Depression - treatment and

 management

Summary

People need help to cope with and recover from depression. Early intervention will avoid symptoms becoming worse. Mild depression can be helped with healthy sleeping patterns, nutrition and planning. Serious depression requires medical help.

Tackling depression as early as possible may mean that you can address problems quickly and avoid symptoms becoming worse. There are various signs to watch out for. Knowing how to manage these signs and where to get support can help you cope with and recover from depression.

Depression is common

One in five women and one in eight men suffer from depression at some time in their life. Different types of depression exist, with symptoms ranging from relatively minor (but disabling) to very severe.

Seek help for depression

If you experience some or most of the symptoms of depression, seek advice from a doctor or counsellor. Don’t delay. Tackling depression early can help you address problems quickly and avoid symptoms becoming worse.

Types of depression

Different types of depression often have slightly different symptoms. The main types of depression are:

• major depressive disorder
• bipolar disorder (which used to be called manic depression)
• cyclothymic disorder
• dysthymia
• seasonal affective disorder (SAD).

Treatment for depression

Depression is often not recognised and can go on for months or even years if left untreated. Seek help early. The sooner a person gets treatment, the greater their chance of a faster recovery. A range of treatments, health professionals and services are available, and there are many things that people can do to help themselves.

Different types of depression require different treatment. Mild symptoms may be relieved with lifestyle changes (such as regular physical exercise) and self-help (for example, online e-therapies). For moderate to more severe depression, psychological or medical treatments are likely to be required, with a combination of treatments often being the most useful.

Treatment for depression should start with seeing your doctor. Book an extended consultation to give you time to discuss your symptoms and treatment options. Treatment might include medication, therapy or both.

Your doctor may refer you to a psychiatrist or psychologist. However, it can sometimes be difficult to get an appointment with a psychiatrist and you may need to wait some time before you can be seen. Whether this is okay for you will depend on the severity of your depression. If you feel that you need to see someone sooner, let your doctor know and work with them to find a solution.

Another option is your local community health centre. Your local council will have contact details. Most major hospitals also have a psychiatric department with staff available for assessments. If it is an emergency, call your local mental health crisis number for advice.

Psychological treatments for depression

Psychological treatments (talking therapies) help people change negative patterns of thinking and sort out relationship difficulties. They improve coping skills so people feel more able to deal with life’s stresses and conflicts, and help to prevent relapse once the person is well again.

These treatments include cognitive behaviour therapy, interpersonal therapy and family therapy. You can also access a psychologist through Medicare. This requires that your doctor writes a mental health plan – ask them for more details.

Antidepressant medications

Antidepressants are often prescribed alongside psychological treatments when a person experiences a moderate to severe episode of depression. 

Antidepressants take at least two weeks before they start to help, and it may also take some time for your doctor to find the most suitable medication and dosage. It is important to persist with your medication, even if it doesn’t seem to be making a difference at first. Stopping medication should only be done gradually, on a doctor’s recommendation and under supervision. 

Like with any other medication, some people will experience some side effects. Discuss any side effects of the medication or issues with your doctor or therapist. Remember, everyone is different and many people need to try a number of medications and treatment approaches before they find one that suits them. Don’t give up – keep talking to your doctor about finding medication that works for you.

Depression – coping and recovering

Medical help is very important, but there are also things you can do every day to help your recovery.

Enjoying activities

When you are depressed, you might not enjoy activities that you once loved. You might also think you won’t enjoy something but, when you do it, you actually enjoy it more than you expected.

If you don’t try activities, you reduce the number of things that may help you cope with your depression. To increase the amount of activities you enjoy, you can:

• list activities you used to enjoy – include as many as possible
• plan one of these activities each day
• increase the amount of time available for activities you enjoy
• after an activity, think about or write down what you enjoyed about it
• talk to others about activities they like.

If you keep going, it will help you get better. You will enjoy activities more as you recover.

Sleeping patterns and depression

Changes in sleeping patterns are common in people experiencing depression. Not sleeping enough or sleeping too much can make you feel worse, but you can help by:

• getting up at the same time every morning, regardless of how tired you feel
• avoiding sleeping during the day or taking a nap before bedtime
• drinking no more than four cups of tea or coffee a day, and don’t have either after 4 pm
• getting out of bed and going to another room if you are awake at night. try to relax – for example, by reading, drinking warm milk, listening to music or doing relaxation exercises
• doing regular exercise earlier in the day.

Negative thoughts and depression

Worrying or thinking negatively is common in people with depression. This affects your ability to focus on getting better and makes you more vulnerable to unhealthy emotions.

Tips to help you control worry and reduce negative thinking include:

• Write down what you are worried about. Go through each concern and examine all the possible positive and negative outcomes.
• Think about how realistic your negative thoughts are. Explore alternative thoughts and explanations.
• Avoid talking about negative thoughts and feelings. Try to find realistic thoughts, which will at least balance your negative ones.
• Keep busy and focused on tasks.
• Think about your skills, talents and achievements. Look at the good things around you. Remember happy times.
• Write down your thoughts. Identify negative ones and try to correct them.
• Avoid making major decisions about your life at this time.

Dealing with irritability, agitation and fatigue

People with depression often experience irritability, agitation and fatigue. These feelings can become worse because of changes in sleeping patterns and lifestyle.

Help yourself to deal with this by:

• telling your friends, family and colleagues what you are going through and that you may appear to be irritable
• when you are agitated or irritable, stopping and thinking about what is causing you to feel this way and how you can calm down
• practicing regular relaxation to reduce the effects of irritating or frustrating situations
• talking to people who are supportive
• being as active as possible, despite fatigue. Schedule activities each day, such as exercise, meeting people, going on outings or even doing household chores.

Treatments for seasonal affective disorder (SAD)

Treatments for SAD might include phototherapy (controlled use of artificial light that mimics the sunlight spectrum), medications or psychotherapy.

Be guided by your doctor, but SAD can be helped if you:

• increase your exposure to sunlight every day
• bring sunshine into your home – install skylights, keep the curtains open
• get regular outdoor exercise
• look after yourself – have good sleeping habits and eat a healthy diet. avoid cigarettes, drugs and excessive alcohol
• holiday in a warmer, sunnier climate during winter.

Things to remember

• If you feel depressed, see your doctor for an assessment.
• Don’t delay. Tackle depression early to address problems quickly and avoid symptoms becoming worse.
• Depression can be mistaken for a physical illness, such as fatigue.
• Antidepressants can help most depressed people, but they must be accompanied by psychological therapy and education.
• Take the time to find the treatment that’s right for you.
• Medications may take up to six weeks to be effective, so be patient.
• Medical help is very important, but there are also things you can do every day to help your recovery.