What treatment can I get for depression?
Before you go to see your health care professional, it may help to think about these questions, and take your answers with you.
Over the last 2 weeks, how often have you been bothered by the following problems? (Make a note of your answers)
|Not at all||Several days||More than half the days||Nearly every day|
|Feeling nervous, anxious or on edge||0||1||2||3|
|Not being able to stop or control worrying||0||1||2||3|
|Little interest or pleasure in doing things||0||1||2||3|
|Feeling down, depressed, or hopeless||0||1||2||3|
The sort of treatment you’re offered will depend on how much your symptoms are affecting you and what sort of treatment you find helps you. The main treatments are talking treatments and medication.
Your health care professional may offer you:
- Pulmonary rehabilitation or another group exercise class
- Peer group support like our Breathe Easy groups
- Cognitive behavioural therapy (CBT)
- An antidepressant medication
CBT is based on the idea that the way we feel is affected by our thoughts and beliefs and how we behave.
People with depression tend to have negative thoughts, which can lead to negative behaviour. For example:
“I’m a failure” → I stop doing things that I used to enjoy
“It’s hopeless” → I stop trying to do anything to make things better
This turns into a vicious cycle.
CBT aims to break this cycle. It encourages people to think about their problems and find ways to tackle them. It looks at unhelpful thoughts they may have or perhaps what they are doing (their behaviour). This helps them to identify negative thoughts or behaviour and develop ways to counteract them.
Your health care professional may offer you CBT on your own or with a group of other people. These sessions may happen over 6 - 8 weeks, or longer. Your health care professional should support you and review your progress.
You may be given an online course or a book or self-help manual, to work through. A health care professional will provide support and check progress either face-to-face or by phone. It’s usually about 6 sessions over about 12 weeks.
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Acceptance and commitment therapy (ACT) is a form of therapy that uses techniques such as mindfulness and acceptance to help you through difficulties. Using ACT, therapists aim to change how you experience negative thoughts and feelings. You are taught methods to reduce the impact of these thoughts, so that if they reoccur you don’t experience them in the same negative way. There is still limited evidence supporting the use of new therapies such as ACT, but many therapists are already using these techniques to help their patients.
Learning to adapt to life changes is one of the key aspects of counselling. The depression that kicks in - of feeling worthless and angry at the body that won't do what you want to, or could do, or look as it used to - is a battle and a constant fight. So too is the realisation that life has changed. You have to accept it, and so do those around you.
One thing I’m constantly learning is, acceptance helps us with how we communicate our limitations or what’s changed to those around us. It also helps us see solutions and breakdown barriers.Julie
You may be offered a medication called an antidepressant either on its own or as well as a talking treatment.
Your health care professional should discuss which antidepressant is most suitable for you. They should take into account your long-term condition and any potential side effects the drugs may have. Some antidepressants cannot be taken alongside certain medication. Your doctor should talk through the risks and benefits of particular types and monitor you carefully.
You should usually be offered a type of antidepressant called a selective serotonin reuptake inhibitor or SSRI. Ones called citalopram and sertraline are less likely to affect any other medication you are taking.
Antidepressants do not start to work immediately - you won’t feel the benefits as soon as you start taking them. Doctors tend to start people on low doses.
If you don't notice a difference to your mood in 4 weeks, your doctor may consider increasing the dose a little bit, or changing you to another medication.
Getting the right antidepressant and the right dose can take a bit of experimentation - be patient. Discuss any side effects with your doctor.
Mental health is as important as physical health
Phil explains how his team helps people with a lung condition who have anxiety and depression.