Treating Depression

Depression is a highly treatable disease. Every person's situation is different, and there are many options you and your mental health professional may want to pursue. Depending on your particular needs, your treatment program will likely include some form of talk therapy combined with some form of medication.

It's important to understand that there is no magic pill or perfect therapist that will work for everybody, every time. Finding a solution to depression takes time and effort. Medications in particular often require a bit of trial-and-error to find just the right prescription and dosage for you. For this and other reasons, it's important to find a doctor or therapist that you trust and that you can work with through the process.

Medications for Depression

There are a wide variety of medications for depression. Antidepressants are among the most common treatments, and they work by altering the chemicals in your brain that manage mood changes. Most antidepressants are equally effective but will affect different people in different ways, especially with regard to side effects. In some cases, your doctor may recommend combining two or more antidepressants or other medications for better effect, which is sometimes called augmentation.

Many physicians will begin by prescribing an SSRI (a selective serotonin reuptake inhibitor). The side effects of these medications are generally low while their effectiveness is generally high. SSRIs include fluoxetine (Prozac, Sarafem), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa), and escitalopram (Lexapro).

There are also SNRIs that inhibit serotonin and norepinephrine reuptake, NDRI's that inhibit norepinephrine and dopamine, and tetracyclic antidepressants.

If none of these medications is effective after awhile, your doctor might move on to another class of antidepressants called tricyclic antidepressants. These TCAs tend to have harsher side effects.

Finally, MAOIs, or monoamine oxidase inhibitors, are often prescribed as a last resort. These drugs can have serious side effects and require dietary restrictions because of rare but potentially fatal interactions with certain foods.

In addition to antidepressant medications, your doctor or therapist has a whole arsenal of other types of drugs to treat depression including stimulants, mood-stabilizing medications, anti-anxiety medications, and antipsychotic medications.

All antidepressant medications can cause unwanted side effects but not everyone will experience the same amount or intensity of side effects. Some are so mild you won't need to stop taking the antidepressant and many will go away or lessen within several weeks. Never stop taking an antidepressant without consulting your health professional first. Some antidepressants can cause withdrawal-like symptoms unless you slowly taper off your dose.

Children, adolescents, and young adults up to age 24 are more likely than any other age group to experience an increase in suicidal thoughts or suicidal behavior when taking antidepressants. It's important that young people in particular be closely monitored while taking these medications.

Talk Therapy

Talk therapy – also called psychotherapy, counseling, or cognitive behavioral therapy – is another key element of depression treatment that is often used in combination with medication.

Working with a professional will help you identify potential causes of your depression and learn how to deal with difficult emotions and situations. This can include identifying unhealthy behaviors, unproductive thought processes, and negative relationships. If you are going through a crisis or major life challenge, talking with a knowledgeable and non-judgmental professional can help you find ways to cope with what you are going through.

When Therapy and Medication Aren't Enough

In some cases, depression may become so severe that a person will require hospitalization or a residential treatment program. Psychiatric hospitalization options include 24-hour inpatient care, partial or day hospitalization, or residential treatment, which offers a structured, supportive environment to get well.