Most people with major depression symptoms start treatment with their primary care doctor, but your doctor may refer you to a mental health specialist, such as a psychiatrist or psychologist, for depression treatment.
The Goal of Major Depression Treatment
The goal of major depression treatment is to alleviate your depression symptoms and help you return to your normal activities. Your doctor may prescribe medications (pharmacotherapy), depression-focused psychotherapy, and/or other treatments. The best treatment for you will depend on the severity of your depression symptoms, your treatment preferences, medications you're taking, and your age and overall health. Education about depression for you and your family, and regular checkups, are also part of a good treatment plan. Here are the most common depression treatments:
- Medications. In most cases, your doctor will prescribe medication as part of your treatment plan. Antidepressants, the most common medications prescribed for depression, are effective for about 60% to 70% of patients. If your symptoms don't improve or you have side effects, you may need to switch or combine medications. If you have other symptoms, such as anxiety, or don't respond to a single medication, a combination of medications can increase your chances of a full recovery.
- Psychotherapy. Psychotherapy (also called counseling, talk therapy, or behavioral therapy) allows you to talk through your depressed feelings with a mental health specialist. Therapy can provide you with a source of social support, and help you form helpful ways of thinking and responding to stress. Research shows that psychotherapy with medication can make your treatment plan more effective.
- Electroconvulsive therapy (ECT). If your major depression symptoms are severe, disabling, or don't respond to any type of medication or psychotherapy -- or if you can't take medication -- your doctor may recommend ECT, which involves passing electrical currents through your brain to change the levels of your brain's neurotransmitters (e.g., serotonin, norepinephrine, dopamine). Side effects of ECT include temporary confusion and memory loss, but these side effects are usually short-term. ECT can bring immediate relief for some people with depression.
If the usual treatments for depression don't alleviate your symptoms, other treatments may be an option. Vagus nerve stimulation involves a surgical implant that sends electrical impulses to your brain's mood centers. Transcranial magnetic stimulation uses magnetic fields to change brain activity. In most cases, hospitalization or residential treatment is not needed for major depression, but if depression symptoms interfere with a person's ability to take care of his or herself, it may be helpful.