Depression is a mood disorder marked by feelings of sadness and a loss of interest in things you usually enjoy doing. You might also have a hard time thinking or getting things done, among other symptoms. Thoughts of suicide are possible in more severe cases.
The good news? There are lots of ways to treat depression and get you back to your best self. Here’s what you need to know.
A diagnosis of depression is different from feeling down one day or being in a crappy mood for a few days. These are normal reactions if you lose your job, a loved one dies, or something else happens. But with major depression disorder (MDD), chemicals in your brain don’t always work the way they’re supposed to. Other things, like genetics, sometimes play a role. So you feel this way for a much longer period of time — typically 2 or more weeks.
David A. Adler, MD, a senior psychiatrist and director of the Mental Health Services Research Group at Tufts Medical Center, says that 50% of people diagnosed with MDD will have a second episode of depression. And if you’ve had two episodes, there’s a 75% chance it’ll happen a third time, and then a 95% chance of a fourth.
Depression can come on by itself or be triggered by a life event. There are different kinds, some of which include:
Major depression disorder (MDD). This is considered the classic type. It includes common symptoms like loss of interest in hobbies, trouble sleeping, and more.
Persistent depressive disorder. This lasts for at least 2 years, but it may not be as intense as major depression. It used to be called dysthymia.
Postpartum depression. This type of depression happens after giving birth.
Seasonal affective disorder. This can happen as the seasons change and the days get shorter. Experts think it may have something to do with not getting enough sunlight, among other things.
Bipolar disorder. If you have this condition, you may get depressed but also have periods of really high or intense energy levels.
Treatment depends on the person. What worked for a friend or family member may not work for you. And just because they had certain side effects doesn’t mean that’ll happen to you. For example, just because a certain antidepressant triggered weight gain in your mom doesn’t mean the same thing will happen to you. It’s important to approach treatment with an open mind.
Options include:
Psychotherapy. Also called talk therapy, this involves meeting with a mental health professional in person or virtually to talk about and work through your feelings. It “helps the person optimize their coping strategies to deal with life’s stressors,” says James Murrough, MD, PhD, director of the Depression and Anxiety Center for Discovery and Treatment at Mount Sinai.
Antidepressants. These are prescription medications that help balance brain chemicals.
Brain stimulation therapies. This is when doctors use electrical pulses in hopes of changing brain activity. It’s an option for people who don’t respond to psychotherapy or antidepressants.
Electroconvulsive therapy (ECT). This is used for severe depression. Unlike brain stimulation therapies, your doctor puts you to sleep during the procedure. They send electrical currents through the brain to cause a short seizure. This seems to ease symptoms of some mental health conditions.
Murrough says talk therapy and medication are equally likely to be effective in treating a person with MDD. John Greden, MD, founder of the Eisenberg Family Depression Center in Michigan, says he believes people with MDD who receive both psychotherapy and antidepressants fare better.
“It shouldn’t be [psychotherapy] versus [antidepressants],” Greden says.
It’s important to talk with your doctor honestly about what’s going on so they can help you decide what might work best. It may take a few tries, but you’ll figure it out together.
“The best evidenced-based treatments follow an individual’s preference, since both medication therapy and the psychotherapies have demonstrated good outcomes,” Adler says.
These also depend on the person. Some people have zero side effects, while others have to try a few antidepressants before they find one whose side effects they can handle.
The older class of traditional antidepressants (monoamine oxidase inhibitors, or MAOIs) were known to cause significant weight gain or lower your sex drive. They worked, but people tend to choose the newer ones that have better “side effect profiles,” Greden says
It’s hard to get good data on how lifestyle changes can help manage depression, says Murrough, but “exercise has been shown to have antidepressant effects.”
He says there’s also evidence to suggest that stress management, whether through meditation or other mindfulness practices, is helpful.
Researchers are also looking into ketamine for treating severe depression.
If you’re having suicidal thoughts or feelings of self-harm, know that you’re not alone. There are resources and people that can help. Reach out to your doctor, a family member, or friend. You can also call the National Suicide Prevention Lifeline at 800-273-8255 or the Substance Abuse and Mental Health Services Administration Helpline at 800-662-4357.
