Psychological therapies
1. Cognitive behaviour therapy (CBT)
CBT is based on the idea that how we think affects the way we feel and behave. Depression makes individuals have a negative outlook about themselves, the world and the future. This thinking process can become unconsciously automatic as depression becomes severe.
CBT helps one:
- Recognise unhelpful thoughts and change them into more realistic ones.
- Change depressive behaviours by scheduling regular activities and engaging in pleasurable activities. This can include stress management, relaxation techniques, and sleep management.
It is recommended that a person has 16-20 sessions of CBT in order to experience an effective outcome.
2. Behavioural therapy (BT)
Behavioural therapy focuses on the person’s behaviour by increasing the person’s level of activity and pleasure in life. It usually works by helping the client identify and change self-destructive or unhealthy behaviours into more productive ones. This therapy can be carried out with individuals or groups, and generally takes 8-16 weeks.
3. Interpersonal therapy (IPT)
IPT is based on the idea that interpersonal problems/personal relationships are the main cause of depression. Therefore, the therapy focuses on problems in relation to personal relationships, and on building skills to deal with these problems. Examples of some skills that are taught in IPT are:
- Resolving conflicts with other people
- Deal with grief or changes in relationships
- To develop better relationships
It is recommended that a person has 16-20 sessions of treatment in order to get effective outcomes.
4. Mindfulness-based cognitive therapy (MBCT)
MBCT is the combination of mindfulness meditation and CBT. It teaches people to focus on the present moment by being aware of what they are currently experiencing or can notice (including pleasant and unpleasant experiences), without trying to change them. This approach is used to focus on physical sensations, feelings, and thoughts.
Medical treatment
1. Antidepressant medications
Antidepressants are types of drugs commonly used to treat depression, and can only be prescribed by a doctor or psychiatrist. There are different types of antidepressants, but their main mechanism of action is to change levels of chemicals in the brain related to emotion and motivation. Antidepressants are effective for adults who have moderate to severe depression. All antidepressants have some side-effects such as suicidal thinking, nausea, headache, feeling drowsy, or sexual difficulties.
2. Antipsychotic medications
Antipsychotic drugs can be used for severe depression and may be used alone or with antidepressants, where other treatments have not worked. Common side-effects include weight gain, dry mouth, sexual problems and movement problems in limbs and face.
3. Electroconvulsive therapy (ECT)
ECT can be effective for people with severe depression that has not responded to other treatments, or where there is a risk of death from suicide or refusal to eat or drink. ECT involves electrical currents that are passed through the brain to cause a seizure. The treatment is given under general anaesthetic, along with muscle relaxants. ECT may cause short-term side-effects such as confusion, problems concentrating and memory loss.
4. Transcranial magnetic stimulation (TMS)
TMS is sometimes used to treat severe depression or depression that has not responded to other treatments. It works by holding a strong magnet over the scalp, stimulating some areas of the brain. When TMS is used correctly, there is a very low risk of seizure. Side-effects can include mild headache and scalp or neck pain.
Complementary interventions and lifestyle changes
- Exercise, like jogging, walking, yoga, or weight training.
- Light therapy which involves bright light exposure to the eyes, often in the morning. This is most useful when depression is associated with lack of light exposure during winter.
- Self-help books which are based on CBT can be effective. It is more effective when used under a health professional’s guidance.
- Foods/Nutrition like Omega-3 fatty acids (fish oil), turmeric/curcumin, traditional Chinese medicine
- Peer support interventions. Peers are people who have recovered from depression that can offer support to those experiencing depression. It can take many forms including mutual support groups, internet support forums, and peer support services provided by mental health service. Examples of support that they may provide include:
- Effective emotional and social support.
- Inspiring hope by demonstrating that recovery is possible.
- Giving practical advice on how to reach recovery.
Finding balance in treatments
Treatment for depression varies depending on its severity, whether mild, moderate, or severe. Most people benefit from a holistic approach, which may include:
- Self-help strategies
- Talking therapies
- Medication, when appropriate
Each person’s experience with depression is unique, so it may take time to find the right combination that works best for you.
Understand that healing is not linear
Recovery from depression is not always a straight path. There will be good days and tough days. Sometimes, people experience significant progress, followed by setbacks or relapses – and that’s completely normal.
What’s important is to acknowledge every step forward, no matter how small it may seem. These moments of progress are signs of healing and resilience.
If you are a caregiver or supporter of someone with depression:
- Be patient with their journey
- Avoid rushing their recovery
- Offer understanding and encouragement even during relapses
Healing takes time. And every step – even the slow or painful ones – is still progress toward a healthier and more balanced life.
