If you are diagnosed with depression, here's some good news: Excellent treatment options are available to you.
Many people use a combination of treatments, such as medication and psychotherapy. For depression that doesn't respond to standard treatment, non-drug approaches can be effective, either alone or used with other treatments.
Learn more here about the most common approaches to treating depression.
Talk Therapy for Depression
Talking with a trained therapist is one of the best treatments. Some people choose to be in therapy for several months to work on a few key issues. Other people find it helpful to continue in therapy for years, gradually working through larger problems. The choice is up to you and your therapist. Here are some common types of therapy:
- Cognitive behavioral therapy helps you see how behaviors and the way you think about things plays a role in your depression. Your therapist will help you change some of these unhealthy patterns.
- Interpersonal therapy focuses on your relationships with other people and how they affect you. Your therapist will also help you pinpoint and change unhealthy habits.
- Problem-solving therapy focuses on the specific problems you face and helps you find solutions.
Medicines for Depression
Medicines are the other key treatment for depression. If one antidepressant doesn't work well, you might try a similar one or a different kind. Your doctor might also try changing the dose. In some cases, he or she might recommend taking more than one medication for your depression. There are now dozens of antidepressants that your doctor can choose from. They include:
- Selective serotonin reuptake inhibitors (SSRIs). These common medicines include Celexa (citalopram), Lexapro (escitalopram), Paxil (paroxetine), Prozac (fluoxetine), and Zoloft (sertraline). Side effects are generally mild. They include stomach upset, sexual problems, insomnia, dizziness, weight change, and headaches.
- Other serotonergic antidepressants. These include Brintellix (vortioxetine) and Viibryd (vilazodone).
- Serotonin and norepinephrine reuptake inhibitors (SNRIs) This class of medicines includes Cymbalta (duloxetine), Effexor (venlafaxine), Fetzima (levomilnacipran), and Pristiq or Khedezla (desvenlafaxine). Side effects include upset stomach, insomnia, sexual problems, anxiety, dizziness, and fatigue.
- Tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). These were some of the first medicines used to treat depression. TCAs include amitriptyline (Elavil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), and protriptyline (Vivactil). Side effects include stomach upset, dizziness, dry mouth, constipation, tremor, changes in blood pressure, and nausea. MAOIs can cause serious interactions with other medications and certain foods. While they can work extremely well, these drugs are usually reserved for depression that doesn’t respond to other medicines that are simpler to take. MAOIs include isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Emsam), and tranylcypromine (Parnate).
- Other antidepressant medications. Bupropion (Wellbutrin, Aplenzin) is a unique antidepressant option with side effects that are usually mild, including upset stomach, headache, insomnia, and anxiety. Bupropion may be less likely to cause sexual side effects or weight gain than most other antidepressants. Mirtazapine (Remeron) is usually taken at bedtime. Side effects are usually mild and include sleepiness, weight gain, elevated triglycerides, and dizziness. Trazodone (Desyrel) is usually taken with food to lower the chance for stomach upset. Other side effects include drowsiness, dizziness, constipation, dry mouth, and blurry vision.
For depression that's hard to treat, doctors sometimes pair an antidepressant with another prescription medicine, such as:
- Abilify (aripiprazole)
- Lithium (Lithobid, Eskalith)
- Risperdal (risperidone)
- Seroquel (quetiapine)
- Zyprexa (olanzapine)
All antidepressants carry a boxed warning about increased risks of suicidal thinking and behavior in children, teens, and young adults 18-24 years old. If you start taking an antidepressant and begin having troubling thoughts, tell your doctor and loved ones right away.
Working with your doctor, you can weigh the risks and benefits of treatment and find the medication and dose that work best for you.