Depression - management and treatment options

Depression - management and treatment options

There are many different management and treatment options for depression. Try to remember that overcoming depression will take time and you will need to stay strong through some of the tougher days. Still, overcoming it is achievable!

Treatment options for depression

Psychological treatment

Psychological treatment provides either an alternative to medication, or works alongside medication, and is usually provided by a mental health professional, such as a counsellor, psychiatrist or psychologist. 

Psychiatrists are health workers who have special training in mental illnesses, including depression and schizophrenia.

Clinical psychologists have a similar training but do not prescribe medication. You may be able to find them through your GP, your local community health centre, or through colleges of psychiatry and psychology. Some GPs and other allied health staff also do counselling.

There are a number of psychological treatments or therapies used for depression, including Cognitive Behavioural Therapy, Interpersonal Therapy, Psychotherapy and Counselling. Check out the Getting help section and Different counselling techniques fact sheet for more info on getting the best help. As always, talk to your GP or therapist about the best set of approaches for you.

Physical treatment

Medication - medication may be helpful in managing depression. There are several different types of antidepressant medication, which are prescribed by doctors or psychiatrists.

• Tricyclics
• MAOIs (Monoamine oxidase inhibitors)
• SSRIs (Selective Serotonin Reuptake Inhibitors)
• SNRIs (Serotonin and Noradrenaline Reuptake Inhibitors)
• NASSAs (Noradrenaline and Specific Serotoninergic Antidepressants).

How do they work?

• moderate to severe depressive illness (Not mild depression)
• severe anxiety and panic attacks
• obsessive compulsive disorders
• chronic pain
• eating disorders
• post-traumatic stress disorder

If you are not clear about why an antidepressant has been suggested for you, ask your doctor.

Medication should be used as a way to manage the symptoms of depression effectively while the person works with the support of therapy or counselling to address the issues that are at the root of the problem in the first place.

Hospital - hospitalisation may be necessary if your depression is particularly severe or if you are suicidal. You might also spend a short amount of time in hospital if you begin taking medication to make sure that it is working effectively or to gauge side effects.  

ECT - ECT is short for Electro Convulsive Therapy, sometimes called 'shock therapy'. While under anaesthetic, you receive a brief, mild electric shock (lasting only a fraction of a second) that is delivered to the brain via electrodes placed on the head.

The National Institute of Health and Clinical Excellence (NICE) have looked in detail at the use of ECT and have said that it should be used only in severe depression, severe mania or catatonia. ECT is most often used for severe depression, usually only when other treatments have failed.

Self-help and alternative therapies for treating depression

Along with seeking treatment to manage depression there are a number of things you can do that may help when you are feeling depressed. Some of these include:

Eating well and being active - even though you might not feel like it, exercising and eating well can help when you are feeling down. Biological factors, as well as social factors, influence how you will feel, react and think about things and yourself. Exercise helps stimulate hormones, such as endorphins, which help you feel better about yourself and your life. If you haven't done a lot of exercise before, it might be a good idea to start doing something small a couple of times each week.  For example, a 15 minute walk or two or three laps of a pool.

Getting out into nature - evidence shows that when you have some sort of contact with nature (such as pets, plants, gardens or parks) your mood improves and you feel less stressed. Even just going for a walk in the park or at the beach may help. 

Writing down your feelings - writing down your feelings, or keeping a journal, can be a great way of understanding your emotions and a specific situation. It can also help you think about alternative solutions to problems.

Taking time out to relax - it is a good idea to try and take a bit of each day to do something you enjoy. When you are feeling down it may be hard to be social or motivate yourself to do things. It may help to make a list of all the things you enjoy doing and then plan to do something from this list each day.

Talking to someone - although it may seem hard, sharing how you feel and hanging out with someone you trust can help you get through the hard times, see alternative ways of solving or thinking about a problem, and help to make you a happier person in general. If you are having difficulty speaking about what you're going through, you might start with sentences such as 'Right now, I'm feeling...', 'I think it started when...', 'I've been feeling this for...', 'My sleep has been...', 'Lately school/work/college has been...'.

Contacting support groups - as well as family and friends, support groups can be a place to share experiences and inspiration with others going through similar times. Contact your local community health centre for details of support groups in your area. Alternatively, check out Aware or Shine who can link you with support groups in your area.

Ringing a help line - if you feel you are having difficulty talking to people you know, phone a help line. Samaritans on 1850 60 90 90 is a 24 hour anonymous help line.

Setting small goals - sometimes people set goals which are almost unachievable and then feel even worse when they cannot reach them. Try to set goals that are achievable for you, even if it's on a day by day, or hour by hour, basis. And remember to reward yourself too.

Reducing stress - it may be a good idea to try and reduce the level of stress you are feeling. You may like to check out the fact sheet on stress for some ideas on how to manage stress.

Going easy on drugs and alcohol - try not to use drugs or alcohol in the hope of feeling better. The feeling is usually temporary and the after effects often make the problem worse.

St. John's Wort -  St. John's Wort is a popular herbal remedy for depression. It is a flower with many chemical compounds, some of which are believed to help depression by preventing nerve cells in the brain from reabsorbing the chemical messenger serotonin. Studies have shown that St. John's Wort is an effective antidepressant in cases of people with mild, non-melancholic depression, but not effective for people with melancholic (biological) depression. However, it does have side-effects, including a possibility of effecting reproductive functioning and interacting with certain medications.