Many types of psychotherapy are effective. Here are two that are commonly used:
- Cognitive-behavioral therapy (CBT): This form of counseling helps you to identify and change negative beliefs and behaviors that contribute to your depression. By replacing these patterns with healthier, more realistic thoughts and actions, you can avoid the traps that worsen your depression.
- Interpersonal therapy (IPT): This type of therapy aids you in understanding and working through difficult relationships that may be contributing to your depression.
If you're open to joining a depression support group, ask your counselor or doctor for a recommendation.
If your depression is severe or life-threatening and does not respond to treatment with multiple antidepressants and other medicines, another option is electroconvulsive therapy. The treatment involves giving general anesthesia to the patient, along with a muscle relaxant to prevent body movement. ECT passes electrical currents through the brain to induce a seizure. Although doctors aren't sure why, it is thought that the treatment changes the functioning and efficiency of brain areas that regulate emotion.
Other types of brain stimulation therapies can also treat severe depression, including vagus nerve stimulation (VNS) and repetitive transcranial magnetic stimulation (rTMS).
Maintenance Treatment: Preventing More Episodes
After patients have been treated for an acute bout of depression, doctors sometimes place them on maintenance therapy to try to prevent another episode, especially if they're at high risk for a recurrence. Talk to your doctor about whether you need maintenance therapy. For this type of ongoing treatment, which can last one year or longer, you may continue taking an antidepressant, with or without psychotherapy. Ask how long you may need maintenance therapy.
In some cases, patients choose watchful waiting instead of maintenance therapy with antidepressants. In this case, they'll keep an eye out for depression symptoms and restart an antidepressant at the first sign of a recurrence.
How to Help Yourself
While you can't just "shake off" your depression, you can certainly take steps to improve your mood and outlook. Be sure to get plenty of sleep and steer clear of alcohol and illegal drugs, which can worsen depression.
In addition to seeing your doctor immediately, consider these tips from the National Institute of Mental Health:
- Try to be active and exercise.
- Go to a movie, sporting event, or other activity that you once enjoyed.
- Set realistic goals for yourself. Break up large tasks into small ones, set some priorities, and do only what you can manage without causing stress for yourself.
- Try to spend time with other people. Confide in a trusted friend or relative. Don't isolate yourself, and let others help you.
- Expect your mood to improve gradually, not immediately. Do not expect to suddenly "snap out of" your depression. Often, during treatment, your sleep and appetite will begin to improve before your depressed mood improves.
- Postpone important decisions, such as getting married or divorced or changing jobs, until you feel better. Discuss decisions with others who know you well and have a more objective view of your situation.
- Negative thoughts are a hallmark of depression, but take heart that positive thinking will replace them as your depression responds to treatment.
- Continue to educate yourself about depression, including any ways that might help you to prevent recurrences.