Depression Treatment Options

Major Depressive Disorder (MDD)

Major depression is a serious illness that can impact a person’s quality of life and ability to function. Also known as clinical depression or major depressive disorder, this is a mental health condition characterized by persistent feelings of sadness, hopelessness, and a loss of interest in activities that the person used to enjoy. These feelings are severe and last for at least two weeks, affecting a person’s ability to function normally in their daily life.

Symptoms may also include:

• Changes in appetite
• Changes in sleep patterns
• Fatigue
• Feelings of worthlessness
• Difficulty concentrating
• Suicidal thoughts or behaviors

The treatment options for major depressive disorder (MDD) typically include a combination of psychotherapy options such as cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and psychodynamic therapy and antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). These medications can help regulate neurotransmitters in the brain that play a role in mood regulation.

Persistent Depressive Disorder (formerly known as Dysthymia Disorder)

Persistent depressive disorder (PDD), also known as dysthymia disorder, is a form of chronic depression lasting for at least two years. The difference between MDD and PDD lies in its chronic nature, as PDD symptoms are milder but persist for a more extended period. Treatment options for PDD are similar to major depressive disorder treatment options and may include psychotherapy, medication (antidepressants), lifestyle changes, and support groups. Consistent, long-term support is often essential for effectively managing PDD.

Bipolar Disorder

Previously called manic-depressive illness, this disorder involves extreme mood swings that include emotional highs (mania or hypomania) and lows (depression). The depressive episodes can mimic major depressive disorder.

Seasonal Affective Disorder (SAD)

This type of depression usually occurs during the winter and fall months when there is less daylight, due to reduced sunlight exposure. Treatment options for SAD include light therapy, also known as phototherapy, which involves exposure to bright artificial light to mimic natural sunlight. This can help regulate the body’s internal clock and may alleviate symptoms.

Used to offset SAD for decades, light therapy has been a useful treatment for some suffering from SAD. It exposes people with SAD to a very bright light box (10,000 lux) every day for about 30 to 45 minutes, usually first thing in the morning, from fall to spring. This tries to make up for the lack of natural sunshine in the winter months. The light boxes are much brighter than ordinary indoor light and are designed to filter out damaging UV light.

Additionally, psychotherapy, particularly cognitive-behavioral therapy (CBT), can help individuals cope with seasonal changes and develop healthy coping mechanisms. In some cases, antidepressant medications may be prescribed. Embracing outdoor activities and maintaining a balanced lifestyle, such as exercise and proper nutrition, can complement treatment effectiveness for SAD.

Postpartum Depression (PPD)

Postpartum depression refers to depression occurring after childbirth. This form of depression is a serious but treatable medical illness that involves feelings of extreme sadness, indifference, and anxiety that often brings significant changes in energy, sleep, and thought patterns. The exact cause of postpartum depression is not known but it is believed to be linked to physical, chemical, social, and emotional changes that happen when having a baby. The good news is that postpartum depression can be treated with medication and counseling, and relief can be found.

LifeStance offers a wide range of postpartum depression treatments.

Psychotic Depression

This is a form of major depression accompanied by some form of psychosis, such as hallucinations (seeing or hearing things that aren’t there) or delusions (false beliefs). The psychotic symptoms often have a depressive “theme” (e.g., guilt, poverty, or illness).

Premenstrual Dysphoric Disorder (PMDD)

PMDD is a severe form of premenstrual syndrome (PMS) that includes emotional and physical symptoms that disrupt daily life. It occurs during the luteal phase of the menstrual cycle and resolves once menstruation starts.

LifeStance offers a wide range of premenstrual dysphoric disorders (PMDD) treatments.

Atypical Depression

Atypical depression is a subtype of depression characterized by mood reactivity—mood can temporarily lift in response to positive events. Other symptoms include increased appetite, weight gain, excessive sleep, and a feeling of heaviness in the arms and legs.

Situational Depression (Adjustment Disorder with Depressed Mood)

This type of depression is triggered by a specific stressful event, such as the loss of a loved one, divorce, or a major life change. It is usually short-term and improves once the person adjusts to the situation.

Symptoms of depression can vary wildly. For example, some people exhibit uncontrolled anger, while others do not have the energy to get out of bed. Furthermore, people with similar symptoms may have different severities of each one.

Generally, individuals qualify for depression diagnoses if they exhibit at least five of the following symptoms:

• Low or depressed mood daily
• Intrusive thoughts about death or committing suicide
• Feeling uninterested in activities that they used to enjoy
• Difficulty concentrating or remembering
• Unintended weight loss or gain
• Feeling guilty or worthless
• Trouble with sleep
• Fatigue or low energy levels
• Slowed movements
• Fidgeting

A few symptoms do not fit the diagnostic criteria but are common in people with depression:

• Irritability
• Changes in appetite
• Anxiety

For some people, depression can also cause physical symptoms. Sometimes co-existing conditions, such as thyroid disorders, create the physical symptoms and the depression itself. Other times, the stress of depression causes distress in the body as well.

Depression can also occur as a symptom with other mental health conditions:

Depression is a common symptom of bipolar disorder. People who have been diagnosed with bipolar disorder often experience periods of depression that may last weeks. They also experience periods of mania, which is an elevated mood that may cause a person to feel very happy, aggressive, or out of control. Medication management is vital to stabilize mood swings, with mood stabilizers prescribed to manage manic or hypomanic episodes and antidepressants used cautiously to avoid triggering manic symptoms. Psychotherapy, especially cognitive-behavioral therapy (CBT), can help individuals develop coping strategies and manage depressive symptoms while helping to reduce triggers for mania. A strong support system, including family and friends, plays a crucial role in monitoring mood fluctuations and encouraging adherence to treatment plans.

Depression can also be present in psychotic depression cases. Psychosis can involve delusions, false beliefs and a detachment from reality. It can also involve hallucinations. Treatment options for psychotic depression typically combine both antidepressant medications and antipsychotic medications to target the depressive and psychotic symptoms simultaneously. Electroconvulsive therapy (ECT) may be considered in cases of severe or treatment-resistant psychotic depression. Alongside medication, psychotherapy, such as cognitive-behavioral therapy (CBT) or supportive therapy, can aid in managing underlying emotional issues. Early intervention and close collaboration with mental health professionals are crucial in providing more effective treatment and improving the overall outcome for individuals with psychotic depression.

Talk therapy is perhaps the most common form of treatment for depression. It is a form of depression treatment where individuals speak with a trained therapist to explore their thoughts, feelings, and behaviors. The goal of talk therapy is to help people understand their emotions, develop healthier coping mechanisms, and work through challenges that may be affecting their mental well-being.

The most common types of psychotherapy treating depression are as follows:

Cognitive Behavioral Therapy (CBT)

CBT is one of the most common forms of talk therapy for depression. It focuses on identifying and changing negative thought patterns and behaviors that contribute to depressive symptoms. CBT is structured and goal-oriented, often lasting for a set number of sessions.

• Example: A person with depression may have thoughts like “I’m a failure” or “Nothing will ever get better.” CBT would seek to help them recognize that these thoughts are not accurate and develop more balanced, hopeful perspectives.

Behavioral Activation (BA)

A specific form of CBT, Behavioral Activation focuses on encouraging individuals to engage in activities they find pleasurable or meaningful, even when they feel depressed or unmotivated. The goal is to improve mood by increasing positive experiences.

• Example: A therapist might work with someone to schedule small, manageable activities, like going for a walk or calling a friend, which can help lift their mood over time.

Interpersonal Therapy (IPT)

IPT focuses on improving relationships and social functioning, which can directly impact depression. It can help individuals address relationship issues, social isolation, role transitions (like a job change or divorce), or unresolved grief.

• Example: If someone’s depression is triggered by relationship conflict, IPT might focus on improving communication with their partner or working through unresolved grief from a loss.

Psychodynamic Therapy

This form of therapy explores unconscious thoughts, childhood experiences, and past trauma that may contribute to depression. It can help individuals gain insight into unresolved issues from the past that are affecting their current mood and behaviors.

• Example: Someone with depression may explore unresolved conflicts from their childhood or understand how early experiences influence their self-esteem and relationships today.

Dialectical Behavior Therapy (DBT)

Originally developed for borderline personality disorder, DBT can also help people with depression, particularly those who struggle with intense emotions or self-harming behaviors. It combines mindfulness, emotional regulation, and distress tolerance techniques.

• Example: DBT can help individuals learn to manage overwhelming emotions through mindfulness practices and healthier emotional responses to stress.

Antidepressants are commonly prescribed as medication for young adults with depression, but extra caution is recommended for children and teenagers. While antidepressants are generally considered safe when taken as prescribed, there is a slight risk of increased suicidal thinking in some individuals under the age of 25.

For many children and teens, antidepressants can be an effective way to treat depression, anxiety, obsessive-compulsive disorder, or other mental health conditions. If these conditions aren’t treated effectively, your child may not be able to lead a satisfying, fulfilled life or do everyday activities.

The FDA has approved certain antidepressants for use in children and teenagers for depression:

• Escitalopram (Lexapro®) for 12 years and older for Major Depressive Disorder
• Fluoxetine (Prozac®) for 10 years and older for Major Depressive Disorder

Group therapy can be a powerful tool for treating depression, offering support through shared experiences and fostering a sense of community. Lifestance provides group therapy in select states, both in person and online, allowing individuals to connect with others facing similar challenges while receiving professional guidance in a supportive environment.

Find group therapy/support groups that help treat depression near you.