An Overview of the Treatments for Depression

Your Guide to Psychotherapy, Medications, and Self-Help

Doctor talking to patient in office. Tetra Images/ GettyImages

Depression is extremely treatable and most people see improvements in their symptoms when treated with medication, psychotherapy, or a combination of the two. Here are some general treatment options that you may want to take into consideration when seeking treatment for depression and/or related mood disorders. This information, however, is not meant as an alternative to seeking professional help.


There are a wide variety of types of therapeutic approaches utilized for the treatment of depression. These range from cognitive-behavioral therapy (CBT) to behavioral therapy to interpersonal therapy to rational emotive behavior therapy (REBT) to family and psychodynamic approaches. Both individual and group modalities are commonly used, depending upon the severity of the depressive episode, the person's financial resources and the local resources available.

Cognitive-Behavioral Therapy

Cognitive-behavioral therapy is the most popular and commonly used therapy for depression treatment. Hundreds of research studies have been conducted that verify its safety and effectiveness in treating depression. It consists of simple techniques that focus on the negative thought patterns, called cognitive distortions, which you, the depressed person, may habitually use.

Therapy begins by establishing a supportive environment.

Educating you about how depression may be caused by cognitive distortions is the next step. The types of faulty thinking are discussed, such as "all or nothing thinking", "misattribution of blame", "overgeneralization", etc, and you're encouraged to begin noting your thoughts as they occur throughout the day.

This is done so you can see in black and white how often these thoughts are occurring.

In cognitive-behavioral therapy, emphasis is placed on discussing the thoughts and the behaviors associated with depression rather than the emotions themselves. The rationale for this is that it is believed that by changing thoughts and behaviors the emotions will also change. Because of this approach, cognitive-behavioral therapy is short-term, usually under two dozen sessions, and works best for people experiencing quite a bit of distress related to their depression. Individuals who are able to approach a problem from a unique perspective and who are more cognitively-oriented will to do best with this approach.

Interpersonal Therapy

Interpersonal therapy is another short-term therapy used in the treatment of depression. The focus of this treatment approach is usually on an individual's social relationships and how to improve them. It is thought that good, stable social support is essential to a person's overall well-being.

When your relationships are unhealthy, you suffer. This therapy seeks to improve your relationship skills, communication skills, expression of emotions and assertiveness. It is usually conducted on an individual basis, but it can also be used in a group therapy setting.

Most individual approaches will emphasize how important it is for you to be actively involved in your own recovery. You are are usually encouraged to do homework assignments between sessions. If you're not yet able to participate actively in therapy, then the therapist may provide a supportive environment until medication begins to improve your state of mind.

Psychoanalytic Therapy

Psychoanalytic or psychodynamic approaches in the treatment of depression have little research to support their use at this time. Although some therapists may make use of psychodynamic theory to help conceptualize an individual's personality, there is much debate as to whether this is an effective treatment for depression.

Family or Couple Therapy

Family or couple therapy should be considered when your depression is directly affecting family relationships. Such therapy focuses on the interpersonal relationships shared among family members and seeks to ensure effective communication. The roles played by various family members in your depression may be examined. Education about depression in a general way may also be a part of family therapy.


Hospitalization may become necessary when it is deemed that a patient has become a danger to himself or others.

Care should be taken with regard to the hospitalization procedure. When possible, the patient's informed consent should be obtained and the patient encouraged to check him or herself in. Hospitalization is usually until the patient becomes fully stabilized and the therapeutic effects of an antidepressant begin to take hold, usually 3 to 4 weeks.

Because suicide is the most dangerous outcome of depression, suicidal ideation should be assessed during regular intervals throughout therapy. The beginning stages of medication are especially crucial. Often, as the medication begins to take effect, you will be at higher risk for acting on suicidal impulses. Patients should be monitored closely during the initial weeks of drug therapy.


Tricyclic antidepressants (TCAs) were among the first developed antidepressants. They have more side effects than newer antidepressants, but can be more effective for certain patients. These include Elavil (amitriptyline), Tofranil (imipramine) and Pamelor (nortriptyline). 

Monoamine oxidase inhibitors (MAOIs) are another older type of antidepressant. If you are taking an MAOI, you will have to follow certain dietary restrictions to prevent high blood pressure. Like tricyclics, these are not generally used first. MAOIs include Marplan (isocarboxazid), Nardil (phenelzine) and Parnate (tranylcypromine).

Selective serotonin reuptake inhibitors (SSRIs) are the most commonly prescribed medication for depression today. Prozac (fluoxetine), Paxil (paroxetine), Zoloft (sertraline) Celexa (citalopram) and Luvox (fluvoxamine) are the most commonly prescribed brand names. Compared to other antidepressant types, SSRIs have fewer side effects. SSRIs should not be prescribed in conjunction with the older MAOIs due to the potential for a dangerously high level of serotonin to build up, which can cause serotonin syndrome

Serotonin and norepinephrine reputake inhibitors (SNRIs) are a newer type of antidepressant that work similarly to SSRIs only they also block the reuptake of norepinephrine along with serotonin. Common medications in this class are Effexor (venlafaxine), Cymbalta (duloxetine) and Pristiq (deslavenfaxine).

The medication Wellbutrin (buproprion) is in a class all by itself called norepinephrine and dopamine reuptake inhibitors (NDRIs). Wellbutrin is less likely to have the sexual side effects that are common in the other antidepressants.

Self-Help Strategies

Self-help methods for the treatment of depression may be very successful for some people. Support groups are especially effective, since they allow you an opportunity to socialize and be with others who suffer from similar feelings. Many support groups exist both online and off where depression sufferers can share their common experiences and feelings. 

Online resources such as newsgroups, mailing lists or chat rooms can provide a safe, anonymous place for people to talk about their feelings.

There are also many useful self-help books which are available to help people overcome depression on their own. These may be highly effective for people with mild to moderate depression. Some books emphasize a cognitive-behavioral approach, which is similar to those used within therapy and therefore may be a useful supplement to conventional therapeutic approaches.

Continue Reading