Depression: Treatments

Doctors usually can treat depression with counseling or antidepressant drugs. Sometimes counseling alone is enough. Often a combination of the two works best.

Depression is a medical condition, not a character flaw or weakness.

Many people do not get help because they are embarrassed or think that they will get over depression on their own. But you do not have to suffer. Treatment works well for most people.

Treatment goals

Treatment can make you feel better.

With treatment, depression will have less of an effect on your work life and your family life. With treatment, you will not be as likely to have other health problems that are linked to depression.

Treatment also will make you less likely to have a relapse of your depression.

Getting started

If you think you may be depressed, see a doctor right away. Your depression may get worse without treatment. It may take longer for you to recover.

Your doctor may ask you questions to find out how severe your depression is, including whether you are having any thoughts about suicide.

You may need to take written or verbal tests that can detect depression. You may also have other tests to make sure your symptoms are not caused by something else, such as a thyroid problem or not having enough red blood cells.

Treatment choices

Usually doctors try counseling or medicine first. Counseling may be all that you need for mild to moderate depression, but it may take a while to be effective.

If your early symptoms are severe, you probably will have both medicine and counseling. If you show warning signs of suicide, you may need to be treated in a hospital. Warning signs include having thoughts about hurting yourself or someone else or feeling disconnected from reality. Heavy use of alcohol or drugs is another warning sign.

Finding a treatment that works

You may begin to feel better within 1 to 3 weeks of starting antidepressant medicine. It can take as many as 6 to 8 weeks to see more improvement.

If you have problems or concerns about your medicines, or you do not notice any improvement within 3 weeks, talk to your doctor. You may have to try a couple of different medicines before you find the one that works best for you. Try to be patient.

Antidepressants often have side effects. They can make you feel tired, dizzy, or nervous. Some people have dry mouth, constipation, headaches, sexual problems, or diarrhea. Many of these side effects are mild and go away after you take the medicine for a few weeks. Some may last longer.

Talk to your doctor if side effects are bothering you too much. You might be able to try a different medicine.

If you plan to stop taking your medicine, talk with your doctor first about how to do it safely. Your doctor may want you to slowly decrease your dose. Stopping antidepressants can cause side effects and may cause your depression to come back or get worse.

A type of counseling called cognitive behavioral therapy not only helps treat depression but can help stop it from coming back. In this type of therapy, you learn how to identify and change unhelpful thinking styles that may be adding to your depression.

Maintenance treatment

At least half of those who have depression once will have it again. Although you may not be able to prevent your first bout of depression, you may be able to prevent future ones.

Continue to take your medicine after your symptoms improve. Taking your medicine for at least 6 months after you feel better can help keep you from getting depressed again. If your depression keeps coming back, your doctor may recommend you to take medicine even longer.

If you are in counseling, you may want to keep it up even after you have stopped taking your medicine. This may help keep your depression from coming back.