- Immediate treatment.
- Continuing treatment to prevent relapse. This includes antidepressant drug therapy, usually lasting for about six months.
- Maintenance therapy (longer-term therapy), if needed.
The following treatments, which may be used together, can help treat depression among older adults:
- Psychotherapy (“talk therapy”).
- Antidepressant medications.
- Electroconvulsive therapy.
- Light therapy during the winter months for people with seasonal affective disorder (SAD). This therapy may help restore normal sleep and decrease symptoms of depression.
- Some newer treatments can involve (non-invasive) surgery. These treatments include vagus nerve stimulation (VNS), deep brain stimulation (DBS), and the most recent, transcranial magnetic stimulation (TMS).
A person with severe depression needs a combination of medications and psychotherapy. This combination often works quickly and keeps depression from happening again.
Sometimes depression is so severe that a person can’t do daily activities, is suicidal, or isn’t safe in the community. This means a person may need treatment in a psychiatric hospital.
A person needs treatment as long as their healthcare provider recommends it.
Psychotherapy is a safe and helpful way to treat a person who has depression. People often also have therapy with antidepressant drugs (described below).
There are several useful psychotherapy techniques:
- Problem-solving therapy. A therapist helps a person figure out the parts of their life that are causing problems and helps them find solutions.
- Cognitive behavioral therapy (CBT). This helps a person understand how their thoughts and other things affect their depression. People also learn ways to deal with them. CBT therapy has a limited number of weekly visits. Visits may include helpful activities and assignments to do at home.
- Interpersonal psychotherapy. This therapy can treat minor depression, especially:
- After the death of a close friend or relative.
- For caregivers of older adults who develop depression.
This therapy helps a person deal with their relationships, grief, loss and coping with their role in life.
A person may need medication during treatment for depression. The choice of medication 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
- Monitors the levels of the medication in the blood to make sure they don’t get too high, especially if the person has kidney or liver problems
- Changes medications or arrange psychotherapy