There’s no cure for depression, but you still have plenty of options for treatment, all of which can improve your symptoms and minimize their impact on your daily life.
You might think, “But if my symptoms go away, that means I’m cured, right?”
Not exactly. Symptoms might ease you to the point where you’re able to return to your usual routine, but you could still notice lingering changes in your mood and mindset. Plus, depression often happens in episodes, so it’s possible to have another episode later in life.
Below, you’ll find details on expert-recommended treatments for depression, complementary and alternative approaches, and emerging treatments, plus tips to help prevent a recurrence.
Does depression always come back?
Some mental health professionals describe recovery from all or most depression symptoms as “remission.” You’ll also find this term in the “Diagnostic and Statistical Manual of Mental Disorders (DSM-5).” Other experts object to this term, as it implies that depression will eventually return.
Depression does, in fact, have a high risk of recurrence — but it doesn’t return for everyone.
According to 2018 research:
- Among non-clinical samples, about a third of people with depression will have more than one episode.
- Among clinical samples, more than 75 percent of people with depression will have multiple episodes.
- At least half of all people with depression will have more than one episode.
- About 80 percent of people who have had two episodes will have additional episodes.
To sum up: Depression does return for many people, but one episode doesn’t always mean you’ll have another. Treatment, self-care, and coping techniques may help lower your chances of recurrence. But perhaps more importantly, these strategies can make it easier to manage any symptoms that do return.
If a mental health professional diagnoses you with major depression, they’ll most likely recommend one, or a combination, of the following treatments:
In most cases, the first step to treating depression involves therapy with a trained mental health professional.
Therapy for depression can take many forms, including:
- Cognitive behavioral therapy (CBT). Often described as the “
gold standard” treatment for depression, CBT teaches you to identify and reframe unhelpful thought and behavior patterns. You might learn techniques, like cognitive restructuring, positive self-talk, behavioral activation, or guided discovery and questioning.
- Interpersonal therapy (IPT). This approach to therapy helps you recognize and address challenges in your personal relationships that may play a part in depression symptoms. You’ll learn skills to manage difficult emotions, improve communication, and participate in social activities.
- Mindfulness-based cognitive therapy (MBCT). This approach, which combines principles of CBT with mindfulness techniques, like meditation and present-moment awareness,
shows promisefor both relieving symptoms of depression and reducing the likelihood of them recurring.
The best therapy approach for you can depend on a lot, including your specific symptoms and how depression affects your daily life and relationships. If one approach seems to have little effect, ask your therapist about other types of therapy.
If you’d like to try medication for depression, most mental health professionals will recommend combining medication and therapy. That’s because medication doesn’t always address the underlying causes or triggers that contribute to depression symptoms.
Medications used to treat depression include:
- selective serotonin reuptake inhibitors (SSRIs), often as a first approach to treatment
- serotonin-norepinephrine reuptake inhibitors (SNRIs), which may help if you live with both depression and a chronic pain condition
- tricyclic antidepressants, which may ease symptoms that don’t respond to other antidepressants
- atypical antidepressants, which might ease sexual side effects of other antidepressants
- mood stabilizers or antipsychotics, which can boost the effects of your antidepressant
Psychiatrists may recommend antidepressants for children or adolescents when they have severe symptoms that:
- significantly affect daily routines and overall well-being
- make it difficult to attend or succeed at school
- don’t improve with other treatments
Keep in mind that medication isn’t necessarily a life-long commitment. If your symptoms keep you from going to therapy or taking care of basic everyday needs, medication could relieve symptoms enough to make it possible for you to try other treatments.
Once you find a treatment approach that works for you, you may be able to stop taking medication.
Never stop your antidepressant without guidance from a doctor
Quitting the medication abruptly without professional support could potentially make your symptoms worse.
If you don’t notice improvement after taking your prescribed antidepressant for several weeks, or if you experience unwanted side effects, it’s best to ask the prescribing psychiatrist or clinician about alternatives.
Sometimes, depression symptoms persist, even after months of therapy and medication. If you have treatment-resistant depression, your care team may recommend:
- Electroconvulsive therapy (ECT). This treatment delivers electrical impulses to the brain to trigger a seizure, which changes electrical activity in your brain. You’ll be anesthetized during the procedure, so you won’t feel anything at all. Keep in mind that modern ECT is very different from the “shock therapy” administered in the mid-20th century.
- Transcranial magnetic stimulation (TMS). Also called repetitive transcranial magnetic stimulation (rTMS), this treatment delivers magnetic impulses to your brain, which is believed to help stimulate nerves in the brain and increase brain activity.
- Vagus nerve stimulation. This treatment, which stimulates your vagus nerve through a device implanted in your chest, is believed to help restore the balance of brain chemicals linked to depression.
Therapy, medication, and brain stimulation are the primary treatment options for depression. But complementary approaches can be a helpful addition to your treatment plan:
- Acupuncture. A
2019 reviewof 29 studies suggested this traditional Chinese medicine practice may have clinically significant benefits for depression symptoms, both on its own and in combination with antidepressants.
- St. John’s wort. Some
researchsuggests St. John’s wort may help relieve mild to moderate depression symptoms, but this treatment won’t work for everyone. Always check with a healthcare professional before trying St. John’s wort, or any other herbal remedies.
- Supplements. Adding supplements to your diet, such as
vitamin D, saffron, and magnesium, could help improve mild to moderate depression symptoms.
- Exercise. According to 2019 research, getting just 2 and a half hours of physical activity each week can help ease both depression and anxiety, with outdoor exercise offering more benefit than indoor exercise.
- Music therapy. According to
2020 research, music therapy and music medicine — listening to music on your own — may temporarily help relieve symptoms of depression.
- Relaxation techniques. Various approaches to relaxation, including meditation, yoga, and guided imagery, may help improve symptoms of depression, anxiety and other mental health concerns.
Just keep in mind that research exploring the effectiveness of these approaches remains limited, so experts typically don’t recommend them as first-line approaches to care.
Researchers continue to explore potential approaches that could relieve depression, especially when symptoms resist other treatments.
Emerging possibilities include the following.
Stanford accelerated intelligent neuromodulation therapy (SAINT)
This accelerated approach to TMS involves multiple sessions of TMS per day for 1 to 5 days, instead of a single daily session for about 6 weeks.
SAINT is also different in two additional ways:
- It involves more magnetic pulses than typical TMS (think of it as a “higher dose”).
- Every participant first receives a brain MRI that identifies the specific subregion of the prefrontal cortex linked to the subgenual cingulate, an area of the brain associated with depression.
The first small study testing the effectiveness of SAINT involved 21 participants living with severe depression. After treatment, 19 of them no longer met diagnostic criteria for depression, and none experienced suicidal thoughts.
Side effects included fatigue, along with some mild discomfort in the head and face during treatment.
The researchers continue to explore the effectiveness of SAINT with a follow-up study exploring how long treatment benefits last, as well as a double-blinded study involving more participants.
Scientific studies began to explore this anesthetic’s potential for treating depression in
Ketamine is believed to bind to NMDA receptors in your brain, increasing glutamate and promoting better communication between brain cells. Antidepressants, on the other hand, typically work by increasing serotonin in your brain. This process also eventually acts on glutamate, but it can take several weeks before you notice improvements in your mood.
Not only does ketamine appear to offer quick (sometimes in a matter of minutes) relief from severe depression symptoms that have resisted other treatments, but it may also help reduce suicidal thoughts.
Two types of ketamine can help treat depression:
- racemic ketamine, typically given via intravenous (IV) infusion
- Esketamine (Spravato), a nasal spray
You can only get this treatment at certified treatment centers, from professionals trained to administer the dose and monitor you for side effects. This treatment is combined with antidepressant medication or psychotherapy.
Ketamine does have the potential to cause some temporary side effects, including:
- disconnection from reality
- changes in perception, including vision, hearing, and your sense of time
- increased blood pressure
- nausea or vomiting
There’s also the potential for dependence or addiction, so treatment professionals will taper the dose once treatment ends. You might notice improvements in your mood after just one session, but your care team may recommend up to eight sessions to help ketamine’s effects last.
Keep in mind that ketamine’s effects generally only last
Recent research suggests psilocybin, which you might know as the active component in magic mushrooms, may have significant benefits for the treatment of depression when combined with psychotherapy:
- According to a small
2021 study, 24 people who received psilocybin-assisted therapy experienced quick relief from persistent depression symptoms, with no major side effects. Improvements in depression held for several weeks.
- In a 2021 randomized controlled trial, 30 participants received psilocybin treatment while 29 received the antidepressant escitalopram. After 6 weeks, both groups reported similar improvements in their symptoms. Researchers noted that psilocybin appeared slightly more effective, but emphasized the need for larger, longer studies to support its benefits.
Psilocybin helps ease depression by acting on serotonin pathways in your brain. Like ketamine, this psychedelic also works quickly.
The Food and Drug Administration (FDA) has yet to approve psilocybin-assisted therapy, but certain trained professionals can administer the substance and monitor you for potential side effects, like panic, anxiety, or other emotional distress.
Other potential side effects include dizziness, nausea, and drowsiness.
There’s no surefire way to keep depression symptoms from coming back, but finding an effective treatment and sticking with it can go a long way toward lasting improvement.
These self-care strategies may also help lower the chances of depression returning:
- Stay connected. Talking with loved ones about depression can be tough. But staying in touch doesn’t just help you get essential emotional support, it may also
lower the riskof depression returning.
- Take care of your physical health. Your care team may recommend getting regular exercise if you’re able, eating a balanced diet, and limiting alcohol, which can interact with antidepressants and worsen depression symptoms.
- Get quality sleep. Depression can disrupt sleep, but lack of sleep can also worsen symptoms. To get the right amount of rest, set aside 7 to 9 hours for sleep and aim to get up and go to bed around the same time each day.
- Make time for enjoyable activities. Doing something you enjoy each day, whether that’s cooking a meal, reading a favorite book, or taking your dog on a long walk, can further boost your mood and well-being.
Research hasn’t identified a way to completely cure depression, meaning symptoms can return, even with professional treatment and a solid self-care routine.
Remember: If your depression returns or gets worse, this doesn’t mean you’re weak, did something wrong, or simply need to “try harder.” Plenty of complex factors contribute to depression, and you can’t always address or eliminate these factors — or ease depression simply through willpower or a positive attitude.
Keep in mind, though, that you do have plenty of options, including alternative and emerging approaches. If one approach doesn’t seem to help improve your symptoms, it’s worth asking a mental health professional about other types of treatment.