Information about depression, its symptoms and possible causes, and how you can access treatment and support. Includes tips on caring for yourself, and guidance for friends and family.
There are various treatments that have been found to help with depression. This page covers:
There is also information that you may find useful if a treatment isn't helping you to feel better.
"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."
A self-help resource might be the first treatment option your doctor offers you, especially if your depression is mild. This is because it's available quite quickly, and there's a chance it could help you to feel better without needing to try other options.
Self-help could be delivered through:
There are many different talking therapies that can be effective in treating depression:
Your doctor or mental health professional can talk through the options available in your area and help you find the right kind of talking therapy for you. Unfortunately, we know that in many places NHS waiting lists for talking treatments can be very long.
Our talking therapy and counselling page 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."
If you're currently receiving a talking therapy, 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 guidelines recommend CBT or mindfulness-based cognitive therapy to help you stay well if you've had episodes of depression in the past.
"The more I opened up in counselling, the less of a burden I felt on my shoulders."
If self-help, computerised cognitive behavioural therapy or physical activity have not helped you, you might also be offered an antidepressant medication, either on its own or in combination with a talking therapy. There are different types of antidepressant:
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."
If you are taking medication for depression, it's important not to stop suddenly. Withdrawal symptoms from antidepressants can be difficult to cope with, and stopping suddenly can be dangerous. See our pages on coming off antidepressants and coming off psychiatric medication for more information.
If you decide to try coming off your medication, it's very important to:
NICE guidelines recommend 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.
"I've had three experiences of reducing/coming off medication all together with my GP: one was a successful reduction that led to 5 years full time work whilst the other two led to what I believe was 'rebound psychosis' (rather than 'a return to my underlying illness'). I believe this happened because I came off medication too quickly ie over months rather than over a year or more."
"Taking care of my diet and body, talking and alternative methods work far better for me."
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:
"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."
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, and either:
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.
According to NICE guidelines, you might be offered repetitive transcranial magnetic stimulation for severe depression that has not responded to other treatments.
Treatment involves daily sessions of about 30 minutes, lasting for a number of weeks.
The NICE guidelines say that it's safe enough and works well enough to be offered on the NHS. Currently this treatment is available at a limited number of NHS trusts and some private clinics.
Different things work for different people, so if a particular medication or talking therapy doesn't work for you, your doctor should offer an alternative.
It's important to remember that recovery is a journey, and it won't always be straightforward. You might find it more helpful to focus on learning more about yourself and developing ways to cope, rather than trying to get rid of every symptom of your depression.
This information was published in March 2019. We will revise it in 2022.
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