The sort of treatment you're offered for depression will depend on:
- how much your symptoms are affecting you
- your personal preference for what sort of treatment you find helps you
The main treatments for depression are:
This page also covers:
I really struggled with the SSRIs, even though my GP told me that was the only course of action. They made me feel worse than I did to start with, then incredibly tired. I fought for a referral for CBT and in the end it saved me.
Talking treatments for depression
There are many different talking treatments that can be effective in treating depression:
- cognitive behavioural therapy (CBT)
- group-based CBT
- computerised CBT (CCBT) – this is CBT delivered through a computer programme or website
- interpersonal therapy (IPT)
- behavioural activation
- psychodynamic psychotherapy
- behavioural couples therapy – if you have a long-term partner, and your doctor agrees that it would be useful to involve them in your treatment
Your doctor or mental health professional can talk through the options available in your area and help you find the right kind of talking treatment for you. Unfortunately, we know that in many places NHS waiting lists for talking treatments can be very long. Our talking treatments section has more detail about these therapies, and information on how to access them – through the NHS, charities and privately.
Talking things through with a counsellor or therapist really helps me to see things more rationally and make connections between reality and inside my head.
Medication for depression
You might also be offered an antidepressant, either on its own or in combination with a talking treatment. There are different types of antidepressants:
Different people find different medications most helpful. You can talk to your doctor about your options – you might find you need to try out a few different types of medication before you find the one that works for you. See our pages on antidepressants for more information.
Antidepressants have helped to put me in a place where I was more able to cope with counselling. This required a lot of hard work and I had to accept a completely different way of thinking.
Treatment for severe and complex depression
If your depression is severe and complex, your doctor should refer you to specialist mental health services. They can discuss with you the following options:
- trying talking treatments and medication again
- hospital admission (see our page on hospital admission for more information)
- medication for psychotic symptoms (see our pages on psychosis and antipsychotics for more information)
- planning for and managing a crisis (see our page on crisis services for more information)
A majority of the treatments I tried were ineffective – but at crisis point, about to be admitted to a psychiatric hospital, I started Interpersonal Psychotherapy and Sertraline. I can honestly say that they saved my life.
There are also other options you can try instead of, or alongside, medication and talking treatments.
If you aren't experiencing many symptoms, or they aren't impacting on your daily life too much, then your doctor might suggest:
- watchful waiting – this means being aware of your mood, and seeing how you feel after a few weeks have passed; many people find that some mild depressive symptoms can go away on their own
- guided self-help – this is usually using ideas from cognitive behavioural therapy (CBT) one-to-one with a mental health professional to learn problem solving techniques
- physical activity programmes – these are specifically designed for people with depression and run by qualified professionals
You might also find these other treatments helpful, however many symptoms you're experiencing:
Your doctor may be able to refer you to some of these. You can also contact your local Mind to find out what they have available.
Taking care of my diet and body, talking and alternative methods work far better for me.
Electroconvulsive therapy (ECT) should only be considered a treatment option for depression in extreme circumstances. According to NICE guidelines this could be if:
- you're experiencing a long and severe period of depression
- other treatments have not worked
- the situation is life-threatening
If you feel like you're in this situation, your doctor should discuss this option with you in a clear and accessible way before you make any decisions.
See our pages on ECT for more information about this treatment and when it can be performed. Also see our legal pages on consent to treatment and the Mental Capacity Act 2005 for information about your legal rights regarding treatment.
Is neurosurgery ever used to treat depression?
Neurosurgery for mental disorder (NMD) is only performed very rarely, in extreme circumstances. NMD is only offered if all other treatments have failed and cannot ever be performed without your consent. See our pages on NMD for more information.
If you start to feel better, it's important to discuss with your doctor whether you should continue your treatment. Your doctor can also discuss your options for treatment to stay well after an episode of depression has passed. See our pages on self-care for more ideas on staying well.
If you're taking medication for depression, it's important not to stop suddenly. This can be dangerous, and withdrawal symptoms can be difficult to cope with. See our pages on coming off antidepressants and coming off psychiatric medication for more information.
NICE recommends that you continue to take your antidepressants for at least six months after your episode of depression ends. If you've experienced several episodes of depression before, you might want to keep taking your medication if you feel it could help you prevent another episode.
Fluoxetine has helped me to manage my lows so they do not become as crippling as they used to.
If you're currently receiving a talking treatment, you don't have to stop just because you're feeling better. You can discuss your mood with your therapist and talk about what options might be right for you.
NICE recommends CBT or mindfulness based cognitive therapy (MBCT) to help you stay well if you've had episodes of depression in the past.
An understanding counsellor who gave me techniques to use as I moved forward helped me get on the right track.
This information was published in June 2016. We will revise it in 2019.