Types of treatment for depression fall into two broad categories: psychosocial and pharmacologic . Within each category are many choices. Psychosocial treatments include individual therapies, group therapies, vocational services, and family/couples therapies. Furthermore, there are different types of individual therapies, such as supportive, insight oriented, or cognitive–behavioral.
There are also various levels of treatment settings, ranging from private practice settings, outpatient clinic settings, day treatment or partial hospital programs, and inpatient treatment.
Pharmacologic treatment involves the use of medications from various groups, such as antidepressants, anticonvulsants, antipsychotics, or anxiolytics . Psychotropics are those medicines primarily used in psychiatric care for the treatment of mental disorders, including depression.
However, there is often a crossover use of medicines from other medical specialties, such as from neurology, wherein antiseizure medications (anticonvulsants) are frequently found to have efficacy in the treatment of many psychiatric conditions.
As part of an evaluation your clinician will consider the most appropriate treatment plan for your depression. For a mild depression psychotherapy alone may be recommended first.
For more severe depressions both medication and therapy may be recommended. If already in psychotherapy, your therapist may refer you to a psychiatrist for a medication evaluation if there are concerns about the level of response, the severity of symptoms, or confounding comorbid conditions.
The type of therapy chosen can depend on many factors such as cost, duration, or patient fit (Table 3). Frequency of psychotherapy typically starts at once per week but may be more or less often depending on your individual needs or therapy type.
As part of the treatment plan, the treatment setting also needs to be determined. Most individuals can be treated in private office settings or outpatient clinic settings. Sometimes, a higher level of structure is needed in which more services can be provided, on a daily basis, such as in a day treatment program.
If impairments are severe or if safety is in question, hospitalization may be warranted. Within the hospital several modalities of treatment are provided on a daily basis, making the treatment more intense.