Effective Treatment Plans For Depression

Medically reviewed by Aaron Dutil, LMHC, LPC
Updated July 25, 2024by BetterHelp Editorial Team
Please be advised, the below article might mention trauma-related topics that include suicide, substance use, or abuse which could be triggering to the reader.
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When a person is experiencing a persistently depressed mood—i.e., clinical depression—and makes the decision to seek psychiatric or psychological help, this is a big step. Treatments for depression range from interpersonal therapy to selective serotonin reuptake inhibitors (SSRIs) to electroconvulsive therapy. Seeking mental health care can be a move in the right direction, but sometimes, once treatment begins, it may seem like it’s progressing slowly.

Worried that your depression treatment plan isn't working?

What is depression?

Depression is a serious mental health condition characterized by low mood, fatigue, loss of interest, and lack of motivation. The term depression encompasses several psychiatric disorders, including major depressive disorder, seasonal affective disorder, persistent depressive disorder, and postpartum depression. Depressive symptoms are also a primary feature of bipolar disorder; and they can occur in anxiety disorders, post-traumatic stress disorder, and substance use disorder. However, when experts use the term depression, they are typically referring to major depressive disorder. Common forms of treatment for major depressive disorder are psychotherapy (e.g., interpersonal therapy), medication (e.g., selective serotonin reuptake inhibitors), and lifestyle changes (e.g., regular exercise).

What are the main causes of depression?

Depression is a mental illness that is thought to occur in adults and adolescents as a result of a combination of genetic, environmental, and psychological factors. Risk factors that increase an individual’s risk of developing depression include a family history of depression, personal history of mental illness (such as major depressive disorder or an anxiety disorder), stressful life events, and certain medications or substance use disorder. Additionally, an imbalance in neurotransmitter levels is thought to contribute to depression. This is why selective serotonin reuptake inhibitors—which help correct deficiencies in serotonin—and similar antidepressants are prescribed.

Some of the main symptoms of depression are overwhelming feelings of sadness, loss of interest in things you were once passionate about, and physical symptoms like loss of appetite and disruptions with sleep. These symptoms can make living with depression difficult, which is why many seek professional help.

What are the treatments for depression?

Frontline treatment options for depression in adults include antidepressant medications, psychotherapy, and lifestyle changes. For individuals experiencing treatment-resistant depression, electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), or another brain stimulation therapy may be recommended.

Medications used to treat depression include selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), and tricyclic antidepressants (TCAs). Always consult with a healthcare professional prior to starting or stopping any medication. A qualified provider can discuss with you the efficacy, side effects, and treatment duration of selective serotonin reuptake inhibitors and other medications.

Firstline treatments are effective for many people, but some find that their depression symptoms persist or that the side effects are too strong. Noninvasive procedures like electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) are often utilized in these cases. These brain stimulation therapies work by activating certain regions of the brain through electrical currents. Electroconvulsive therapy and transcranial magnetic stimulation can also help someone experiencing suicidal thoughts who’s at an acute risk of self-harm.

In addition to professional treatment, some additional strategies that may help alleviate symptoms of depression include:

  • Prioritizing daily physical activity
  • Maintaining a healthy diet
  • Engaging in proper sleep hygiene practices
  • Trying to reduce isolation and connecting with friends and family members
  • Engaging in relaxation techniques to manage stressors
  • Avoiding alcohol or drug use—or addressing concerns around substance misuse

If you believe you may be experiencing depression, it’s crucial to reach out to a mental health professional who can provide a diagnosis and assist you identifying triggers and setting treatment goals.

Why you may feel that your treatment is not working

Getting help for depression may be like seeing a physical therapist to assist in the recovery process from an injury or surgery. The injury has already occurred, and the purpose of physical therapy is to help the body learn or relearn how to function or to compensate for the loss of functioning in some way. 

Physical therapy exercises may be painful; muscles and joints that have not been used in some time can be reactionary. The person undergoing treatment may go home and feel uncomfortable aftereffects. Sometimes people give up physical therapy due to the challenge and discomfort of the process; if they do so, they may never fully regain the use of the injured limb.

The same is true for mental health therapy, especially when it comes to treating difficult conditions such as depression.

When patients believe they are at an impasse with their treatment, they may have reached the point in the layers of hurt where the pain originates. They may decide to quit because it has become too painful and they feel that they are making no progress.

How you can address this lack of effectiveness 

If a specific modality isn’t working, there are often alternatives that can be utilized. Consider a situation in which a certain dosage or type of selective serotonin reuptake inhibitors (SSRIs) isn’t working. In such a case, a different type of medication, such as a tricyclic antidepressant or a monoamine oxidase inhibitor, may be prescribed. A professional may also try other types of selective serotonin reuptake inhibitors. If traditional approaches aren’t working, the provider might then recommend transcranial magnetic stimulation or another brain stimulation therapy.   

Leaving therapy early may cause setbacks in a person’s recovery. If they choose not to continue with their treatment plan for depression, the unconscious mind may continue peeling back the layers on its own or perhaps in dreams, or times when the mind is unguarded. This can cause people to sink into an even deeper depression as cognitive distortion becomes more prevalent. 

A good therapist may explain that things can get worse before they get better; therapy can be about facing pain, recognizing its origins, and working through the process of placing it in perspective. If a person with depression never addresses the source of the depression in therapy, and never allows the pain to come to the surface, then recovery may be inhibited. 

Of course, if you feel your therapist is not a suitable match or your values are not quite aligned, you reserve the right to terminate the connection and seek another counselor. This is important if you prefer to work with a therapist with a background in a specific therapy approach such as cognitive behavioral therapy (CBT), Gestalt therapy, or sublimation therapy. Moreover, if you prefer to work with a therapist of color or an LGBTQ+ therapist who may understand your experience, you can connect with a professional that aligns in that way. One of the most important factors in mental health therapy is trusting your therapist.  

Online therapy for depression

If you’re having concerns about your treatment plan or how you are progressing in treatment, consider bringing this up with your therapist, questioning and skepticism are appropriate responses when trying new therapies. They may be able to clarify for you what you are experiencing as a normal part of the recovery process or help you to explore other types of treatment that may be more effective for you.

An online-therapy platform like BetterHelp allows people to communicate with a therapist on their schedule from the comfort of their home. Internet-based counseling is also beneficial because it’s generally more affordable than traditional, in-person therapy.

Additionally, a study conducted by the University of California, Berkeley, found that digital therapy is just as effective at treating depression as in-person therapy. With BetterHelp, therapists are available via live chat, phone, and video conferencing.

Worried that your depression treatment plan isn't working?

Takeaway

Depression is a serious mental illness that can have significant impacts on your daily life. It can take a long time to treat, and treatment looks different for every person. If you feel that your depression treatment is no longer as effective as it once was or has not had the effect you wanted, it may be time to discuss your treatment with your therapist and re-evaluate it to see if you are at a normal plateau or if you need to change tactics.

Designing a treatment plan can seem challenging, especially if it requires resurfacing painful topics. But a licensed therapist at BetterHelp can assist you as you take this step toward a healthy state of mind. 

Depression is treatable, and you're not alone
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