Which treatment is best
For mild depression your health professional might suggest lifestyle changes, such as regular exercise and avoiding alcohol. You might also like to try online e-therapies. Many e-therapies are free, anonymous and easily accessible.
For moderate to severe depression, psychological or medical treatments (or both) are likely to be recommended.
On this page we focus on 6 treatments for depression which have been proven to work by a lot of good-quality studies.
For a comprehensive review of the effectiveness of more than 50 different depression treatments, download our booklet:A guide to what works for depression: an evidence-based review (PDF, 6.67 KB).
Cognitive behaviour therapy
CBT is one of the most effective treatments for depression. It’s a structured psychological treatment which recognises that the way we think (cognition) and act (behaviour) affects the way we feel.
A mental health professional will work with you to identify unhelpful thought and behaviour patterns. Unhelpful thoughts and behaviours can make you feel more depressed and stop you from getting better.
CBT will help you replace unhelpful thoughts and behaviours with new ones that reduce your depression. It can be delivered one-on-one with a professional, in groups, or online.
Example: Managing catastrophising thought patterns
You might find yourself stuck in catastrophising thinking patterns. Maybe you:
think the worst
believe something is far worse than it actually is
expect things to go wrong.
CBT helps by teaching you to have a more balanced attitude and focus on problem-solving.
Behaviour therapy
Behaviour therapy is used as part of CBT. Unlike CBT it doesn’t attempt to change beliefs and attitudes.
Behaviour therapy focuses on encouraging activities that are rewarding, pleasant or satisfying. It aims to reverse the patterns of avoidance, withdrawal and inactivity that make depression worse.
Interpersonal therapy
IPT is a structured psychological therapy that focuses on problems in personal relationships and the skills needed to deal with these. Relationship problems can have a significant negative effect on someone experiencing depression.
IPT helps you recognise patterns in your relationships that can make your depression worse. It helps you focus on:
improving relationships
coping with grief
finding new ways to get along with others.
Mindfulness based cognitive therapy
MBCT uses 'mindfulness meditation' and is usually delivered in group therapy. It teaches you to focus on the present moment without trying to change it. First, you’ll learn to focus on physical sensations such as breathing. Then you’ll learn to focus on feelings and thoughts.
MBCT can help to stop your mind:
wandering off into thoughts about the future or the past
avoiding unpleasant thoughts and feelings.
Noticing feelings of sadness and negative thinking patterns early can help stop them from becoming worse.
Online therapies
If you have mild or moderate depression, online therapies can be effective. They’re sometimes known as e-therapies or computer-aided psychological therapy.
Most online therapies follow the same principles as CBT or behaviour therapy.
You work through the program by yourself, usually with some support from a therapist. The therapist will help you apply what you’ve learned to your own life. You might talk to them on the phone, by email, text, or instant messaging.
Where to find online therapies
Online therapies are easy to access and can be done from home from anywhere in Australia. Usually you don’t need a referral from a GP.
Find a range of online programs at theAustralian Government'sHead to Healthwebsite.
Antidepressants
Antidepressant medication can effectively treat moderate to severe depression and some anxiety disorders.
It can take a while for you to see improvements. Antidepressants take at least 2 weeks before they start to help. Your depression symptoms are likely to begin to improve after 4 to 6 weeks.
If you have severe depression, bipolar disorder or psychosis you may also be prescribed mood stabilisers or anti-psychotic drugs.
Best antidepressant for you
Deciding which antidepressant is best for you can be complex. Even if a treatment is proven to be effective, it may not be equally effective for every person.
To decide which antidepressant is best for you, your doctor might ask about your:
medical history
age
symptoms
other medications.
If you’re female, they may ask if you’re pregnant or breastfeeding.
Your doctor might need to change your medication or dosage if it’s not working as well as expected. It can take time to find the antidepressant that works best for you.
Antidepressants side effects
Antidepressants won't change your personality or make you feel happy all the time. Possible side effects depend on the antidepressant medication. The likelihood of experiencing side effects also varies from person to person.
Common side effects of antidepressantsinclude:
nausea and weight gain
headaches and dizziness
anxiety and agitation
sweating and dry mouth
sexual difficulties – for example, difficulty becoming or staying aroused.
If you do experience side effects, tell your doctor – there are ways of reducing them. Some symptoms don’t last long and will go away by themselves.
Suicidal thoughts
Sometimes people with depression have suicidal thoughts. People are less likely to hurt themselves if the depression is treated effectively.
It can take more than two weeks for antidepressant medication to start to be effective. During this time you should be monitored closely by your doctor. The risk of suicidal behaviour may be slightly increased during this time, especially in young people.
Types of antidepressants
There’s a wide range of antidepressant medication available. We’ve listed the different types of antidepressants used in Australia.
Selective Serotonin Reuptake Inhibitors (SSRIs)
This class includes sertraline, citalopram, escitalopram, paroxetine, fluoxetine and fluvoxamine.
SSRIs are:
the most commonly prescribed antidepressants in Australia
often a doctor's first choice for most types of depression
often used for obsessive compulsive disorder
generally well tolerated by most people
generally non-sedating.
Serotonin and Noradrenalin Reuptake Inhibitors (SNRIs)
This class includes venlafaxine, desvenlafaxine and duloxetine.
SNRIs:
have fewer side effects compared to SSRIs
are often prescribed for severe depression
are safer if a person overdoses.
Reversible Inhibitors of MonoAmine oxidase (RIMAs)
This class includes moclobemide.
RIMAs:
have fewer side effects
are non-sedating
may be less effective in treating more severe forms of depression than other antidepressants
are helpful for people who are experiencing anxiety or sleeping difficulties.
TriCyclic Antidepressants (TCAs)
The class includes nortriptyline, clomipramine, dothiepin, imipramine and amitriptyline.
TCAs are:
effective, but have more harmful side effects than newer medications such as SSRIs
more likely to cause low blood pressure
often used for obsessive compulsive disorder.
Noradrenaline Serotonin Specific Antidepressants (NaSSAs)
This class includes mirtazapine.
NaSSAs are:
relatively new antidepressants
helpful when there are problems with anxiety or sleeping
generally low in sexual side effects but may cause weight gain.
Noradrenalin Reuptake Inhibitors (NARIs)
This class includes reboxetine.
NARIs are:
designed to act selectively on one type of brain chemical – noradrenalin
less likely to cause sleepiness or drowsiness than some other antidepressants
more likely to cause difficulties with sleeping
After the initial doses, NARIs are more likely to cause:
increased sweating
sexual difficulties
difficulty urinating
increased heart rate.
Monoamine Oxidase Inhibitors (MAOIs)
This class includes tranylcypromine.
MAOIs are prescribed only under exceptional circ*mstances. They require a special diet and have adverse effects.
Agomelatine
Agomelatine is an atypical antidepressant that stimulates melatonin receptors.
Common side effects include headaches and sleep disturbances.
In rare cases it can affect your liver and it’s not recommended for people who already have liver problems. Regular blood tests to monitor your liver function are usually recommended if you take agomelatine.
How long are antidepressants usually needed?
The length of time you need antidepressants depends on the severity of your condition and how you respond to treatment.
Some people only need to take antidepressants for 6 to 12 months. Others may need to take it for longer, just like someone with diabetes might use insulin or someone with asthma would use Ventolin.
Don’t stop taking your antidepressant medication suddenly. Stopping antidepressant medication should be:
done gradually
on a doctor's recommendation
under supervision.
More information on medical treatments for anxiety and depression
Do I have depression?
It can be hard to know whether you’re feeling depressed or have depression.
Our anonymous Anxiety and Depression Test (K10) can help you understand whether your anxious feelings are the kind of worries that will go away on their own, or whether it’s time to get more support to help you feel better.
It’s an evidence-based test that asks 10 questions about how you've been feeling over the past 4 weeks. Australian doctors and mental health professionals use this test, known as the K10. They sometimes ask you to take the K10 and talk about it with you.
Start the K10 test
Finding mental health support
Your GP can be a good place to start the conversation about your mental health.
We can also help you find other support that’s right for you. This could include talking to our counsellors or helping you find a mental health professional near you.
Get mental health support
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