Major depression can be a devastating—even life-threatening—condition. Thousands of studies have examined what works in restoring hope and vitality.
I’ve compiled 27 important facts about depression treatment, based on the latest research. Whenever possible I’ve relied on the most recent meta-analyses which combine results from all relevant studies to establish general trends.
Take care in interpreting these findings, as research in these areas is ongoing.
- Medication and cognitive behavioral therapy (CBT) are equally effective in treating depression. Medication can help with severe depression even as much as CBT.
- There is a very strong placebo effect in depression treatment. The average person in a clinical trial does just about as well on placebo as on medication—a 40 versus 48% reduction in symptoms, respectively, based on a major review.
- Chronic and more severe depression responds better to a combination of medication and therapy. Medication plus CBT is more effective than meds alone, and medication adds additional benefit for those receiving CBT. For mild, non-chronic depression, a single treatment typically works as well as the combination—and avoids the additional time, effort, cost, and side effects.
- About 1 in 8 adults in the US are taking medications that are prescribed for depression. Two-thirds of these individuals are taking a selective serotonin reuptake inhibitor (SSRI) like Prozac or Zoloft.
- CBT is not the only type of talk therapy that works well in treating depression. Psychodynamic therapy—which is based largely on a Freudianunderstanding of the mind—has gotten a bad rap in the era of evidence-based treatment. However, there’s growing evidence that short-term psychodynamic therapy is helpful, as is a more general type of treatment called “nondirective supportive therapy.” The Society of Clinical Psychology—a division of the American Psychological Association—keeps a list of treatments with the strongest research support.
- Exercise can be a powerful antidepressant treatment. Researchers have found benefits of walking, jogging, running, resistance training, and other forms of movement. More intense activity generally leads to greater depression relief.
- Improving diet may be an effective way to relieve depression. A study from earlier this year found that educating people about better eating habits could lead to big reductions in depression. Participants were advised to increase consumption of vegetables, whole grains, legumes, healthy fats, and lean proteins, among other foods; and to reduce heavily processed and sugary foods, as well as alcohol.
- The addition of omega 3 fatty acids is not considered an effective treatment. A review from 2007 had suggested the these supplements were effective, but cautioned that it was “premature to validate this finding” as more research was needed. A more recent meta-analysis found minimal effectiveness of omega 3s compared to placebo—although it’s worth noting that the same has been found for medications for depression, and “placebo” doesn’t mean there was no benefit.
- Self-directed CBT can be an effective treatment for depression. It tends to be somewhat less helpful than partnering with a therapist, and is probably most appropriate for those with mild to moderate depression. A hybrid approach—self-help with some guidance from a professional—can be just as effective as face-to-face therapy.
- There is a high risk for relapse after discontinuing medication for depression. In a meta-analysis of 31 trials, people who were switched to placebo had about a 40% risk for relapsing in the following 4-36 months; continuing on medication reduced that risk to 18%.