Procedures to treat depression

If medications and psychotherapy aren't working, you may want to talk to a psychiatrist about these additional treatment options:

  • Electroconvulsive therapy (ECT). During ECT, electric currents are passed through the brain, intentionally triggering a brief seizure. ECT seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental illnesses. Although many people are leery of ECT and its potential side effects (such as confusion or amnesia), it can offer immediate relief of even severe depression when other treatments don't work.
  • Transcranial magnetic stimulation (TMS). TMS uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. A large electromagnetic coil is placed against your scalp near your forehead. The electromagnet creates electric currents that stimulate nerve cells in the region of your brain involved in mood control and depression.
  • Vagus nerve stimulation (VNS). VNS stimulates the vagus nerve with electrical impulses. This treatment uses a device implanted in your chest that's connected by a wire to a nerve in your neck (vagus nerve). Electrical signals from the implant travel along the vagus nerve to the mood centers of the brain, which may improve depression symptoms.

Other steps you can take

To make the most of depression treatment:

  • Stick to your treatment plan. Don't skip therapy sessions or appointments. Even if you're feeling well, don't skip your medications. If you stop, depression symptoms may come back, and you could also experience withdrawal-like symptoms. If side effects or medication costs are a problem, talk with your doctor and pharmacist to discuss options.
  • Stop drinking or using drugs. Many people with depression drink too much alcohol or use street drugs or marijuana, which worsen depression. If you can't stop drinking alcohol or using drugs on your own, talk to your doctor or mental health provider. Depression treatment may be unsuccessful until you address your substance use.
  • Manage stress. Relationship issues, financial problems, an unhappy work life and many other issues can all contribute to stress, which in turn worsens depression. Try stress-reduction techniques such as yoga, meditation, mindfulness or writing in a journal.
  • Sleep well. Poor sleep may worsen depression. Both the amount of time and how well you sleep can affect your mood, energy level, ability to concentrate and resilience to stress. If you have trouble sleeping, research ways to improve your sleep habits or ask your doctor or mental health provider for advice.
  • Get regular exercise. Exercise has a direct effect on mood. Even physical activity such as gardening or walking can reduce stress, improve sleep and ease depression symptoms.

Don't settle for a treatment that's partially effective at relieving your depression or one that works but causes intolerable side effects. Work with your doctor or other mental health provider to find the best treatment possible, even though it may take time and effort to try new approaches.

July 24, 2014 See more In-depth