Talking (psychological) treatments

If available in your area, an option is to be referred to a psychologist or other professional for a more specific type of talking treatment. Most psychological treatments for depression last in the range of 16-20 sessions over 6-9 months. For example:

• Cognitive therapy. Briefly, cognitive therapy is based on the idea that certain ways of thinking can trigger, or 'fuel', certain mental health problems such as depression. The therapist helps you to understand your thought patterns. In particular, to identify any harmful, unhelpful, and 'false' ideas or thoughts which you have that can make you depressed. The aim is then to change your ways of thinking to avoid these ideas. Also, to help your thought patterns to be more realistic and helpful. Therapy is usually done in weekly sessions over several months. You are likely to be given 'homework' between sessions.
• Cognitive-behaviour therapy (CBT). This is a combination of cognitive therapy and behaviour therapy. Behaviour therapy aims to change any behaviours which are harmful or not helpful. In short, CBT helps people to achieve changes in the way that they think, feel and behave. (See separate leaflet for more details on CBT.)
• Other types of therapy sometimes used include: interpersonal therapy, problem-solving therapy and psychodynamic psychotherapy.

For moderate depression, the number of people who improve with cognitive therapy and cognitive behaviour therapy is about the same as with antidepressants. These treatments may not be so good for some people with severe depression. This is because you need some motivation to do these treatments and people with severe depression often find motivation difficult.

Also, there is a shortage of trained therapists who can perform psychological treatments. So, it might not be an option in your area, or there may be a long waiting list.

Some research suggests that a combination of an antidepressant plus a talking treatment such as CBT is better than either treatment alone.

Exercise and counselling

In addition to the above treatments, as with mild depression, regular exercise is thought to help to improve symptoms (if you are able to do some exercise). Also, counselling for a specific problem may help too if a particular problem is troubling you (relationship breakdown, bereavement, etc).