Depression Treatments Without Drugs

Antidepressants are useful in treating depression, but the side effects they produce may outweigh their benefits, or they may not fully treat severe or resistant depression. Fortunately, antidepressants aren't the only way to treat depression. There are several ways to fight depression that don't involve medication, ranging from a walk in the sunshine to the use of new experimental brain-stimulation methods. Some of these depression-easing treatments can also be used in conjunction with antidepressants and can help end a depressive episode or prevent another one from occurring.

Short-term Psychotherapy

• Short-term psychotherapy concentrates on changing your thoughts and behaviors to avoid future bouts of depression. A common type of short-term psychotherapy is cognitive-behavioral psychotherapy, which can last for a few months. During cognitive-behavioral therapy, patients are given "homework" by a therapist--they keep diaries to see which events trigger anxiety or depression, confront events that make them nervous or unhappy, and so on. This helps patients change untrue negative beliefs about themselves and the world, which in turn helps prevent depression.

Long-term Psychotherapy

• Unlike short-term psychotherapy techniques such as cognitive-behavioral therapy, long-term psychotherapy is open-ended. This "traditional" psychotherapy concentrates on events in the patient's life, looking backwards to see how past interpersonal dynamics produced a tendency toward depression. (While long-term psychotherapy may concentrate on a patient's family life, most psychotherapists do not directly use Freudian principles in their work with patients--so don't worry about discussing wanting to kill your father and marry your mother.) Family or marriage counseling can also help people who live with a depressed person learn to help their family member deal with depression.

Complementary Treatment

• Exercise has been proven to ease depression, as does sunlight. Meditation and massage can also help against depression symptoms. The herb St. John's wort can help treat mild and moderate depression. Tell your doctor if you're taking St. John's wort, as the supplement can interact with other medications, such as heart disease medication and birth control pills.

ECT

• Electroshock therapy (ECT) "jolts" the brain into a seizure, a process that may affect levels of neurotransmitters in the brain. While this therapy is associated with the archetypal "insane asylum," it's actually an effective way to ease hard-to-treat depression. However, because of side effects such as memory loss, ECT is usually used on people who haven't found success with any other treatment or on people at high risk of suicide. It may also be a treatment option for people who, for medical reasons, can't use antidepressants.

Other Options

• When all else fails, neurotheraputic treatments can be used to treat depression. These highly experimental treatments involve stimulating the brain through various methods. The best-known neurotheraputic treatment is vagus nerve stimulation. This FDA-approved procedure sends electric impulses to a nerve in the brain and was originally used to treat people with epilepsy. Other neurotheraputic treatments include transcranial magnetic stimulation (TMS), in which magnets are held against the skull, and implanting electrodes directly into the brain.