What Clinical Depression Treatments are available?

We recently received this letter from one of our visitors who’s looking for clinical depression treatments and we  felt it offered a good opportunity to talk about depression treatments in general:


Dear Dr Purves

 I’m 25 years old and today when I saw my doctor he told me I have clinical depression. I wasn’t exactly surprised as I’ve had bouts of depression lasting a few months at a time over the past few years.

 I often feel anxious as well as depressed and don’t want to leave the house and this often makes me late for work. I hate my job but the pay is good and I can’t afford to leave.  I haven’t the energy to put any effort in to friendships and many have fallen by the wayside. I just don’t enjoy anything anymore. I feel flat all the time.

 My doctor talked to me about different clinical depression treatments. He said he wanted to put me on antidepressants and arrange for me to see a therapist. I’ve had antidepressants before and they didn’t work. I also had a couple of sessions with a counsellor a long time ago but found them a complete waste of time. Is there anything else I could try that might actually work?


Clinical depression treatments: Antidepressants

Research has shown that antidepressants aren’t that helpful in cases of mild to moderate depression and the latest guidance from the National institute for Health and Clinical excellence (NICE) is that doctors should only prescribe them for the more serious cases. Some GPs adhere to this but some are giving them out for the mild cases.

From what you’ve said you sound as if you have a moderate case of depression. However, I would suggest that you talk this over with your doctor as he will fully understand your case. If you do have a severe case of depression then antidepressants do have their place as part of your treatment plan. Your doctor is in the best place to advise you.

Clinical depression treatments: Cognitive-behavioural therapy (CBT Therapy)

I’m sorry that you didn’t get on well with your counselling. Counselling can be very helpful if you have a problem that you need help solving. Counsellors don’t tell you what to do but provide you with practical advice.

clinical depression treatments - therapy
Treatments which include cognitive-behavioural therapy techniques tend to be really successful and NICE recommends that therapy is offered to patients with depression. It’s likely this is what your doctor has in mind when he says he wants you to see a therapist and I’d encourage you to give it a try.

In a nutshell CBT therapy is a talking therapy which helps you to make sense of your thoughts and behaviours. It will teach you how to go about replacing your negative thoughts with positive ones and change your actions.

If you don’t like the idea of having face to face therapy you could try computerised CBT (cCBT) which is just as successful. Basically you undertake a course of treatment in the comfort of your own home on your own computer. Blues Begone and Mood Control are two such treatments.

Clinical depression treatments: Lifestyle changes

As part of your treatment plan you might like to consider introducing regular exercise. I’m sure you know about the general health benefits of exercise but it’s also a great mood booster. It doesn’t matter what you do as long as you get moving.

Clinical depression treatments - exercise
I have clients who walk and others who have become involved in team sports such as five-a-side football. The key is to do something you enjoy. I know you’re feeling flat at the moment so enjoy might be a strong word but choose something you can tolerate and go from there. If it’s a 15 minute walk then start there. Try to build exercise in to your daily routine.

Clinical depression treatments: Self help support groups

Depression can be isolating. As you mentioned you don’t feel you have the energy to put in to friendships at the moment and as a result have lost friends. Some of my clients have felt that their friends didn’t understand what they were going through and others have deliberately distanced themselves feeling they were no fun to be around anymore.

If this is how you’re feeling then you might benefit from joining a support group for people with depression and talking to people who understand where you’re coming from.

There is a list of self help groups on the Depression Alliance website


Clinical depression treatments: Other treatments

If depression is severe and you haven’t responded to any of the above treatments there are some other options available which your doctor may suggest.

Electroconvulsive therapy (ECT) is one. It passes electrical currents through your brain.

Another option for severe depression is Vagus nerve stimulation which involves having an implant to control the brain’s mood centre.

And there’s Transcranial magnetic stimulation which involves holding an electromagnetic coil to your head.

Clinical depression treatments: Conclusion

As your depression appears to be moderate I hope that you will respond well to treatment. All depression is treatable to some extent and most of it to a great extent. I would urge you to participate actively in your own recovery.

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