What is involved in getting help? >

Introduction to Non-Drug Therapies The research shows that for mild depression, non-drug therapies are as effective as antidepressant medications. For mild-to-moderate depression, non-drug therapies may be sufficient, but many people also need antidepressant medications. The two often work best together.

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For moderate to severe depression, medications are recommended. But the non-drug therapies can still play a valuable supportive role in treatment. Have more fun. In mild depression, this often helps. "Happiness requires action," says psychologist Jennifer James, Ph.D., author of Women and the Blues. Try not to mope. Visit a friend. Have a massage. Get a pet. Redecorate. Take a class. Take a vacation. If nothing feels fun, do things you used to enjoy.


Cognitive therapy >

You can't talk yourself out of depression, but you can stop talking yourself deeper into it. Cognitive therapy -- also called cognitive restructuring -- teaches people to recognize and correct depressive thinking. If you make a mistake at work, you might think, "I'm hopelessly incompetent," and slide toward depression. That's "awful-izing" -- a thought distortion that magnifies minor upsets into catastrophes. With cognitive therapy, the reaction changes: "OK, I made a mistake. Everyone makes mistakes. Fortunately, my boss and co-workers know I don't make many. And I can fix this one easily." A National Institute of Mental Health (NIMH) study showed that after 16 weeks of cognitive restructuring training, 51 percent of those with mild to moderate depression reported significant improvement. "Cognitive therapy also lends itself to self-help," Dr. Freeman says.


Exercise >

A tremendous amount of research shows that exercise -- particularly strenuous aerobic exercise -- elevates mood, relieves anxiety, improves appetite, sleep, sexual interest and functioning, and self-esteem. Studies show that it also helps normalize the chemical imbalances in the brain linked to depression, Dr. Stuart Yudofsky says


Psychotherapy >

Long-term Freudian psychoanalysis has been largely replaced by shorter-term "talk therapies." The NIMH study showed that after 16 weeks of psychotherapy, 55% of those with mild to moderate depression reported significant improvement. How long is long enough? "For most major depressive episodes," Dr. Freeman says, "four to five months is usually about right."


Support groups >

Depression feels terribly isolating. Support groups show you that you're not alone. They are particularly helpful for depressions associated with drug or alcohol abuse, which is why Alcoholics Anonymous and the other Anonymous organizations are so popular.


Herbal medicines >

Several medicinal herbs have antidepressant effects. The most powerful is St. John's wort, a natural SSRI and weak MAO inhibitor. In addition, kava-kava, ginkgo, and caffeine can also help.


Dietary supplements >

Certain vitamin deficiencies -- notably B-6, B-12, C, folic acid, thiamine, niacin, riboflavin, biotin, and pantothenic acid -- can cause depression.


Phototherapy >

Seasonal affective disorder is caused by lack of sunlight in winter. Supplemental artificial light successfully treats it. A half-hour a day in front of a special bright-light appliance lifts the spirits of 60% to 80% of those with winter depression. Another appliance that simulates an earlier dawn may also be beneficial. Antidepressant medication can help as well. So can midwinter tropical vacations. The emotional benefits typically last a week or two after returning north.


Electroconvulsive therapy (ECT) >

In cases of severe depression where antidepressants prove ineffective, ECT is another option. Once known as "shock therapy," and given an undeservedly bad reputation by the book and movie, One Flew Over the Cuckoo's Nest, Dr. Yudofsky says: "When used properly, ECT is safe and effective. Unfortunately, because of fear of electricity, and the inaccurate ways ECT has been portrayed in movies and on television, many people who could be benefit from it don't consider it." They should: In severe depression, it helps 80% to 90% of cases. "