Treatment Options

Understanding your options is key to getting the support you need to overcome depression

When we are dealing with depression, we want to make sure that we’re receiving research-backed treatments that are proven to work.

The two most common and well-researched professional treatment options for depression are talk therapy and, if appropriate, antidepressant medication. There is also research supporting the use of self-help strategies including exercise, mindfulness, and journaling for managing depression symptoms.

In addition, researchers are developing and testing new complementary and alternative treatments that may become more available in the future.

Below, we’ll go over the different options for treating depression and how each can help.

Talk Therapy

Talk therapy (formally referred to as ‘psychotherapy’, but commonly referred to simply as ‘therapy’) is a research-backed form of treatment for a broad range of mental health concerns. Talk therapy is one of the most effective and widely used treatments for depression.[1]

In therapy, you and a trained mental health professional discuss what’s going on in your life, working together to develop insight into the challenges you are facing, new strategies and skills to help you regulate your emotions/thoughts/behaviours more effectively, regain a sense of control, and lead a more enjoyable and satisfying life.

Men who have gone to therapy often regard it as one of the most profound and empowering experiences of their life.

For more information on how talk therapy can help, and how to make the most out of it, see our Guide to Talk Therapy for Men.

Medication

Medication may be recommended by a physician (i.e., medical doctor) if our depression symptoms are severe and significantly interfere with our ability to function. If deemed appropriate, medication can help stabilize our mood and functioning so we can focus on building other strategies to recover from depression (like engaging in therapy).[2]

Medications can take some time to work (about 4-6 weeks) and some may be accompanied by unwanted side effects, including dry mouth, drowsiness, nausea, trouble sleeping, weight gain, and decreased sex drive. Despite this, medication can be an important component of one’s recovery plan.

Additionally, everybody reacts differently to medications, so our experiences may be very different from that of a friend.

It is important to note that antidepressant medications are not addictive and you are not bound to be on them for life.

Inpatient

Inpatient services (accessed through Urgent Care or the Emergency Room) are an option if you are having thoughts of suicide and think you may act on them.

Inpatient services will provide around-the-clock care and connect you with mental health professionals such as psychiatrists and social workers for the duration of your stay. They can also refer you to additional support once you are discharged.

Complementary and Alternative Approaches

Peer-led Support Groups

Peer-led support groups are a way of connecting with other people who share similar experiences. The focus of conversation tends to be less about treating an issue (like in formal group therapy led by a therapist), and more about sharing experiences and providing one another with mutual support.

For more info, see our Guide to Men’s Groups.


Physical Activity and Exercise

Exercise is known to release endorphins, natural pain-killing chemicals produced by the human body that can help lift a person’s mood. In addition to temporarily boosting your mood, research has shown that exercise has a significant antidepressant effect.[3] This effect is most pronounced with moderate to vigorous intensity aerobics-based exercise, which includes swimming, running, cycling, or any other physical activity that gets your heart rate up.

Any amount of exercise can make a difference – we don’t need to start an intensive training program. Small changes like taking the stairs and getting more steps in our day can add up to positively impact both our physical and mental health.

To learn more, see our guide on Physical Activity 


Mindfulness

Mindfulness involves focusing on the present moment and accepting our current thoughts and feelings without judgment. In doing so, we give ourselves a break from stressing about the past or worrying about the future, increasing our sense of calm.

Mindfulness is rooted in Buddhist meditation, but has recently gained popularity in many parts of the world as a non-religious practice that is used to help people clear their heads and reduce stress. Certain activities, such as yoga, Tai chi, and meditation, incorporate aspects of mindfulness and may also be beneficial for reducing stress and symptoms of depression.

To learn more, see our course on mindfulness.


Journaling

A journal isn’t just a diary for dwelling on negative feelings. Journaling is a tool that can be used to keep track of our goals, organize our thoughts, and understand our behaviours – all things that are useful when we are dealing with depression.

Research has found several benefits to keeping a journal. One study found that expressive writing (the technical term for journaling) can reduce rumination and depressive symptoms.[4] Many mental health professionals recommend it as a useful strategy that can be used in conjunction with other more formal depression treatments, namely talk therapy.

Learn more about How Journaling Can Help Combat Depression.


Herbs and Supplements

Certain supplements, such as Omega-3 fatty acids and St. John’s Wort have been found to potentially alleviate depression symptoms and may be worth considering (especially if you do not respond to or cannot take traditional antidepressants). Meanwhile, other products like marijuana are often advertised as helping with depression, though research shows that they are more likely to cause harm and worsen mental health issues over time.

It is very important to keep in mind that supplements can interact poorly with many medications, including antidepressants, so always do your research and always consult a health professional before taking supplements or medications.

Our guide goes through the evidence for supplements like Omega-3 fatty acids, St John’s Wort, SAM-e, Ginkgo biloba, Vitamin D, B Vitamins, and marijuana.

To learn more, see our Guide to Herbal Treatments and Supplements for Depression.


Acupuncture

Acupuncture has a long history of use in Traditional Chinese Medicine for treating various ailments. During acupuncture, a practitioner inserts extremely thin needles into various points of the body called “acupoints”. These acupoints vary depending on what illness is being treated. It is believed that these points of insertion activate the central nervous system and release endorphins, brain chemicals that are associated with positive mood and pain relief.

There is limited research on the efficacy of acupuncture for treating depression, however, a 2019 meta-analysis found that acupuncture was associated with reduced severity of depression when compared to usual care alone, to sham acupuncture, and to SSRI/SNRI medication alone.[5] While it still lacks conclusive evidence, acupuncture may be worth considering as an additional intervention to complement standard treatment methods, such as therapy and medication.

For Treatment-Resistant Depression

If after trying multiple treatment options without improvement in symptoms, you and a doctor may consider one of the treatments for treatment-resistant depression described below.

Please note that some older treatment options, like electroconvulsive therapy (ECT), carry unwarranted levels of stigma as the way they are performed today is very different from how they were applied in the past and portrayed in popular media.

Meanwhile, other newer treatments for depression, like ketamine and TMS, are often presented before they have been fully studied. When seeking help for treatment-resistant depression it’s important to keep an open but critical mind.

Electroconvulsive Therapy (ECT)

ECT is a medical procedure that involves triggering a small seizure by passing small electric currents through a person’s brain using electrodes that are placed on their head. The procedure occurs while the patient is under anesthesia, and a session typically lasts for as little as five to ten minutes, typically with multiple sessions occurring over a span of weeks.

 

ECT is often stigmatized because early treatments were performed without the use of anesthesia, and involved higher doses of electricity which often resulted in significant side effects, such as serious memory loss. Dramatized depictions of ECT in popular media based on outdated practices have further contributed to a negative public perception of the procedure. However, ECT is now performed under very controlled conditions making it much safer.

 

ECT has been demonstrated to provide significant improvement for some people with severe depression who have not responded to other treatments. A 2022 study of more than 67,000 patients found that ECT was associated with a 50 percent reduction in risk for suicide in the year after being hospitalized for depression.[6] Side effects may include headache, nausea, confusion, and memory loss lasting from a few weeks to months.

Transcranial Magnetic Stimulation (TMS)

Transcranial Magnetic Stimulation is a non-invasive procedure in which an electromagnetic pad is placed on a person’s head and is used to painlessly send magnetic pulses to stimulate nerve cells in regions of the brain associated with depression symptoms.

 

The procedure takes roughly half an hour, and occurs while the patient is fully awake. It is often referred to as repetitive transcranial magnetic stimulation (rTMS), as it takes repeated sessions to see results. A standard course of treatment involves five sessions per week over a four to six-week period. Like ECT, it is recommended for people who do not respond to standard treatments like talk therapy and medication. It is generally considered safe, though side effects can include headache, lightheadedness, tingling, and scalp discomfort.

 

A 2022 meta-analysis found that thoughts of suicide were significantly reduced in depressed patients who received rTMS compared with a control group.[7] rTMS has only recently begun being used to treat depression, so there are still many unknowns associated with its use and the underlying mechanism for its effectiveness.

Experimental Drug Treatments

Recent research has explored the potential benefits of using certain substances, including ketamine and psilocybin (a.k.a. magic mushrooms), to treat severe cases of depression. This research is still in its early stages and is very limited. Further, it is important to be aware of the laws regarding their use in your region, as they are not currently legal in many places.

 

For those who have been fighting depression for years and have already tried first-line treatments such as talk therapy and antidepressant medication without success, certain experimental drug treatments may be options worth discussing with their doctor.

 

For a more in-depth look at the latest research, see our posts about using ketamine and psilocybin to treat depression.


References:

  1. Cuijpers, P., Quero, S., Noma, H., Ciharova, M., Miguel, C., Karyotaki, E., Cipriani, A., Cristea, I. A., & Furukawa, T. A. (2021). Psychotherapies for depression: A network meta-analysis covering efficacy, acceptability and long-term outcomes of all main treatment types. World Psychiatry, 20(2), 283 293. https://doi.org/10.1002/wps.20860
  2. Cipriani, A., Furukawa, T. A., Salanti, G., Chaimani, A., Atkinson, L. Z., Ogawa, Y., Leucht, S., Ruhe, H. G., Turner, E. H., Higgins, J. P. T., Egger, M., Takeshima, N., Hayasaka, Y., Imai, H., Shinohara, K., Tajika, A., Ioannidis, J. P. A., & Geddes, J. R. (2018). Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis. Lancet, 391(10128), 1357–1366. https://doi.org/10.1016/S0140-6736(17)32802-7
  3. Schuch, F. B., Vancampfort, D., Richards, J., Rosenbaum, S., Ward, P. B., & Stubbs, B. (2016). Exercise as a treatment for depression: A meta-analysis adjusting for publication bias. Journal of Psychiatric Research, 77, 42–51. https://doi.org/10.1016/j.jpsychires.2016.02.023
  4. Gortner, E. M., Rude, S. S., & Pennebaker, J. W. (2006). Benefits of expressive writing in lowering rumination and depressive symptoms. Behavior Therapy, 37(3), 292–303. https://doi.org/10.1016/j.beth.2006.01.004
  5. Armour, M., Smith, C. A., Wang, L. Q., Naidoo, D., Yang, G. Y., MacPherson, H., Lee, M. S., & Hay, P. (2019). Acupuncture for depression: A systematic review and meta-analysis. Journal of Clinical Medicine, 8(8), 1140. https://doi.org/10.3390/jcm8081140
  6. Kaster, T. S., Blumberger, D. M., Gomes, T., Sutradhar, R., Wijeysundera, D. N., & Vigod, S. N. (2022). Risk of suicide death following electroconvulsive therapy treatment for depression: A propensity score-weighted, retrospective cohort study in Canada. The Lancet Psychiatry. https://doi.org/10.1016/s2215-0366(22)00077-3
  7. Sonmez, A. I., Camsari, D. D., Nandakumar, A. L., Voort, J., Kung, S., Lewis, C. P., & Croarkin, P. E. (2019). Accelerated TMS for Depression: A systematic review and meta-analysis. Psychiatry Research, 273, 770–781. https://doi.org/10.1016/j.psychres.2018.12.041

THIS IS MEN'S HEALTH WEEK | JUNE 10-16TH, 2024

Men's Health Week takes place annually in mid-June, during the week preceding Father’s Day. The week is not just a campaign, but a call to action for men to take better care of their health and for communities to support men in this endeavour.

Men's Health Week 2024