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Treating depression is different for everyone


Depression is a mood disorder characterized by feelings of sadness and a loss of interest in the things you usually enjoy doing. You might also have trouble thinking or getting things done, among other symptoms. Thoughts of suicide are possible in the most serious cases.

The good news? There are many ways to deal with depression and make yourself feel better. Here’s what you need to know.

Depression vs. Depressed mood

A diagnosis of depression is different from feeling depressed one day or being in a bad 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 depressive disorder (MDD), the chemicals in your brain don’t always work the way they are supposed to. Other things, like genetics, sometimes play a role. So you feel that way for a much longer period – usually 2 weeks or more.

David A. Adler, MD, senior psychiatrist and director of the Mental Health Services Research Group at Tufts Medical Center, says 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 will happen a third time, and then a 95% chance it will happen a fourth time.

Depression can happen on its own or be triggered by a life event. There are different types, among which:

Major depressive disorder (MDD). This is considered the classic type. It includes common symptoms like loss of interest in hobbies, trouble sleeping, etc.

Persistent depressive disorder. It lasts at least 2 years, but it may not be as intense as major depression. It was once called dysthymia.

Postpartum depression. This type of depression occurs after childbirth.

Seasonal affective disorder. This can happen when the seasons change and the days get shorter. Experts believe it may have something to do with lack of sunlight, among other things.

Bipolar disorder. If you have this condition, you may be depressed, but also have periods of very high or intense energy levels.

Treat major depressive disorder

Treatment depends on the person. What worked for a friend or family member may not work for you. And just because they’ve had certain side effects doesn’t mean it will happen to you. For example, just because a certain antidepressant caused your mother to gain weight doesn’t mean the same will happen to you. It is important to approach treatment with an open mind.

The options include:

Psychotherapy. Also called talk therapy, this involves meeting with a mental health professional in person or virtually to talk about and work on your feelings. It “helps the person optimize their coping strategies to cope with life stressors,” says James Murrough, MD, PhD, director of the Center for the Discovery and Treatment of Depression and Anxiety at Mont. Sinai.

Antidepressants. These are prescription drugs that help balance chemicals in the brain.

Brain stimulation therapies. This is when doctors use electrical impulses in hopes of altering brain activity. It is an option for people who do not respond to psychotherapy or antidepressants.

Electroconvulsive therapy (ECT). This is used for severe depression. Unlike brain stimulation therapy, your doctor puts you to sleep during the procedure. They send electric currents through the brain to cause a short seizure. It appears to relieve the symptoms of some mental health issues.

Murrough says talk therapy and medication are also likely to be effective in treating someone with MDD. John Greden, MD, founder of the Eisenberg Family Depression Center in Michigan, says he thinks people with MDD who receive both psychotherapy and antidepressants fare better.

“It shouldn’t be [psychotherapy] against [antidepressants], says Greden.

It is important to speak honestly with your doctor about what is going on so they can help you decide what might work best. It may take a few tries, but you’ll find out together.

“The best evidence-based treatments follow an individual’s preferences, because both drug therapy and psychotherapy have worked,” says Adler.

Side effects

These also depend on the person. Some people have no side effects, while others need to try a few antidepressants before they find one whose side effects they can handle.

The old class of traditional antidepressants (monoamine oxidase inhibitors or MAOIs) were known to cause significant weight gain or reduce your libido. They’ve worked, but people tend to choose the newer ones that have better “side effect profiles,” Greden says.

Lifestyle changes and alternative treatments

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 is also some evidence to suggest that stress management, whether through meditation or other mindfulness practices, is helpful.

Researchers are also studying ketamine to treat severe depression.

If you are having suicidal thoughts or feelings of harming yourself, know that you are not alone. There are resources and people who can help you. Contact your doctor, a family member or a friend. You can also call the National Suicide Prevention Lifeline at 800-273-8255 or the Addiction and Mental Health Administration Helpline at 800-662-4357.

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