Which treatment is best
Cognitive behaviour therapy
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
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
Antidepressants
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 antidepressants include:
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.
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.
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.
