Psychological treatments
Psychological treatments (talking therapies) are used to treat all types of depression. For mild depression they might be the only treatment needed.
Treatment is provided by trained therapists (e.g. psychiatrists, psychologists, or GPs).
Several different psychological treatments work for depression. These include:
- cognitive behavioural therapy (CBT)
- interpersonal psychotherapy
- problem-solving therapy
- short-term psychodynamic therapy.
CBT and interpersonal therapy work just as well as medication for people with mild-to-moderate depression.
Some psychological treatments, such as CBT and mindfulness-based cognitive therapy, can also stop depression coming back after you have recovered.
If you have psychological treatment as your main treatment, it should be started as soon as possible after you get the diagnosis of depression.
If you are taking medication for depression, your doctor or psychologist might advise you to start psychological treatment a bit later.
More about psychological treatments
Medication
Antidepressant medications are used to treat moderate and severe depression.
Antidepressant medications can reduce symptoms of depression, such as feelings of sadness, thoughts of suicide, tiredness, poor appetitie and sleep problems.
More about antidepressant medication
Brain stimulation treatments
Electroconvulsive therapy (ECT)
For severe depression, ECT works better than medication. It’s a safe and effective treatment.
Doctors mainly recommend ECT when someone has not improved after trying several different medications.
It can be the best treatment for people with severe symptoms –for example someone whose depression is so bad that they can’t eat or drink, are at high risk of suicide, or are having hallucinations or delusions.
More about ECT
Repetitive transcranial magnetic stimulation (rTMS)
rTMS works in a similar way to ECT, but uses magnets near the head to change brain activity.
Doctors use it when medications or psychological treatments haven't worked.
People are awake during the treatment and there are few side effects.
It is currently only available in some private hospitals and clinics.
Will I have to go to hospital?
Most people with depression don’t need to stay in hospital. Normally your treatment will involve regular visits to your GP or psychologist.
You may need to stay in hospital if:
- you are suicidal or at risk of physical harm
- you can’t eat and drink properly
- you have a medical illness that is making your depression severe
- you have serious problems with alcohol or other drugs
- you need a special hospital-only treatment like ECT.
More about psychiatric hospitals
Why should I get treatment?
With effective treatment, you can recover from depression and live a full, satisfying life.
The right treatment can help you:
- recover from symptoms of depression
- get on with life – study, work, finances and relationships
- stop symptoms coming back again
- stop having thoughts about suicide or self-harm.
What if I'm not getting better?
If your symptoms don’t improve with treatment, there are several things your doctor or psychologist will check before deciding what to do.
Reasons for not getting better can include:
- not taking the medication properly (e.g. not being able to take it every day, or taking other medications that are interfering with it)
- treatment that doesn’t suit you (e.g. medication that isn’t working for you, or having psychological therapy from a therapist who's not a good match for you)
- having another mental health problem (e.g. anxiety or borderline personality disorder) as well as depression
- having depression that's caused by undiagnosed bipolar disorder – up to 1 in 10 people with depression go on to be diagnosed with bipolar disorder
- problems with alcohol or other drugs.
If you're receiving psychological treatment alone, your therapist might suggest starting medication.
If you're already taking medication, your doctor might suggest increasing the dose or changing to a different medication.
If you want, you can ask for a second opinion from another doctor.