This is a question I often get via phone calls, before people have even made their appointment. The question is which therapy can cure a depression? And how do you treat the underlying stress?

Treatment of depression with antidepressant medication

Antidepressants are often useful tools in the treatment of depression, but not always, and it is hardly ever enough to treat a depression solely with medication.

Do antidepressants help in the treatment of depression?

Yes, sometimes, but not always. Research agrees on that major depressions are positively influenced by antidepressant medicines, by speeding up the healing process. So for major depressions it is definitely recommended to discuss taking an antidepressant with your doctor. Important, too, is that you continue taking the antidepressant even after your depressed symptoms disappear. Often up to several months after. So never stop taking antidepressant medication without discussing this with your doctor, first. To know if your antidepressant works, you need to take it for at least a month, because most antidepressants show their first effects after about 2 or 3 weeks, and in some people it can even take up to 6 weeks. If you have still not noticed any results after that length of time, then you and your doctor should discuss whether it could be useful to take another type of antidepressant. It regularly happens that someone responds to one product, yet not to another.

Is an antidepressant enough to treat depression?

No, most often it is not. To prevent relapse after quitting the medication, it is important that a depressed patient handles certain things differently in their life. Sometimes, it is needed to look at things in a different way, and other times it can be important to organize one's life in a different way. It can also be so that certain exercises are useful to handle depressed feelings in a different way, or to even solve them. Without such changes, you risk regular relapse.

Psychotherapy and depression

How can psychotherapy help treatment of depression? First of all, by helping to make the right changes in what you think, what you do, and what you feel. By changing thinking, doing, and feeling, you learn new habits which will make it so that you do not end up in the vicious cycle again. A good therapist will ask you very concrete and practical questions which will help you to discover what you need to focus on specifically in order to live a happier life.

Online help for depression

A good online self-help program will, just like a good therapist, ask you the right questions in order to help you discover what it is you need to change in your thoughts, actions, or feelings to become happy again. Also, it will provide you with videos which teach you practical exercises and give you insight into the mechanisms which cause depression. This way, you will more easily learn what you need to do to prevent this. In the basic program of '15Minutes4Me.com' this is standardly included, and if you want more guidance, it is possible to request additional guidance by a psychologist via e-mail or chat. In certain minor depressions, online self-help can be enough, especially if you are properly supported by family, partner, or friends. In major depressions, it can be useful to complement the online self-help program with guidance or even psychotherapy.

Online test for depression

To know if you are really suffering from a depression, it is best to ask your doctor for help. They can diagnose you and find out whether you have a depression or something else. What you can do to prevent this meeting, however, is to do our free online self-test. This is designed in such a way that you can measure with just 21 questions whether you have a normal score on the depression scale, or that your scores are too high. You can also make use of this self-test during your treatment in order to see whether or not your treatment is helping you. Feel free to do this test on a weekly or monthly basis until you are fully cured and relapse-free. In this short article I cannot go into detail on all the aspects of depression. In my books, I do go deeper into these topics. It is best to speak to your doctor about what treatment suits you best, after doing the online self-test.

Paul Koeck, MD