Living In Recovery

By getting help for your depression, you've done a brave thing. You've made a commitment to getting well. Unfortunately, your problems won't necessarily disappear once you're in treatment.

Maybe your treatment is working but you're still worried -- what if it comes back? Or maybe your current treatment isn't working well enough or is causing side effects. And you want something better.

Recovering from depression takes persistence and vigilance. You need to keep working closely with your doctor and therapist. You need to keep taking your medicine as prescribed, finding ways to manage stress and avoiding triggers that might have contributed to your depression before.

Remember that now, you have an advantage. You've been through depression once. You know the early signs. If it comes back, you'll be able to get help faster -- and possibly head it off altogether.

Common Concerns

Now that you're getting help for your depression, you may be wondering:

How long will I need medication? Many people take medicines for several months, get better, and may never need treatment again. Others need longer or ongoing treatment in order to stay well. Stick with your treatment and work with your doctor to find what's right for you.

If I'm feeling better, can I stop my treatment? Always talk to your doctor first. It could be the medicine or therapy that's helping you feel better. Giving it up too soon could tip you back into depression.

Treatment is helping, but I still have some symptoms. Talk to your doctor. It's possible that adjusting your medicine or trying a specific type of therapy, could help.

Nothing is helping -- will I ever get better? Yes. Finding the right treatment can take time. But if you stick with it, you can find an approach that works for you. Don't give up!

Treatment Options

We now have more effective, proven treatments for depression than ever before. For most people, the first treatments your doctor will try are antidepressants or specific types of therapy. Studies have found that for many people, combining therapy with medicine can work better than medicine alone.

Making changes in your life can help your treatment work better. Reducing stress, getting enough sleep, and exercising have all been shown to help. Sometimes, if medicines and therapy don't completely relieve your symptoms, new approaches such as transcranial magnetic stimulation (TMS) may help. You can ask your doctor about the many treatment options available.

The important thing is to remember that there are a lot of options out there. With an expert's help you can find the ones that are right for you.

Medications

Antidepressants are some of the best treatments we have for depression. They seem to work by affecting the balance of chemicals in the brain called neurotransmitters.

Some of the most common drugs for depression are called SSRIs, like Celexa, Lexapro, Paxil, Prozac, and Zoloft. Choosing the right medicine depends on your symptoms of depression. Like all medications, antidepressants have side effects.

Which one is right for you? Unfortunately, finding the right drug, at the right dose, can take some time and trial and error.

It can be hard when you're hurting, but try to be patient. Unlike a painkiller or a sleeping medicine, antidepressants can take weeks or months to take effect. As long as you stick with the treatment, you and your doctor will find something that works.

Other Medications for Depression

It can be discouraging when a medication -- or two medications, or three -- doesn't lift your depression. You might give up hope that anything will work.

But you still have lots of options. If therapy and medicines like SSRIs haven't helped, your doctor might try other medicines, like Cymbalta, Effexor, Pristiq, Remeron, or Wellbutrin. Older antidepressants, like MAOIs and tricyclics, may be an option for some people, although they sometimes can have side effects that mean your doctor will have to monitor you closely.

Many people do well with combinations of medicines or drugs besides antidepressants. Some of these drugs come from classes with imposing names -- like antipsychotics or anti-seizure medicines. Those names just refer to how they were first used. Since then, studies have shown that some of these medicines can help with depression too.

Counseling and Psychotherapy

Therapy is a key part of getting help for depression. Although it might not work as fast as medication, some studies show it has more lasting benefits.

There are several approaches. Cognitive behavioral therapy (CBT) helps you see how your own thought patterns can contribute to your depression and learn how to change them. Other approaches focus more on your relationships or dealing with issues from your past.

Therapists include psychiatrists, psychologists, social workers, and counselors. Many use a combination of approaches. Therapy can be one-on-one, with your spouse or family, or in a group. Your doctor can help you find what's right for you.

Support groups are different, in that there's no therapist guiding the discussion. Instead, it's a group of people who, like you, are struggling with depression. Meeting others who know what depression is like can help.

Exercise for Depression

When you're depressed, just getting out of bed and making coffee can seem hard enough. The idea of starting the day with a jog might seem ridiculous.

But exercise is a good idea if you're depressed. It releases chemicals in the brain called endorphins, which boost your mood. Studies have shown that exercise can make you happier, build stamina, and boost self-esteem.

How should you start? Don't set such lofty goals for yourself that you fail and get demoralized. Instead, start with something simple -- like a 10- or 20-minute walk -- and build up from there.

To help you stick to it, set dates to exercise with someone else. Meet a friend at the gym a few times a week or take regular walks with a neighbor.

What About Supplements?

If you're currently taking medicine for depression, you might wonder: Could "natural" remedies offer relief with fewer side effects?

So far, the evidence is unclear. There's some evidence that supplements like fish oil, folic acid, and SAMe might have some benefit. Studies of other supplements -- like St. John's wort and valerian -- have been more mixed.

Talk to your doctor about the pros and cons. Keep in mind that supplements -- like any drug -- have side effects. Just because they're "natural" doesn't make them risk-free. And if they aren't backed by scientific studies, they run the risk of not helping to treat your illness. Some "natural" remedies can interact with the medicine you're already taking, too.

Don't use supplements on your own to treat depression. The risks of depression are just too serious.

Managing Life Stress

It's great that you're getting help from a doctor or therapist for your depression. And there's even more you can do on your own to reduce stress and help your treatment work better.

Learn new ways of taking care of yourself. Getting the right amount of sleep is important. Although there's no "depression diet," making good food choices can help. If you're craving carbs, like some people with depression do, eating healthy can help fight those cravings.

Getting on a daily schedule and setting modest goals will ease you back into the rhythm of your life. Learning to relax -- with yoga, meditation, or breathing exercises -- will help too.

This doesn't mean depression can be conquered with willpower -- and if you overeat sometimes or skip your walk, don't beat yourself up. Just try again tomorrow.

Relationships

Depression doesn't only affect you. You may have already seen its impact on your loved ones. When you're depressed, you turn inward. It's easy to let your relationships wither away too.

Even though you might not feel like it, you need to stay connected to your family and friends. You need them -- not only for support, but to get your mind off your troubles. Breaking out of your isolation can help your treatment work and speed your recovery.

Push yourself to do things you used to enjoy with friends and family. It might not seem like fun at first, but when it comes to having fun, you're out of practice. In time, you'll enjoy their company again.

Talk to a therapist about ways to rebuild your relationships. In some cases, couples or family therapy might help.

When to Call the Doctor

Call your doctor or therapist if

• Your symptoms are getting worse
• Your treatment isn't helping
• You have signs of mania, like an extremely energized or irritable mood and feeling like you don't need to sleep
• You have thoughts of suicide
• You hear or see things that aren't real

If you are thinking about hurting yourself, get help now. Call your doctor, therapist, or an emergency hotline right away.

Depression warps your sense of reality, making things seem much worse than they are. The thoughts that make someone consider suicide aren't a sign of clear thinking. They're a symptom of depression. With treatment, those feelings will go away. You will feel better again.