Depression treatment options
There are many different management and treatment options for depression. Try to remember that overcoming depression will take time.
You will need to stay strong through some of the tougher days. Remember, overcoming it is achievable.
Psychological treatment provides either an alternative to medication, or works alongside medication. It is usually provided by a mental health professional, such as a counsellor, psychiatrist or psychologist.
Clinical psychologists have a similar training but don’t prescribe medication. You can get in touch with them through your GP, your local community health centre, Psychological Society of Ireland (PSI), or by looking in your local Golden Pages.
Some GPs also do counselling, so either way they can be a really good place to start if you need support.
Check out types of therapy to learn about these approaches and how they work.
Medication can be helpful in managing depression. There are several different types of antidepressant medication, which are prescribed by doctors.
Antidepressants are drugs that can help to change the way a person is feeling in such a way that they can cope better with symptoms of depression. They were first developed in the 1950s and have been used regularly since then.
There are almost 30 different kinds of antidepressants available today and there are five main types:
- MAOIs (Monoamine oxidase inhibitors)
- SSRIs (Selective Serotonin Reuptake Inhibitors)
- SNRIs (Serotonin and Noradrenaline Reuptake Inhibitors)
- NASSAs (Noradrenaline and Specific Serotoninergic Antidepressants).
How does medication work for depression?
We don’t know for certain, but it’s thought that antidepressants work by alerting the activity of certain chemicals in our brains called neurotransmitters.
They pass signals from one brain cell to another. The chemicals most involved in depression are thought to be Serotonin and Noradrenaline.
What are antidepressants used for?
- 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, or visit Dr David Healy’s site rxisk.org for firsthand accounts.
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 can sometimes be necessary and helpful if your depression is particularly severe or if you are suicidal, to make sure you get the best care possible. You might also spend a short amount of time in hospital if you begin taking medication to make sure it’s working effectively or to gauge side effects.
Sometimes people with bipolar disorder can spend short periods in hospital during particular episodes.
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 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.
There’s significant geographical variation in the use of ECT across Ireland which is probably related to mixed views of it as a treatment among psychiatrists.
Self-help and alternative therapies
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.
Talk 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…’. Still not sure? Take a look at the benefits of talking to someone.
Contact a support group – 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 or you need to talk to someone at 3am, the Samaritans are always there to listen and support you.
You can call them on 116 123 hours a day and it’s completely anonymous. If you don’t get an answer straight away, keep trying, they will get to your call. For more info on other helplines, check out online and telephone help.
Setting small goals – sometimes people set goals which are almost unachievable and then feel worse when they can’t 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 – try and reduce the level of stress you’re feeling. We know that’s easy to say and not always so easy to do, but check out the section on stress for some advice to help you.
Going easy on drugs and alcohol – try not to use drugs or alcohol in the hope of feeling better. The positive feeling you may get is usually temporary and the after effects often make the problem worse.
Remember, recovering from and managing mental health problems can take a bit of time, but there are lots of different options out there and you’ll find one that works for you.