Depression Treatments: Medications, Lifestyle Changes & More
Depression is a debilitating condition that can leave its millions of sufferers in despair.
Globally, an estimated 5% of adults suffer from depression, according to the World Health Organization.
Luckily, there are a variety of depression treatments that can help manage and ease symptoms. These can range from medications to lifestyle changes, talk therapy and even newer treatments such as ketamine. Here, experts describe the most common treatments for depression and explain how they work.
Depression can be a complex and challenging mental health condition to treat. As James Maddux, emeritus professor of clinical psychology at George Mason University in Fairfax, Va., told HealthDay recently, “One of the primary challenges of treating depression is that individuals with depression may resist taking advice or seeking help. Often, people with depression have difficulty believing that things will get better, which can make it challenging to motivate them to engage in treatment.”
Nonetheless, various options are available that can help manage symptoms and improve quality of life. Depression can impact an individual's quality of life in many ways, such as negatively affecting their work, relationships and overall functioning. Additionally, depression can increase the risk of suicide and other mental and physical health issues, underscoring the importance of effective treatment to manage symptoms.
Non-medication depression treatments
While medications can be an effective tool for managing depression symptoms, alternative therapies can also be used. Known as non-medication depression treatments, they can be used alone or combined with medication.
According to the Cleveland Clinic, some of the most effective non-medication depression treatments include:
- Guided imagery
- Herbal remedies
Of those, perhaps the best treatment for depression is exercise and physical activity. The U.S. Centers for Disease Control and Prevention recommends that people between 18 and 64 years of age get 150 minutes of moderate physical activity per week.
According to New York psychiatrist Dr. Gail Saltz, “Exercise, meaning aerobic exercise for 30 minutes or more three to four times per week, is known to boost mood. Some studies show it to be as effective as antidepressant medication for mild to moderate clinical depression, which makes it a key factor in helping with depression.”
Depression medication treatments
While non-medication treatments can help treat depression, sometimes medication may be necessary to manage symptoms. If other treatment methods have been attempted without success, depression symptoms significantly impact daily life, there is a history of mental health challenges or the individual lacks the energy to engage in other treatments, medication may be appropriate.
In combination with non-medication treatments, medication can help alleviate symptoms and improve overall well-being. According to the Cleveland Clinic, the most common types of antidepressants include the following:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin/norepinephrine reuptake inhibitors (SNRIs)
- Tricyclic antidepressants (TCAs)
- Atypical antidepressants
- Serotonin modulators
- Monoamine oxidase inhibitors (MAOIs)
- N-methyl-D-aspartate (NMDA) antagonists
Antidepressants are a widely prescribed class of medications commonly used to treat depression. More than 1 in 10 people in the United States takes them. The use of antidepressants has been increasing worldwide, reflecting the growing awareness of the prevalence and impact of depression on individuals and society.
SSRIs are the most commonly prescribed antidepressant, and fluoxetine (Prozac) is probably the most well-known. While antidepressants can effectively manage symptoms, they are not without risks and potential side effects. While not everyone experiences these side effects, the Mayo Clinic says they can include:
- Nausea and vomiting
- Weight gain or loss
- Diarrhea or constipation
- Dizziness or lightheadedness
- Sexual dysfunction, including reduced libido and difficulty achieving orgasm or ejaculating
- Insomnia or drowsiness
- Dry mouth
- Blurred vision
- Increased sweating
- Tremors or muscle twitches
- Agitation or restlessness
- Suicidal thoughts or behavior (in rare cases, particularly in children and adolescents)
What about treatment-resistant depression?
What happens when nothing works?
According to a study published recently in the journal Neuropsychiatric Disease and Treatment, treatment-resistant depression is when a patient's depression fails to improve after two or more courses of different antidepressants administered at adequate doses and duration. It is a complex and challenging condition to manage and requires a careful and individualized approach to treatment.
The Mayo Clinic suggests the following options for those suffering from treatment-resistant depression:
- Psychotherapy: Different types of psychotherapy — including cognitive behavioral therapy, interpersonal therapy and psychodynamic therapy — may work for some patients with treatment-resistant depression.
- Electroconvulsive therapy: A type of brain stimulation therapy that sends electric currents through the brain to trigger a seizure.
- Transcranial magnetic stimulation: A noninvasive form of brain stimulation using magnetic fields to stimulate nerve cells in the brain.
- Ketamine therapy: Ketamine treatment for depression involves using the anesthetic drug with rapid antidepressant effects in some patients. The U.S. Food and Drug Administration approved an intranasal form called esketamine that's given as an infusion in a medical setting under close supervision.
SOURCE: Gail Saltz, MD, psychiatrist, New York City