Depression: When You’ve Stopped Treatment

Treating Your Depression:
Don't Give Up

Even though you're not getting help for depression anymore, the fact that you're here suggests you may be reconsidering. That's a good idea.

Depression treatment doesn't work the same for everyone. It also doesn't work immediately. You need to stick with it and talk about your expectations and any problems with your doctor.

In this step-by-step guide you'll find out how to get the help you need, including:

Helping your medication work
Counseling and psychotherapy
Managing stress and the importance of exercise

At the end of this article you will find a list of more in-depth articles on many of the topics discussed here.

I Stopped Getting Help Because…

There are a lot of different reasons people stop getting treatment for depression.

I was feeling better. That's good. But remember that your treatment might have been what helped you feel better. Stopping too early could make your depression worse.
I didn't like the medication side effects. You should know that side effects tend to be worse in the first weeks or months and get better with time. A different dosage or drug could help, too.
I couldn't afford treatment. You have options. Ask about a cheaper generic antidepressant or drug company assistance programs. See if your therapist might charge on a sliding scale.
It didn't work. Many people don't recover with their first treatment. But the odds are very good that other treatments will help.

Finding the Right Medication for You

You may have already tried one kind of antidepressant. But even if one didn't work, another one probably will. Here's what you should know:

What to expect: Antidepressants are effective. But you may need to try more than one -- or a combination -- to find what works for you. Be patient. It can take 6 weeks or longer to get full symptom relief. If your depression is hard to treat, your doctor may combine other medications with antidepressants.

Symptom relief: If all your depression symptoms aren't relieved or you are having trouble living with the side effects of your medication, talk to your doctor immediately to see if you need to make a change. Treatment that doesn't work makes you more likely to stop treatment too soon.

Seeing a specialist: You may want to see a specialist, such as a psychiatrist, who can help you identify the right combination of medication and therapy for your depression. Studies show that for many people, combining therapy with medication can work better than medication alone.

Coping With Side Effects

Most people don't have any problem taking an antidepressant. Like any drug, they can have side effects. Depending on the medication, antidepressants may cause increased appetite and weight gain, low sex drive, insomnia, jittery feelings, dry mouth, blurred vision, and fatigue and drowsiness.

Coping with side effects: Many of these side effects may get better after a few weeks. But if not, ask your doctor about changing your dose or trying another drug.

Staying with it: Don't stop taking your antidepressant on your own. Some can cause withdrawal symptoms -- and you run the risk of your depression coming back, too.

Counseling and
Psychotherapy

In addition to helping treat your depression, psychotherapy can help you reduce stress and make it easier to stick with your treatment. Some of the most common types of therapy are:

Cognitive behavioral therapy (CBT)
Psychodynamic therapy
Interpersonal therapy

How it works: You may need to talk to several therapists until you find the perfect fit for you. You can take part in therapy either one-on-one, with your spouse or family, or in a group. Your therapist will help you determine what is right for you.

Types of Psychotherapy

Cognitive behavioral therapy (CBT) works from the assumption that negative thinking affects your mood. It helps you see how your own thought patterns can contribute to your depression and teaches you practical ways to change them.

Psychodynamic therapy helps you understand and cope better with problems by identifying and talking about unresolved conflicts that may be contributing to your depression.

Interpersonal therapy focuses on helping you improve communication with family and friends and increase your self-esteem so you can interact with them in a healthy way.

Exercise Can Help

When you're depressed, just getting out of bed can seem hard enough. The idea of starting the day with a walk or jog might seem impossible.

But exercise releases chemicals in the brain called endorphins, which boost your mood. Studies have shown that regular exercise -- even just walking -- can make you happier, build your stamina, and boost your self-esteem.

Getting Started: Start with something simple -- like a 10-minute walk around your neighborhood every morning. It's much easier to work your way up from there instead of setting goals that seem impossible to reach.

Tips for Success: To help you stick to your goals, exercise with someone else. Meet a friend at the gym a few times a week or take after-dinner walks with a neighbor.

When Will I Be Able to Stop Treatment?

Quitting therapy too soon -- or going off medication without a doctor's oversight -- can increase the risk your depression will come back.

Sixty percent of people who have been depressed once will get depression again. Seventy percent of people who have been depressed twice will become depressed a third time.

Sticking with treatment is the best way to prevent it from happening again or controlling a relapse before it becomes serious.

This doesn't mean you need to treat depression forever. You and your doctor will determine the right course and length of treatment for you.

Quitting too soon is like taking off a cast before the bone is healed. It can leave you with a long-lasting problem -- one that could have been prevented.

Managing Stress and Other Triggers

To reduce your risk of relapse, watch for triggers that might cause your depression to come back. While depression triggers are different for every person, some include:

Stress. The aftermath of depression can leave you less able to cope with stress at work or home.
Big changes. Getting ill or suffering a loss can push people into depression. So can positive changes, like a move or a new job.
Substance abuse. Using alcohol or illegal drugs to cope with lingering depression symptoms can make them worse.
Anniversaries or seasonal change. Many people get depressed during winter. Anniversaries of painful events -- like your first depression -- can be a trigger too.

Tips to get started

Think about your depression symptoms, such as feeling overwhelmed, hopeless, or worthless, and how they affect your life. It may be time to consider treatment again.

Here are some tips to help you get started.

Make a list of the symptoms that are keeping you from feeling as good as you once did.
Talk to your doctor about your expectations before you start treatment.
Note what worked and didn't work last time and what you liked or didn't like about the treatments you tried.
Be open to trying new treatment or combining different treatments.
Stick to your treatment plan and be willing to ask for help.

Don't settle for feeling just a little better than horrible. With the right treatment, you can feel as good as you did before you got depressed.