Treatment helps most people with depression. Some people have more periods of depression after their first episode is treated. Treatment for depression often includes:
- Immediate treatment
- Ongoing treatment to prevent relapse. This includes taking antidepressant medicine, usually for about six months.
- Maintenance therapy (longer-term therapy), if needed
The treatments below, which may be used together, can help treat depression in older adults:
- Psychotherapy (“talk therapy”)
- Antidepressant medications, ketamine
- Electroconvulsive therapy
- Light therapy during winter for people with seasonal affective disorder (SAD). This therapy may help restore normal sleep and lower symptoms of depression.
- Some newer treatments use non-invasive surgery. These include vagus nerve stimulation (VNS), deep brain stimulation (DBS), and the newest, transcranial magnetic stimulation (TMS).
A person with severe depression needs both medicine and psychotherapy. This combination often works fast and helps keep depression from coming back.
Sometimes depression is so severe that a person cannot do daily activities, is suicidal, or is not safe at home. In these cases, the person may need treatment in a psychiatric hospital.
A person should keep getting treatment as long as their healthcare provider recommends it.
Psychotherapy
Psychotherapy is a safe and helpful way to treat depression. People often have therapy along with antidepressant medicine (described below).
There are several useful types of psychotherapy:
- Problem-solving therapy. A therapist helps a person find the parts of their life causing problems and helps them find solutions.
- Cognitive behavioral therapy (CBT). This helps a person understand how their thoughts affect their depression. People also learn ways to manage these thoughts. CBT has a set number of weekly visits. Visits may include activities and homework.
- Interpersonal psychotherapy. This therapy helps a person handle relationships, grief, loss, and changes in their role in life. This therapy can treat minor depression, especially:
- After the death of a close friend or relative
- For caregivers of older adults who become depressed
You can now get psychotherapy by phone or online.
Antidepressant Medications
A person may need medicine during treatment for depression. The choice of medicine depends on:
- The medical problems a person has
- Side effects of the antidepressant
- Interactions with other medications
Steps the healthcare provider takes:
- Starts the person with a low dose of the antidepressant
- Increases the dose slowly and carefully until the medication takes effect
- Checks medicine levels in the blood to make sure they do not get too high, especially if the person has kidney or liver problems
- Changes medicines or sets up psychotherapy
The below sections provide more information on medication treatment for depression.