According to studies, 80 to 90 percent of people suffering from depression experience significant improvement when undergoing treatment, and almost all experience some control over symptoms. For severe depression, a combination of medication and psychotherapy is the most effective approach. Medication helps many people, but it should never be the whole story. Depression can alter the way people think, and therapy can help correct that, allow people to recognize distorted thinking patterns, and help them return to a more normal way of being.
Antidepressants work slowly. Most people see no benefit for the first 10 to 14 days. During that period, you may experience side effects like nausea, weight gain, insomnia, and other unpleasant symptoms that may tempt you to stop taking the medication. It’s important to stick it out, and take a long-term view. After two weeks, irritability and daily crying spells usually go away. Once a person’s response to medication kicks in, it takes eight to 10 weeks to see the full benefit of an antidepressant. Medication should only be stopped under a physician’s supervision.
There are seven different classes of antidepressant medications, all of which work about equally well. The prescription decision is most often influenced by tolerability, cost, and insurance coverage. Your doctor can recommend the best treatment option for you. 70 percent of people respond well to most antidepressants. If the first medication you try doesn’t work, most doctors recommend trying another class of medication. Some people will need an additional prescription, often called an “augmenting agent” that works to boost the effects of the antidepressant. An augmenting agent can give the extra nudge you need to achieve full remission from symptoms.
Multiple studies have shown that stopping medication before nine months can significantly increase the chance of lapsing back into a full depression. However, after a year of medication, the risk of relapse drops to five percent. If your depression comes back, it doesn’t mean there is something wrong with you. 85 percent of people who have one depressive episode will have more in their lifetime. It’s simply the way your brain is wired.
Two main types of therapy have proven effective in treating depression: cognitive-behavioral therapy and interpersonal therapy. Cognitive-behavioral therapy can help to restructure negative patterns of thinking. Interpersonal therapy can help people understand and overcome problem relationships that can contribute to depression.
Additional Treatment Options
For cases of depression where psychotherapy and medication do not help symptoms, electroconvulsive therapy (ECT) may be a good option. In this treatment, the patient receives mild anesthesia and electrical impulses are passed through the brain. This causes a short brain seizure. Often, ECT occurs several times a week, and may require medication alongside the treatment. After an initial course of ECT, many can move to monthly treatments or personalized maintenance schedules.
Treating Depression Without Medication
If your depression is mild, you may experience improved symptoms with lifestyle adjustments like exercising more to normalize mood, mediating, and keeping yourself busy with projects. Dark moods can come on when idle. The goal of alternative treatments is to reduce the frequency and intensity of symptoms that interfere with living a happy life. Work with your doctor to determine if you need medication, and also try the following lifestyle changes:
• Sleep at least seven hours each night
• Spend at least 30 minutes outdoors daily
• Try light therapy, especially if you tend to get depressed every autumn and winter
• Use relaxation techniques like progressive muscle relaxation
• Have your hormone levels tested
• Try mindfulness, yoga, and meditation to focus on the moment and alleviate stress
• Exercise every day
• Try music therapy – either listening or singing
• Reduce your carb intake
• Eat a diet that is rich in omega-3 fatty acids and healthy fats
• Avoid caffeine, which can reduce serotonin levels in the brain
• Declare zero tolerance for stress
• Take a dietary supplement like saffron,B-vitamins, 5-HTP, L-Theanine, SAMe (S-adenosylmethionine) or St. John’s wort, but consult with a physician first
• Have an acupuncture treatment
Create a monthly chart with categories for sleep, exercise, sunshine, green time, nutrition, and stress in the left-hand margin. Mark a daily check for each category in which you succeed. Try to earn at least three checks a day for the first month. Then, rate your anxiety every day on a scale of one to 10.
Journaling, or keeping a mood diary, can help you to highlight patterns of negative thinking, notice when good things happen, and stay motivated to make progress. It can help give you a perspective that things do get better after a negative event. Start out writing once a week, and aim to write daily if you find it helps.
Don’t struggle with dark moods on your own. Being around positive people is an enormous help. Reach out to friends, especially those who make you feel good about yourself. Or, join a support group. They provide education about depression, and advice from people who have been through it. Even if it is a group not related to depression, joining a club with people of a common interest can help to boost your mood.
Generally relaying on alternative therapies isn’t enough to treat depression. However, they can be helpful when combined with a medication or therapy regimen.