Depression treatment options: therapy, medication and self-help

Talking therapies

CBT (cognitive behavioural therapy) helps you notice and change patterns of thinking and behaviour that keep depression going. It is recommended for mild, moderate and severe depression.

Behavioural activation gradually rebuilds activities that give you pleasure and a sense of achievement. When you are depressed you stop doing things, which deepens the depression; this approach reverses that cycle. It is simple, practical and well supported by evidence.

Counselling offers a supportive space to talk, often useful for depression linked to grief, relationships or life changes.

Interpersonal therapy focuses on relationships and life transitions, such as marriage, moving abroad, conflict or loss.

Medication

Antidepressants can help, particularly for moderate to severe depression. They are prescribed by a doctor or psychiatrist. A few things to know:

• they usually take a few weeks to start working;
• side effects are common at first and often settle;
• you should not stop suddenly; your doctor will help you come off slowly when the time is right;
• antidepressants are not addictive in the way people often fear.

Medication and therapy together often work better than either alone for more severe depression.

Self-help that makes a difference

• Move: regular walking or exercise has real effects on mood.
• Routine: get up at a similar time, eat regular meals, get daylight.
• Small goals: one small task a day builds momentum.
• Connection: contact one person each day, even briefly.
• Limit alcohol: it worsens mood and sleep.

Choosing what is right

• Mild depression: self-help, behavioural activation or a short course of therapy.
• Moderate depression: therapy, with medication as an option.
• Severe depression: usually therapy and medication, with a psychiatrist involved.

How Therapy O'Clock can help

You can book a psychologist for talking therapy or a psychiatrist for assessment and advice on medication, in your language. If medication is recommended, the psychiatrist can write to your local doctor, who can prescribe where you live.

Questions people ask

What is the most effective treatment for depression?

It depends on severity. Talking therapies like CBT and behavioural activation work well for mild to moderate depression; therapy plus medication is often best for severe depression.

Are antidepressants addictive?

Antidepressants are not addictive in the way drugs like painkillers can be, but stopping suddenly can cause discontinuation symptoms. Your doctor will help you reduce slowly.

How long do antidepressants take to work?

Usually a few weeks before benefits are noticeable. Keep in touch with your doctor about side effects and progress.

What is behavioural activation?

A therapy that helps you gradually do more of the activities that give you pleasure and achievement, breaking the cycle of withdrawal that keeps depression going.

Can exercise treat depression?

Regular physical activity has a real effect on mood and is recommended as part of treatment, especially for mild depression.

How many therapy sessions do I need for depression?

Many people need between eight and twenty sessions, depending on severity and how long it has lasted.

Can I treat depression without medication?

Many people with mild to moderate depression recover with therapy and self-help alone. For severe depression, medication is often recommended.

Can a psychiatrist on Therapy O'Clock prescribe for me?

Prescribing across borders is restricted. A psychiatrist can assess you and advise, and write to your local doctor, who can prescribe where you live.

What if my depression does not improve with treatment?

Tell your professional. Options include changing the therapy approach, adjusting medication, or combining treatments.

Can depression come back after treatment?

It can. Continuing helpful habits and using the skills learned in therapy lower the risk, and early help if signs return makes a big difference.