How To Treat Depression
If you’ve ever experienced a bad or sad mood that began to stretch into days or weeks, you probably found yourself wondering what is depression and how to treat it.
While it’s common to talk about it, depression still remains somewhat mysterious and surrounded in shame. But please know, depression is more common than you might think!
If you or someone you know is struggling, there’s hope. Numerous resources, therapies, and support networks are available and today we’re exploring many of them here. Remember, always consult your doctor for personalized advice.
Immediate Support
If you’re in immediate crisis, please reach out:
- National Suicide Prevention Lifeline: 800.273.TALK (8255) (US)
- Crisis Text Line: Text HOME to 741741 (US)
- International Association for Suicide Prevention: https://www.iasp.info/
Understanding the Scope of Depression
The World Health Organization estimates that over 4% of the world’s population experiences depression. In the US alone, 8% of adults struggle with it, with women being twice as likely affected.
Beyond Mood: The Impact of Depression
Depression goes beyond just feeling low. It can impact energy levels, lead to substance misuse, and affect work, relationships, and even physical health. Depression can be more debilitating than other chronic illnesses and can increase the risk of suicide. Tragically, depression was the 10th leading cause of death in the US in 2019.
Destigmatizing Depression
Even in our modern age, depression can still be ignored, minimized, or even shamed. While there’s still a way to go, recent years have seen progress in destigmatizing depression and encouraging open conversations about mental health. I hope this conversation today is a part of that.
Different Types of Depression
Depression manifests in various ways, including major depressive disorder (MDD), seasonal affective disorder (SAD), situational depression, postpartum depression, and bipolar disorder. They’re all similar with slight variations. Today we’re focusing mostly on MDD, but this information can be useful for the other variations as well.
Symptoms, Causes, and Diagnosis of Depression
Understanding the Signs
Depression can be a persistent or intermittent condition, often manifesting in bouts. Symptoms can vary widely but may include:
- Changes in sleep patterns: Difficulty falling asleep, waking up frequently, or excessive sleep
- Appetite fluctuations: Loss of appetite or overeating
- Energy shifts: Fatigue or a lack of energy
- Loss of interest: Diminished interest in activities once enjoyed
- Suicidal thoughts: Thoughts of harming oneself or others
Potential Causes of Depression
For decades, it was commonly thought that depression stemmed from biological factors, such as brain changes and chemical imbalances. While this perspective remains influential, many healthcare professionals now recognize that depression is likely influenced by a complex interplay of factors, including:
- Genetics: Depression often runs in families, suggesting a genetic predisposition.
- Trauma and stress: Adverse life events can contribute to depression.
- Social isolation: Lack of social connection may increase the risk of depression.
- Illnesses and medical conditions: Certain physical health conditions can be associated with depression.
- Medication side-effects: It’s important to be aware that certain medications can have depression as a side effect. If you’re taking multiple medications, consult with your healthcare provider to assess potential interactions and adjust your treatment plan if necessary.
Depression As The Freeze Trauma Response
Depression can often be understood as a manifestation of the body’s freeze response, a natural survival mechanism triggered by overwhelming threats. When our brain perceives a danger as too significant to fight or flee, it activates the freeze response, causing us to shut down and become immobile. This can lead to a range of symptoms commonly associated with depression.
Symptoms of Depression as a Freeze Response
- Emotional detachment: Feeling disconnected from your thoughts and emotions.
- Helplessness: A sense of powerlessness and inability to cope.
- Withdrawal: Shrinking inward or wanting to disappear.
- Immobility: Feeling unable to move or take action.
The Brain’s Protective Mechanism
The freeze response is a hardwired survival mechanism that has helped us stay safe for centuries. It’s triggered by highly stressful situations and is the brain’s most desperate attempt to protect us from harm. When faced with overwhelming challenges, our bodies may go into freeze mode as a way to cope.
If you suspect that you have been stuck in freeze, check out this post about what is polyvagal healing or this one about how to stimulate the vagus nerve.
Diagnosing Depression With the DSM-5 & Beyond
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), outlines specific criteria for diagnosing depression. According to the DSM-5, a major depressive episode involves at least two weeks of depressed mood or a loss of interest in activities, along with other symptoms like:
- Weight changes
- Sleep disturbances
- Fatigue
- Feelings of worthlessness or guilt
- Difficulty concentrating
- Suicidal thoughts
- Psychomotor agitation
While the DSM-5 has been a valuable tool, it’s important to note that not everyone with depression will exhibit all listed symptoms. Subsymptomal depression, even if it doesn’t meet the full DSM-5 criteria, can still be distressing and require treatment. If you’re experiencing symptoms of depression, seeking professional help is crucial, regardless of whether you meet the DSM-5 diagnosis.
How To Treat Depression With Dietary Changes
While there are a number of ways to treat depression, let’s start with the most basic. A balanced, Mediterranean-style diet can significantly benefit both mental and physical health. Additionally, moderating caffeine and alcohol consumption is essential for overall well-being.
The Mediterranean Diet
Research from Australia has demonstrated that a Mediterranean diet can be a cost-effective treatment for depression. That means incorporating nutritious foods, cooking workshops, and social eating. This style of eating clinically outperforms the effectiveness of traditional social support groups.
On the health side, numerous studies have found a strong association between a Western diet (high in red and processed meats, refined grains, sweets, and high-fat dairy) and an increased risk of depression compared to a Mediterranean diet (rich in fruits, vegetables, whole grains, fish, olive oil, and low-fat dairy).
While the exact mechanism behind this association is still debated, researchers speculate that it may be due to the Mediterranean diet’s higher omega-3 fatty acid content or the overall well-roundedness of the dietary pattern.
Coffee
Coffee lovers, rejoice! Studies suggest that coffee, a major source of caffeine, may positively influence neurotransmitters like dopamine and serotonin in the brain, potentially reducing the risk of depression and suicide.
However, moderation is key. Research from Finland revealed a relationship between coffee consumption and suicide risk, with moderate coffee drinkers (2-3 cups per day) experiencing the lowest risk and heavy coffee drinkers (8+ cups per day) facing the highest risk.
Alcohol
Alchohol is definitely something to watch out for. While a moderate glass of wine is fine, excessive alcohol consumption can exacerbate depression. Several studies have linked increased alcohol use (along with substance abuse) to a higher risk of depression and suicide.
The CDC recommends limiting alcohol intake to one drink per day for women and two drinks per day for men. If you find yourself drinking excessively, consider seeking professional help to address potential alcohol-related issues.
Nutrients and Supplements
Adequate intake of omega-3 fatty acids, folate, vitamin B12, and vitamin D, either through diet or supplementation, can be beneficial for individuals with depression.
Omega-3s
These essential fatty acids, found in foods like flaxseed, chia seeds, walnuts, and seafood, have been studied for their potential benefits in depression. While research results have been mixed, supplementation may be beneficial for those with low dietary intake.
Folate and Vitamin B12
These B vitamins are crucial for neurotransmitter production and have been linked to depression risk. Ensuring adequate intake through dietary sources or supplementation can be helpful.
Vitamin D
Often referred to as the “sunshine vitamin,” vitamin D deficiency has been associated with depression. Supplementation may be beneficial, especially for those with limited sun exposure or dark skin.
S-Adenosylmethionine (SAMe)
This compound, involved in neurotransmitter synthesis, has shown promise in treating depression in some studies. However, more research is needed to confirm its effectiveness.
Tryptophan and 5-Hydroxytryptophan
These amino acids, precursors to serotonin, have been explored for their potential mood-boosting effects. While some studies suggest benefits, more research is necessary.
Adopting a Mediterranean diet, moderating caffeine and alcohol intake, and ensuring adequate nutrient intake will go a long way to supporting your overall health and well-being. (Of course, consult a health care provider for further information.)
Lifestyle Changes for a Healthier Mind
Exercise
It’s annoying but true: regular physical activity is a cornerstone of good mental health. A meta-analysis of numerous studies found that exercise alone can be an effective treatment for depression–even for those who may not be able to tolerate more aggressive therapies. Exercise is also thought to enhance the effectiveness of antidepressant medications.
While moderate-intensity aerobic exercise has shown significant benefits, the key is to find an activity you enjoy and can stick with. Whether it’s swimming, dancing, or hiking, the goal is to make exercise a regular part of your routine.
The Power of Social Support
Strong social connections play a protective role against depression. Research has shown that parental support is particularly important for children, while spousal support is crucial for adults, especially men. And don’t forget the power of platonic friendships
Remember, reaching out to loved ones or seeking emotional support from others is essential, even when you feel isolated.
Prioritize Sleep
Depression can disrupt sleep patterns, making it difficult to get a restful night’s sleep. However, adequate sleep is vital for mental health.
Studies have found that both insufficient sleep and excessive sleep can increase the risk of depression. Try to get a moderate amount of sleep to support your overall well-being.
Reconnect with Nature
Spending time in nature is more important than ever. Numerous studies have shown that exposure to green spaces can improve mental health and cognition. Whether it’s a simple walk in the park or a weekend getaway to the countryside, immersing yourself in nature can have a profound positive impact.
Mindful Social Media Use
While social media can be a valuable tool for connection, excessive or unhealthy use can contribute to depression. Always be mindful of the content you consume and limit your time on social platforms. If it makes you feel bad, hide or unfollow.
Social Media, Stress, and Conventional Treatment Options for Depression
The Paradox of Connection
In today’s digital age, social media can offer a sense of connection. But conversely, it can also contribute to feelings of isolation. Studies have shown that increased social media use is associated with higher rates of depression and anxiety, particularly among adolescents.
While it’s unclear whether social media directly causes these issues, it’s important to be mindful of its impact on your mental health. If social media is exacerbating feelings of loneliness or sadness, consider limiting your use or taking breaks.
The Impact of Stress
Stressful life events can significantly increase the risk of depression and other health problems. Chronic stress can accumulate over time, eventually triggering depressive symptoms. Additionally, how you respond to stress (stress reactivity) can also influence your susceptibility to depression.
Effective stress management is crucial for both mental and physical well-being. Techniques like mindfulness, yoga, meditation, and social activities can help you cope with stress.
Conventional Treatment Options: Psychotherapy and Antidepressants
The most common treatments for depression are psychotherapy and antidepressants. These options vary in their approaches and potential benefits, and finding the right combination often requires trial and error. Here’s a run down of some popular choices.
Cognitive Behavioral Therapy (CBT)
CBT (Cognitive Behavioral Therapy) is a popular evidence-based treatment for depression. It involves working with a therapist to identify and challenge negative thought patterns and develop healthier coping mechanisms.
Studies have shown that CBT can be as effective as antidepressants and may even be more beneficial when combined with medication.
Interpersonal Therapy (IPT)
IPT is a structured therapy that focuses on addressing interpersonal issues related to depression. It involves three phases over 12-16 weeks, targeting the clinical diagnosis, working through interpersonal problems, and developing problem-solving skills. Studies have shown IPT’s effectiveness in treating acute depression and preventing relapse.
Problem-Solving Therapy (PST)
PST focuses on teaching individuals problem-solving skills and attitudes. It involves two phases: problem orientation and problem-solving strategy development. A recent study suggests that PST can be an effective treatment for adult depression, comparable to other forms of psychotherapy.
Remember, finding the right treatment is a personal journey. It may take time to discover what works best for you. Don’t hesitate to seek professional help and explore different options to improve your mental health.
Professional Help: Understanding the Difference Between Psychiatrists, Psychologists, and Therapists
What’s the difference between psychiatrists, psychologists, and therapists? The choice between these professionals often depends on whether medication is desired. Some individuals may benefit from seeing both a psychiatrist and a therapist for a comprehensive approach to their mental health.
Psychiatrist – A medical doctor specializing in mental health who can prescribe medications.
Psychologist – A mental health professional with a doctorate in psychology who cannot prescribe medications.
Therapist – A broad term encompassing various mental health professionals, including psychologists, social workers, and counselors.
Building a trusting relationship with your mental health professional is crucial. It may take time to find the right therapist, but the effort is worthwhile.
Treatment: All About Antidepressants
Types of Antidepressants
There are various types of antidepressants, including:
- Tricyclic antidepressants (TCAs)
- Selective serotonin reuptake inhibitors (SSRIs)
- Selective serotonin noradrenaline reuptake inhibitors (SNRIs)
- Monoamine oxidase inhibitors (MAOIs)
- Trazodone
- Lithium
Effectiveness and Side Effects of Antidepressants
A study found that all 21 antidepressants studied were more effective than placebos in treating major depression. While fluoxetine (Prozac) and agomelatine were generally well-tolerated, each antidepressant has its own potential side effects, such as sexual dysfunction, sleep disturbances, and weight gain.
Individualized Treatment and Considerations
Finding the right antidepressant and dosage often involves a trial-and-error process. Antidepressants can take several weeks to take effect and are typically prescribed for extended periods to prevent relapse.
Suicidal Thoughts and Teenagers
It’s essential to note that antidepressants may increase suicidal thoughts in teenagers and young adults. Regular monitoring by a mental health professional is crucial when starting or adjusting antidepressant medication.
For children and adolescents, fluoxetine may be the only antidepressant with demonstrated benefits beyond placebo, but the overall risk-benefit ratio for antidepressant use in this age group is often considered unfavorable.
The Rising Use of Antidepressants
Antidepressant use has significantly increased in recent years, with many individuals taking them for extended periods. While antidepressants can be life-saving for some, it’s important to consider potential side effects and withdrawal symptoms when discontinuing medication.
The Debate Over Antidepressants
The effectiveness and mechanisms of antidepressants are subjects of ongoing debate. Some research suggests that antidepressants may be most beneficial for severe depression, while their effectiveness for mild to moderate depression may be limited.
The serotonin theory of depression, often promoted by pharmaceutical companies, has been questioned. Studies sponsored by pharmaceutical companies may be more likely to report positive findings, while those with negative results may not be published (publication bias).
Informed Decision-Making
Ultimately, the decision to use antidepressants should be made in consultation with a healthcare professional. Consider the potential benefits and risks, including side effects and withdrawal symptoms.
If you’ve tried other treatment options without success or are experiencing severe depression, antidepressants may be a viable option. Remember, there is no shame in seeking help and exploring different treatment approaches to improve your mental health.
Brain Stimulation Therapy
Brain stimulation therapy has a reputation fueled by horror movies, but it’s a far cry from the harmful depictions. These therapies are performed under anesthesia and involve the use of electrical currents or magnetic fields to stimulate specific areas of the brain, potentially altering brain chemistry and improving depressive symptoms.
Types of Brain Stimulation
Several types of brain stimulation therapy exist, including:
- Electroconvulsive Therapy (ECT): The most widely used and studied method, ECT involves inducing a brief seizure through electrical stimulation.
- Vagus Nerve Stimulation: A device is implanted under the skin to stimulate the vagus nerve, which connects the brain to the body.
- Repetitive Transcranial Magnetic Stimulation (rTMS): Magnetic pulses are applied to the brain to stimulate specific regions.
- Magnetic Seizure Therapy: Similar to ECT but uses magnetic fields instead of electrical currents.
- Deep Brain Stimulation: A surgical procedure involving the implantation of electrodes in the brain to deliver electrical stimulation.
Treatment-Resistant Depression
Brain stimulation therapies are often considered for individuals who have not responded to other treatments, such as therapy and antidepressants. Of these therapies, ECT has shown the most significant benefits, particularly for those with severe treatment-resistant depression and older adults.
Side Effects and Considerations
While brain stimulation therapies can be effective, they are not without risks. Memory issues are a common side effect, but these typically resolve over time.
If you’re considering brain stimulation therapy, it’s crucial to discuss the potential benefits and risks with your healthcare provider. They can help you determine if it’s a suitable option based on your individual circumstances.
How To Treat Depression: alternative therapies
Mind-body therapies, such as meditation, yoga, and light therapy, have shown promise in addressing depression, especially when combined with traditional treatments.
Light Therapy
Light therapy is particularly effective for seasonal affective disorder (SAD), a type of depression linked to seasonal changes. It involves exposure to bright light, mimicking sunlight, to regulate mood and alleviate symptoms. Studies have shown that light therapy can be as effective as cognitive behavioral therapy (CBT) for SAD and may also benefit individuals with nonseasonal depression.
Mindfulness
Mindfulness-based practices, such as mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT), have been extensively researched for their impact on mental health. Studies have shown that mindfulness meditation can improve mental flexibility, reduce depressive symptoms, and prevent relapse.
Yoga
Yoga combines physical postures, breathing techniques, and mindfulness to promote overall well-being. Research suggests that yoga can be an effective treatment for depression, both as a standalone therapy and in conjunction with other treatments.
Acupuncture
Acupuncture, a traditional Chinese medicine practice, has shown promise in treating depression. Studies have found that acupuncture can be an effective add-on to antidepressant medication, particularly for improving sleep disturbances.
Herbal Supplements: St. John’s Wort and Saffron
St. John’s wort has been shown to be effective for mild to moderate depression. However, it’s important to consult with a healthcare professional before using St. John’s wort, as it can interact with other medications.
Saffron has also demonstrated effectiveness in treating moderate depression. Studies have shown that saffron extracts can be as effective as antidepressants in improving depressive symptoms.
Massage and Aromatherapy
Regular massage therapy and aromatherapy can provide relaxation and relief from stress, contributing to improved mood and well-being. Studies have shown that massage combined with aromatherapy can reduce depressive symptoms and enhance overall quality of life.
Music Therapy
Music therapy, in either one-on-one or group sessions, has been shown to benefit chronic pain, cancer, mental health disorders, and more. A study found that music therapy can effectively reduce depressive symptoms, particularly when used alongside other treatments.
Remember: While these alternative therapies can be beneficial, it’s essential to consult with a healthcare professional before starting any new treatment. They can provide personalized guidance and ensure that these therapies are safe and appropriate for your individual needs.
Emerging Depression Research: Psychedelics and the Microbiome
Recent research has explored the therapeutic potential of psychedelics for mental health conditions, including depression. Additionally, the gut microbiome has been linked to mental health, suggesting that interventions targeting gut health may be beneficial for depression.
Psychedelics
Psychedelics have a long history of use in various cultures for spiritual and therapeutic purposes. Recent research has shown promising results for psychedelic-assisted therapy in treating depression, addiction, and PTSD.
- Psilocybin: Studies have demonstrated the effectiveness of psilocybin-assisted therapy in reducing depressive symptoms, even for treatment-resistant depression.
- Ayahuasca: Research suggests that ayahuasca may be beneficial for depression, particularly treatment-resistant cases.
- Ketamine: Ketamine infusions have shown rapid antidepressant effects for individuals with treatment-resistant depression.
- MDMA: MDMA-assisted psychotherapy has shown promise in treating PTSD and may also be beneficial for depression.
The Gut-Brain Connection
The gut microbiome plays a crucial role in producing serotonin, a neurotransmitter implicated in depression. Interventions targeting gut health, such as probiotics and prebiotics, may be beneficial for individuals with depression.
Healing from Depression: Final Thoughts
By exploring the various options available, including music therapy, alternative treatments, and emerging research, individuals with depression can find the most suitable approach to improve their mental health and well-being.


PS Looking for more? You might also want to check out how to treat anxiety, journal prompts for depression or journal prompts for a breakup.
Or join my Heal’d program for workshops on boundary setting & much more!
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