting a new medication or with a change in dosage. If you or someone you know has suicidal thoughts when taking an antidepressant, immediately contact a doctor or get emergency help.

Keep in mind that antidepressants are more likely to reduce suicide risk in the long run by improving mood.

Psychotherapy

Psychotherapy is a general term for treating depression by talking about your condition and related issues with a mental health professional. Psychotherapy is also known as talk therapy or psychological therapy.

Different types of psychotherapy can be effective for depression, such as cognitive behavioral therapy or interpersonal therapy. Your mental health professional may also recommend other types of therapies. Psychotherapy can help you:

Adjust to a crisis or other current difficulty

Identify negative beliefs and behaviors and replace them with healthy, positive ones

Explore relationships and experiences, and develop positive interactions with others

Find better ways to cope and solve problems

Identify issues that contribute to your depression and change behaviors that make it worse

Regain a sense of satisfaction and control in your life and help ease depression symptoms, such as hopelessness and anger

Learn to set realistic goals for your life

Develop the ability to tolerate and accept distress using healthier behaviors

Alternate formats for therapy

Formats for depression therapy as an alternative to face-to-face office sessions are available and may be an effective option for some people. Therapy can be provided, for example, as a computer program, by online sessions, or using videos or workbooks. Programs can be guided by a therapist or be partially or totally independent.

Before you choose one of these options, discuss these formats with your therapist to determine if they may be helpful for you. Also, ask your therapist if he or she can recommend a trusted source or program. Some may not be covered by your insurance and not all developers and online therapists have the proper credentials or training.

Smartphones and tablets that offer mobile health apps, such as support and general education about depression, are not a substitute for seeing your doctor or therapist.

Hospital and residential treatment

In some people, depression is so severe that a hospital stay is needed. This may be necessary if you can't care for yourself properly or when you're in immediate danger of harming yourself or someone else. Psychiatric treatment at a hospital can help keep you calm and safe until your mood improves.

Partial hospitalization or day treatment programs also may help some people. These programs provide the outpatient support and counseling needed to get symptoms under control.

Other treatment options

For some people, other procedures, sometimes called brain stimulation therapies, may be suggested:

Electroconvulsive therapy (ECT). In ECT, electrical currents are passed through the brain to impact the function and effect of neurotransmitters in your brain to relieve depression. ECT is usually used for people who don't get better with medications, can't take antidepressants for health reasons or are at high risk of suicide.

Transcranial magnetic stimulation (TMS). TMS may be an option for those who haven't responded to antidepressants. During TMS, a treatment coil placed against your scalp sends brief magnetic pulses to stimulate nerve cells in your brain that are involved in mood regulation and depression.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Lifestyle and home remedies

Depression generally isn't a disorder that you can treat on your own. But in addition to professional treatment, these self-care steps can help:

Stick to your treatment plan. Don't skip psychotherapy sessions or appointments. Even if you're feeling well, don't skip your medications. If you stop, depression symptoms may come back, and you could also experience withdrawal-like symptoms. Recognize that it will take time to feel better.

Learn about depression. Education about your condition can empower you and motivate you to stick to your treatment plan. Encourage your family to learn about depression to help them understand and support you.

Pay attention to warning signs. Work with your doctor or therapist to learn what might trigger your depression symptoms. Make a plan so that you know what to do if your symptoms get worse. Contact your doctor or therapist if you notice any changes in symptoms or how you feel. Ask relatives or friends to help watch for warning signs.

Avoid alcohol and recreational drugs. It may seem like alcohol or drugs lessen depression symptoms, but in the long run they generally worsen symptoms and make depression harder to treat. Talk with your doctor or therapist if you need help with alcohol or substance use.

Take care of yourself. Eat healthy, be physically active and get plenty of sleep. Consider walking, jogging, swimming, gardening or another activity that you enjoy. Sleeping well is important for both your physical and mental well-being. If you're having trouble sleeping, talk to your doctor about what you can do.

Alternative medicine

Alternative medicine is the use of a nonconventional approach instead of conventional medicine. Complementary medicine is a nonconventional approach used along with conventional medicine - sometimes called integrative medicine.

Make sure you understand the risks as well as possible benefits if you pursue alternative or complementary therapy. Don't replace conventional medical treatment or psychotherapy with alternative medicine. When it comes to depression, alternative treatments aren't a substitute for medical care.

Supplements

Examples of supplements that are sometimes used for depression include:

St. John's wort. Although this herbal supplement isn't approved by the Food and Drug Administration (FDA) to treat depression in the U.S., it may be helpful for mild or moderate depression. But if you choose to use it, be careful - St. John's wort can interfere with a number of medications, such as heart drugs, blood-thinning drugs, birth control pills, chemotherapy, HIV/AIDS medications and drugs to prevent organ rejection after a transplant. Also, avoid taking St. John's wort while taking antidepressants because the combination can cause serious side effects.

SAMe. Pronounced "sam-E," this dietary supplement is a synthetic form of a chemical that occurs naturally in the body. The name is short for S-adenosylmethionine (es-uh-den-o-sul-muh-THIE-o-neen). SAMe isn't approved by the FDA to treat depression in the U.S. It may be helpful, but more research is needed. SAMe may trigger mania in people with bipolar disorder.

Omega-3 fatty acids. These healthy fats are found in cold-water fish, flaxseed, flax oil, walnuts and some other foods. Omega-3 supplements are being studied as a possible treatment for depression. While considered generally safe, in high doses, omega-3 supplements may interact with other medications. More research is needed to determine if eating foods with omega-3 fatty acids can help relieve depression.

Nutritional and dietary products aren't monitored by the FDA the same way medications are. You can't always be certain of what you're getting and whether it's safe. Also, because some herbal and dietary supplements can interfere with prescription medications or cause dangerous interactions, talk to your doctor or pharmacist before taking any supplements.

Mind-body connections

Integrative medicine practitioners believe the mind and body must be in harmony for you to stay healthy. Examples of mind-body techniques that may be helpful for depression include:

Acupuncture

Relaxation techniques such as yoga or tai chi

Meditation

Guided imagery

Massage therapy

Music or art therapy

Spirituality

Aerobic exercise

Relying solely on these therapies is generally not enough to treat depression. They may be helpful when used in addition to medication and psychotherapy.

Coping and support

Talk with your doctor or therapist about improving your coping skills, and try these tips:

Simplify your life. Cut back on obligations when possible, and set reasonable goals for yourself. Give yourself permission to do less when you feel down.

Write in a journal. Journaling, as part of your treatment, may improve mood by allowing you to express pain, anger, fear or other emotions.

Read reputable self-help books and websites. Your doctor or therapist may be able to recommend books or websites to read.

Locate helpful groups. Many organizations, such as the National Alliance on Mental Illness (NAMI) and the Depression and Bipolar Support Alliance, offer education, support groups, counseling and other resources to help with depression. Employee assistance programs and religious groups also may offer help for mental health concerns.

Don't become isolated. Try to participate in social activities, and get together with family or friends regularly. Support groups for people with depression can help you connect to others facing similar challenges and share experiences.

Learn ways to relax and manage your stress. Examples include meditation, progressive muscle relaxation, yoga and tai chi.

Structure your time. Plan your day. You may find it helps to make a list of daily tasks, use sticky notes as reminders or use a planner to stay organized.

Don't make important decisions when you're down. Avoid decision-making when you're feeling depressed, since you may not be thinking clearly.

Preparing for your appointment

You may see your primary care doctor, or your doctor may refer you to a mental health professional. Here's some information to help you get ready for your appointment.

What you can do

Before your appointment, make a list of:

Any symptoms you've had, including any that may seem unrelated to the reason for your appointment

Key personal information, including any major stresses or recent life changes

All medications, vitamins or other supplements that you're taking, including dosages

Questions to ask your doctor or mental health professional

Take a family member or friend along, if possible, to help you remember all of the information provided during the appointment.

Some basic questions to ask your doctor include:

Is depression the most likely cause of my symptoms?

What are other possible causes for my symptoms?

What kinds of tests will I need?

What treatment is likely to work best for me?

What are the alternatives to the primary approach that you're suggesting?

I have these other health conditions. How can I best manage them together?

Are there any restrictions that I need to follow?

Should I see a psychiatrist or other mental health professional?

What are the main side effects of the medications you're recommending?

Is there a generic alternative to the medicine you're prescribing?

Are there any brochures or other printed material that I can have? What websites do you recommend?

Don't hesitate to ask other questions during your appointment.

What to expect from your doctor

Your doctor will likely ask you a number of questions. Be ready to answer them to reserve time to go over any points you want to focus on. Your doctor may ask:

When did you or your loved ones first notice your symptoms of depression?

How long have you felt depressed? Do you generally always feel down, or does your mood fluctuate?

Does your mood ever swing from feeling down to feeling intensely happy (euphoric) and full of energy?

Do you ever have suicidal thoughts when you're feeling down?

Do your symptoms interfere with your daily life or relationships?

Do you have any blood relatives with depression or another mood disorder?

What other mental or physical health conditions do you have?

Do you drink alcohol or use recreational drugs?

How much do you sleep at night? Does it change over time?

What, if anything, seems to improve your symptoms?

What, if anything, appears to worsen your symptoms?

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Depression is a mood disorder that causes a persistent feeling of sadness and loss of interest and can interfere with your daily functioning.

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Depression is a common mental health problem that causes people to experience low mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration.

An estimated 1 in 6 people experienced a common mental disorder in the past week, ¹ with 3.3% of aged 16 and over in England, Scotland and Wales estimated to experience depression in the past week. ²

Symptoms:

Depression symptoms may vary among people but generally encompass a feeling of sadness or hopelessness. These can include ³:

Tiredness and loss of energy

Sadness that doesn't go away

Loss of self-confidence and self-esteem

Difficulty concentrating

Not being able to enjoy things that are usually pleasurable of interesting

Feeling anxious all the time

Avoiding other people, sometimes even your close friends

Feelings of helplessness and hopelessness

Sleeping problems - difficulties in getting off to sleep or waking up much earlier than usual

Very strong feelings of guilt or worthlessness

Finding it hard to function at work/college/school

Loss of appetite

Loss of sex drive and/or sexual problems

Physical aches and pains

Thinking about suicide and death

Self-harm

Depression symptoms can vary in severity, from mild to moderate to severe depression. If you experience symptoms of depression for most of the day - every day - for more than two weeks, you should seek help from your GP.

Causes:

Depression is a complex condition and its causes are not fully understood. However, various contributing factors can lead to depression. These can include biological factors (for example, genetics ⁴ or experience of physical illness or injury ⁵) and psychological or social factors (experiences dating back to childhood ⁶, unemployment ⁷, bereavement ⁸, or life-changing events ⁹ such as pregnancy. Having a long-standing or life-threatening illness, such as heart disease, back pain or cancer, has been associated with an increased risk of depression ¹⁰.

Getting support:

Common treatment approaches for depression include talking therapies and medication.

Talking therapies

Talking therapies involve speaking in confidence to a trained professional about problems or issues that may be causing concern. Types of talking therapies include cognitive behavioural therapy (CBT), counselling and psychotherapy, and your GP can advise you about which approach you may find most helpful.

Medication

Another treatment option for depression is to take antidepressants. These can be taken on their own or in conjunction with talking therapies.

There are various types of antidepressants available and you can speak with your GP about what might suit you best. If one medication does not work, you may be prescribed something else. It is important that you take the medicine for the length of time recommended by your GP.

For more information about antidepressants, please see NHS Choices.

Other options

Your treatment approach will be informed by the severity of your depression. Those with mild to moderate depression may benefit from talking therapies whilst people experiencing moderate to severe depression may find antidepressants or combination therapy to be more appropriate. There are other treatment options beyond medication and talking therapies. For instance, people with mild depression might find exercise, self-help or mental health apps to be helpful. ³

If you have depression, it is important to speak with your GP or care provider for more detail and to discuss which treatment may be most appropriate for you.

Further Resources and Information
This page was last updated on 01/12/2018.

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Depression is a common mental health problem that causes people to experience low mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration.

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Depression is classified as a mood disorder. It may be described as feelings of sadness, loss, or anger that interfere with a person's everyday activities.

It's also fairly common. Data from the Centers for Disease Control and Prevention estimates that 18.5 percent of American adults had symptoms of depression in any given 2-week period in 2019.

Though depression and grief share some features, depression is different from grief felt after losing a loved one or sadness felt after a traumatic life event. Depression usually involves self-loathing or a loss of self-esteem, while grief typically does not.

In grief, positive emotions and happy memories of the deceased typically accompany feelings of emotional pain. In major depressive disorder, the feelings of sadness are constant.

People experience depression in different ways. It may interfere with your daily work, resulting in lost time and lower productivity. It can also influence relationships and some chronic health conditions.

Conditions that can get worse due to depression include:

It's important to realize that feeling down at times is a normal part of life. Sad and upsetting events happen to everyone. But if you're feeling down or hopeless on a regular basis, you could be dealing with depression.

Depression is considered a serious medical condition that can get worse without proper treatment.

Depression can be more than a constant state of sadness or feeling "blue."

Major depression can cause a variety of symptoms. Some affect your mood and others affect your body. Symptoms may also be ongoing or come and go.

General signs and symptoms

Not everyone with depression will experience the same symptoms. Symptoms can vary in severity, how often they happen, and how long they last.

If you experience some of the following signs and of depression nearly every day for at least 2 weeks, you may be living with depression:

feeling sad, anxious, or "empty"

feeling hopeless, worthless, and pessimistic

crying a lot

feeling bothered, annoyed, or angry

loss of interest in hobbies and interests you once enjoyed

decreased energy or fatigue

difficulty concentrating, remembering, or making decisions

moving or talking more slowly

difficulty sleeping, early morning awakening, or oversleeping

appetite or weight changes

chronic physical pain with no clear cause that does not get better with treatment (headaches, aches or pains, digestive problems, cramps)

thoughts of death, suicide, self-harm, or suicide attempts

The symptoms of depression can be experienced differently among males, females, teens, and children.

Males may experience symptoms related to their:

mood, such as anger, aggressiveness, irritability, anxiousness, or restlessness

emotional well-being, such as feeling empty, sad, or hopeless

behavior, such as loss of interest, no longer finding pleasure in favorite activities, feeling tired easily, thoughts of suicide, drinking excessively, using drugs, or engaging in high-risk activities

sexual interest, such as reduced sexual desire or lack of sexual performance

cognitive abilities, such as inability to concentrate, difficulty completing tasks, or delayed responses during conversations

sleep patterns, such as insomnia, restless sleep, excessive sleepiness, or not sleeping through the night

physical well-being, such as fatigue, pains, headache, or digestive problems

Females may experience symptoms related to their:

mood, such as irritability

emotional well-being, such as feeling sad or empty, anxious, or hopeless

behavior, such as loss of interest in activities, withdrawing from social engagements, or thoughts of suicide

cognitive abilities, such as thinking or talking more slowly

sleep patterns, such as difficulty sleeping through the night, waking early, or sleeping too much

physical well-being, such as decreased energy, greater fatigue, changes in appetite, weight changes, aches, pain, headaches, or increased cramps

Children may experience related to their:

mood, such as irritability, anger, rapid shifts in mood, or crying

emotional well-being, such as feelings of incompetence (e.g., "I can't do anything right") or despair, crying, or intense sadness

behavior, such as getting into trouble at school or refusing to go to school, avoiding friends or siblings, thoughts of death or suicide, or self-harm

cognitive abilities, such as difficulty concentrating, decline in school performance, or changes in grades

sleep patterns, such as difficulty sleeping or sleeping too much

physical well-being, such as loss of energy, digestive problems, changes in appetite, or weight loss or gain

There are several possible causes of depression. They can range from biological to circumstantial.

Common causes include:

Brain chemistry. There may be a chemical imbalance in parts of the brain that manage mood, thoughts, sleep, appetite, and behavior in people who have depression.

Hormone levels. Changes in female hormones estrogen and progesterone during different periods of time like during the menstrual cycle, postpartum period, perimenopause, or menopause may all raise a person's risk for depression.

Family history. You're at a higher risk for developing depression if you have a family history of depression or another mood disorder.

Early childhood trauma. Some events affect the way your body reacts to fear and stressful situations.

Brain structure. There's a greater risk for depression if the frontal lobe of your brain is less active. However, scientists don't know if this happens before or after the onset of depressive symptoms.

Medical conditions. Certain conditions put you at higher risk, such as chronic illness, insomnia, chronic pain, Parkinson's disease, stroke, heart attack, and cancer.

Substance use. A history of substance or alcohol misuse can affect your risk.

Pain. People who feel emotional or chronic physical pain for long periods of time are significantly more likely to develop depression.

Risk factors

Risk factors for depression can be biochemical, medical, social, genetic, or circumstantial. Common risk factors include:

Sex. The prevalence of major depression is twice as high in females as in males.

Genetics. You have an increased risk of depression if you have a family history of it.

Socioeconomic status. Socioeconomic status, including financial problems and perceived low social status, can increase your risk of depression.

Certain medications. Certain drugs including some types of hormonal birth control, corticosteroids, and beta-blockers may be associated with an increased risk of depression.

Vitamin D deficiency. have linked depressive symptoms to low levels of vitamin D.

Gender identity. The risk of depression for transgender people is nearly 4-fold that of cisgender people, according to a 2018 study.

Substance misuse. About 21 percent of people who have a substance use disorder also experience depression.

Medical illnesses. Depression is associated with other chronic medical illnesses. People with heart disease are about twice as likely to have depression as people who don't, while up to 1 in 4 people with cancer may also experience depression.

The causes of depression are often tied to other elements of your health.
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:

Medications

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).

Atypical antidepressants

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.
Psychotherapy

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 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

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.

In this form of therapy, your therapist will help you reflect and examine your childhood and experiences to help you understand and cope with your life.

Looking for ways to support your mental health and well-being? Try Healthline's FindCare tool to connect with mental health professionals nearby or virtually so you can get the care you need.

Light therapy

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

Alternative therapies

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. 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. suggests that acupuncture may help clinical treatments work better and may be as effective as counseling.

Exercise

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.

Supplements

Several types of supplements may have some positive effect on depression symptoms.

S-adenosyl-L-methionine (SAMe)

Some 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-hydroxytryptophan (5-HTP)

5-HTP 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 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

Vitamin B: B-12 and B-6 are vital to brain health. When your vitamin B levels are low, your risk for developing depression higher.

Vitamin D: Sometimes called the sunshine vitamin, vitamin D is important for brain, heart, and bone health. There a link between vitamin D deficiency and depression, but more research is needed.

Vitamins are important to many bodily functions. Research suggests two vitamins are especially useful for easing symptoms of depression:

Many herbs, supplements, and vitamins claim to help ease symptoms of depression, but most haven't shown themselves to be effective in clinical research.

Learn about herbs, vitamins, and supplements that have shown some promise, and ask your healthcare professional if any are right for you.

There isn't a single test to diagnose depression. But your healthcare provider can make a diagnosis based on your symptoms and a psychological evaluation.

In most cases, they'll ask a series of questions about your:

Because depression can be linked to other health problems, your healthcare professional may also conduct a physical examination and order blood work. Sometimes thyroid problems or a vitamin D deficiency can trigger symptoms of depression.

It's important not to ignore symptoms of depression. If your mood doesn't improve or gets worse, seek medical help. Depression is a serious mental health illness with the potential for complications.

If left untreated, complications can include:

Depression can be broken into categories depending on the severity of symptoms. Some people experience mild and temporary episodes, while others experience severe and ongoing depressive episodes.

There are two main types: major depressive disorder and persistent depressive disorder.

Major depressive disorder

Major depressive disorder (MDD) is the more severe form of depression. It's characterized by persistent feelings of sadness, hopelessness, and worthlessness that don't go away on their own.

feeling depressed most of the day

loss of interest in most regular activities

significant weight loss or gain

sleeping a lot or not being able to sleep

slowed thinking or movement

fatigue or low energy most days

feelings of worthlessness or guilt

loss of concentration or indecisiveness

recurring thoughts of death or suicide

In order to be diagnosed with clinical depression, you must experience five or more of the following symptoms over a 2-week period:

There are different subtypes of major depressive disorder, which the American Psychiatric Association refers to as "specifiers."

Persistent depressive disorder

Persistent depressive disorder (PDD) used to be called dysthymia. It's a milder, but chronic, form of depression.

In order for the diagnosis to be made, symptoms must last for at least . PDD can affect your life more than major depression because it lasts for a longer period.

lose interest in normal daily activities

feel hopeless

lack productivity

have low self-esteem

It's common for people with PDD to:

Depression can be treated successfully, but it's important to stick to your treatment plan.

Read more about why depression treatment is important.

Living with depression can be difficult, but treatment can help improve your quality of life. Talk to your healthcare professional about possible options.

The Healthline FindCare tool can provide options in your area if you don't already have a doctor.

Postpartum depression

Postpartum depression refers to depression that happens after childbirth. It is a common disorder after pregnancy, affecting 1 in 9 new parents.

It's common for people to experience "baby blues," or feelings of sadness or emptiness after childbirth. For many people, these symptoms go away in a couple of days.

But if you feel sad, hopeless, or empty for longer than 2 weeks post-childbirth, you may have postpartum depression.

feeling restless or moody

feeling sad, hopeless, or overwhelmed

having thoughts of hurting the baby or yourself

not having an interest in the baby, feeling disconnected, or as if your baby is someone else's

having no energy or motivation

eating too little or too much

sleeping too little or too much

having trouble focusing

having memory problems

feeling worthless, guilty, or like a bad parent

withdrawing from activities you once enjoyed

withdrawing from friends and family

having headaches, aches, or stomach issues that don't go away

feeling empty, unconnected, or as though you might not love or care for the baby

Symptoms of postpartum depression can range from mild to severe and can :

Postpartum depression is thought to be triggered by the dramatic hormonal changes that take place after pregnancy.

Bipolar depression occurs in certain types of bipolar disorder when a person experiences a depressive episode.

Bipolar disorder is a mental disorder that distinct changes in mood, energy, concentration, and the ability to carry out your day-to-day tasks.

There are three types of bipolar disorder, all of which include periods known as manic episodes, where you feel extremely "up," elated, or energized, and depressive episodes where you feel "down," sad, or hopeless.

If you have bipolar disorder, it can be hard to recognize the harmful effects of each "mood episode."

feel very sad, hopeless, or empty

feel slowed down or restless

have trouble falling asleep, wake up too early, or sleep too much

have an increased appetite and weight gain

talk very slowly, forget things, or feel like they have nothing to say

have trouble concentrating or making decisions

feel unable to do basic tasks

have little interest in activities

have a decreased or absent sex drive

have thoughts of death or suicide

People having a depressive episode :

Symptoms during a depressive episode last every day for most of the day and can last for several days or weeks.

If bipolar disorder is treated, many will experience fewer and less severe symptoms of depression, if they experience depressive episodes.

These 7 treatments may help ease symptoms of bipolar depression.

Depression and anxiety can occur in a person at the same time. In fact, research has shown that over of people with depressive disorders also have symptoms of anxiety.

irritability

difficulty with memory or concentration

sleep problems

Though they're thought to be caused by different things, depression and anxiety can produce several similar symptoms, which can include:

The two conditions also share some common treatments.

Both anxiety and depression can be treated with:

If you think you're experiencing symptoms of either of these conditions or both of them, make an appointment to talk with your healthcare professional. You can work with them to identify coexisting symptoms of anxiety and depression and how they can be treated.

Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. It causes unwanted and repeated thoughts, urges, and fears (obsessions).

These fears cause you to act out repeated behaviors or rituals (compulsions) that you hope will ease the stress caused by the obsessions.

People diagnosed with OCD frequently find themselves in a loop of obsessions and compulsions. If you have these behaviors, you may feel isolated because of them. This can lead to withdrawal from friends and social situations, which can increase your risk for depression.

It's not uncommon for someone with OCD to also have depression. Having one anxiety disorder can increase your odds for having another. Up to of people with OCD also have major depression episodes.

This dual diagnosis is a concern with children, too. Their compulsive behaviors, which may be first developing at a young age, can make them feel unusual. That can lead to withdrawing from friends and can increase the chance of a child developing depression.

Some individuals who have been diagnosed with major depression may also have symptoms of another mental disorder called psychosis. When the two conditions occur together, it's known as depressive psychosis.

Depressive psychosis causes people to see, hear, believe, or smell things that aren't real. People with the condition may also experience feelings of sadness, hopelessness, and irritability.

The combination of the two conditions is particularly dangerous. That's because someone with depressive psychosis may experience delusions that cause them to have thoughts of suicide or to take unusual risks.

It's unclear what causes these two conditions or why they can occur together, but treatment can successfully ease symptoms. Treatments include medications and electroconvulsive therapy (ECT).

Understanding the risk factors and possible causes can help you be aware of early symptoms.

Read more about depressive psychosis, how it's treated, and what healthcare professionals understand about why it occurs.

Pregnancy is often an exciting time for people. However, it can still be common for a pregnant woman to experience depression.

changes in appetite or eating habits

feeling hopeless

anxiety

losing interest in activities and things you previously enjoyed

persistent sadness

troubles concentrating or remembering

sleep problems, including insomnia or sleeping too much

thoughts of death or suicide

Symptoms of depression during pregnancy include:

Treatment for depression during pregnancy may focus entirely on talk therapy and other natural treatments.

While some women do take antidepressants during their pregnancy, it's not clear which ones are the safest. Your healthcare provider may encourage you to try an alternative option until after the birth of your baby.
Recognizing the symptoms may help you spot a problem and seek help before it becomes overwhelming.
The risks for depression can continue after the baby arrives. Postpartum depression, which is also called major depressive disorder with peripartum onset, is a serious concern for new mothers.

Research has established a link between alcohol use and depression. People who have depression are more likely to misuse alcohol.

Out of the 20.2 million U.S. adults who experienced a substance use disorder, about had a co-occurring mental illness.

Drinking alcohol frequently can make symptoms of depression worse, and people who have depression are more likely to misuse alcohol or become dependent on it.

Depression isn't generally considered to be preventable. It's hard to recognize what causes it, which means preventing it is more difficult.

But once you've experienced a depressive episode, you may be better prepared to prevent a future episode by learning which lifestyle changes and treatments are helpful.

regular exercise

getting plenty of sleep

maintaining treatments

reducing stress

building strong relationships with others

Techniques that may help include:

Other techniques and ideas may also help you prevent depression.

Read the full list of 15 ways you may be able to avoid depression.

Depression can be temporary, or it can be a long-term challenge. Treatment doesn't always make your depression go away completely.

However, treatment often makes symptoms more manageable. Managing symptoms of depression involves finding the right combination of medications and therapies.
Read this article in Spanish.
If one treatment doesn't work, talk with your healthcare professional. They can help you create a different treatment plan that may work better in helping you manage your condition.

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Everything You Want to Know About Depression

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Depression is classified as a mood disorder. It may be described as feelings of sadness, loss, or anger that interfere with a person's everyday activities. It's also fairly common. Data from the Centers for Disease Control and Prevention estimates that 18.5 percent of American adults had symptoms of depression in any given 2-week period in 2019.

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depression isn't a weakness and you can't simply "snap out" of it
symptoms usually are severe enough to cause noticeable problems in day-to-day activities

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Depression is a complex condition and its causes are not fully understood
An estimated 1 in 6 people experienced a common mental disorder in the past week,

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I feel like more people should take depression seriously. It it a serious mood disorder and people are usually made of for having it. They get told they are just seeking attention or that they can think themselves out of it. But you really can't think yourself out of it. Its a constant feeling sadness that doesn't go away. And if you don't get the right treatment it can and will get worse, and not just help from friends, help from a professional who know what they are talking about.
Conditions that can get worse due to depression include:

arthritis

asthma

cardiovascular disease

cancer

diabetes

obesity

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there is no “one size fits all” treatment that cures depression
Learn as much as you can about your depression.
It takes time to find the right treatment.
Don’t rely on medications alone.
Get social support.
Treatment takes time and commitment

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Medications and psychotherapy are effective for most people with depression
Don't stop taking an antidepressant without talking to your doctor first. Antidepressants aren't considered addictive, but sometimes physical dependence (which is different from addiction) can occur
For some people, other procedures, sometimes called brain stimulation therapies, may be suggested

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This is only if you went to drugs as an option to "get away" from your depression and you are addicted to the drugs you used.

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There are many different types of depression so not just one way will help everyone. Thats why it is best to seek medical attention instead of googling everything or just going to friends about it because what may have worked for someone else may not work for you. There are other types of disorders that can cause depression symptoms too. Some treatments you can get are electroconvulsive therapy and transcranial magnetic stimulation. There are different features to each type of depression. Some pf the ways you get diagnosed with depression are physical exam, lab tests, psychiatric evaluation and DSM-5.

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Depression is classified as a mood disorder
About 30 percent of people who have a substance use problem also experience depression

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National Institute of Mental Health (NIMH)

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Learn about depression, including types, signs and symptoms, risk factors, treatments and therapies, and things you can do to help during treatment.

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Current research suggests that depression is caused by a combination of genetic, biological, environmental, and psychological factors
can happen at any age, but often begins in adulthood
especially in midlife or older adults, can co-occur with other serious medical illnesses, such as diabetes, cancer, heart disease, and Parkinson’s disease
No two people are affected the same way by depression and there is no "one-size-fits-all" for treatment. It may take some trial and error to find the treatment that works best for you

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There is persistent depressive disorder, postpartum depression, psychotic depression, seen effective disorder,and bipolar disorder. Thee are multiple symptoms of depression such as bin persistently sad and anxious, irritability, decreased energy and etc. Risk factors are family history, major life changes, trauma, stress or certain medical illnesses or and medications. Even the most severe cASes of depression can be treated. However what works for one person might not work for the next. Ways to treat it are medications(they might have side effects), psychotherapies, brain stimulation therapies, and some beyond treatments.