Since there is no one-size-fits-all treatment, each person has a unique experience with treatment. However, there are certain things that you can expect in terms of how you will begin treatment, the approaches a doctor might recommend, and the results you might experience. Here are some of the effects you can expect during major depressive disorder treatment.
How to Start Treatment
Treatment usually begins when you see a doctor concerning possible symptoms of depression that you may be experiencing. Such symptoms can include changes in:
Mood (hopelessness, apathy, sadness) Behaviors (irritability, crying, isolation) Cognition (poor concentration, trouble focusing, negative thoughts) Sleep (insomnia, excessive sleepiness, difficulty falling or staying asleep)
A primary care physician may diagnose you and/or refer you to a psychiatrist or other mental health professional. A doctor will ask you questions about your symptoms including what type of symptoms you have, how long you have had them, and how severe they are. In addition to assessing your symptoms, a doctor will also explore possible physiological factors that might contribute to depression. Survey findings by the National Institute of Mental Health (NIMH) found that 17.3 million U.S. adults (or about 7.1% of the population) experienced depression in 2017.
What Happens After You Are Diagnosed
After you are diagnosed with major depressive disorder, what happens next depends on your symptoms and what a doctor thinks is causing your depression.
Ruling Out Medical Causes
A doctor may start by addressing any underlying conditions that might be a factor. Chronic illnesses, thyroid conditions, certain medications, and substance use can cause or contribute to symptoms of depression. Hypothyroidism, or under-active thyroid, can be a common medical cause that contributes to depression, particularly among women. If blood tests reveal that you have hypothyroidism, a doctor may prescribe medications designed to treat the thyroid condition, which may help alleviate depressive symptoms. Once any underlying conditions have been addressed, a doctor may then:
Prescribe an antidepressant. Antidepressants work by balancing the chemicals in your brain called neurotransmitters. These neurotransmitters, which include serotonin, dopamine, and norepinephrine, have an effect on emotions and moods. Refer you to a mental health professional such as a psychiatrist, psychologist, or counselor. Psychotherapy for depression can include a range of techniques including talk therapy, cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), psychodynamic therapy, and individual counseling. Talk therapy involves discussing issues that contribute to your depression symptoms. Cognitive-behavioral therapy focuses on addressing the underlying negative thought patterns that contribute to symptoms of depression.
Research has found that psychotherapy is about as effective as antidepressants in treating depression. However, the effectiveness of treatment depends on the individual and the severity of symptoms. There was an error. Please try again.
How to Know If Treatment Is Working
It may take time to find the treatment approach that is right for you. Read on to learn more about when to expect symptom relief from medication and therapy.
What to Expect From Antidepressants
If you are taking antidepressants, you may begin to experience some benefits fairly quickly. However, antidepressants commonly take four to eight weeks to work. So most people will not begin feeling the full impact until several weeks after beginning the medication. In addition to treating your symptoms of depression, however, you may also experience side effects, which can vary depending on the type of antidepressant you are taking. Some common side effects of antidepressants include dry mouth, sexual side effects, nausea, insomnia, restlessness, weight gain, headaches, and constipation. Not all antidepressants work for everyone, and you may need to adjust your dose or even try a different type of medication. It may seem frustrating or slow-going at times, but carefully monitoring your progress and symptoms can help ensure that you are receiving the best treatment for your needs. If you do not begin to notice any positive changes in your symptoms after eight weeks, talk to a doctor. In most cases, a doctor or psychiatrist may want you to continue to take a specific medication for a while in order for it to reach its full effectiveness. However, if you are not seeing any results, it is worth consulting a doctor to discuss changing your dose, switching antidepressants, or trying another approach. Anyone taking antidepressants should be monitored carefully, particularly during the first few weeks of treatment. People may sometimes experience a worsening of symptoms or may start to have suicidal thoughts or exhibit suicidal behaviors. Don’t stop taking your antidepressant without talking to a doctor. Suddenly stopping your medication can make your symptoms worse, so it is important to develop a plan with a doctor to gradually lower your dosage and allow your body to readjust. For more mental health resources, see our National Helpline Database.
What to Expect From Psychotherapy
Psychotherapy focuses on helping people understand the thoughts, behaviors, and emotions that contribute to symptoms of major depressive disorder. Some of the treatment effects you may experience when you are undergoing psychotherapy depend largely on your individual symptoms and the specific techniques that are used. You will likely begin a regular treatment schedule that involves meeting with a therapist once or twice a week, depending on your needs. Just as with medication-based approaches to depression treatment, psychotherapy takes time. However, a therapist can also help you develop new coping skills that will help you to manage your stress, deal with negative thoughts and emotions, and manage your fears. Such skills can be particularly helpful as you wait for antidepressant treatments to begin working. You can discuss treatment length with a therapist at the start of your sessions. How long you attend therapy depends on the therapist/therapy type, your individual needs, and your specific mental health condition. Research suggests that, on average, half of people who attend psychotherapy benefit from attending at least 15 to 20 sessions. Others benefit from a more intensive schedule, such as 20 to 30 sessions over a six-month period. But some people attend therapy with no specified end date. You and a therapist can also set therapy goals for your depression, and can base your end date on when you both feel you’ve learned adequate coping mechanisms to handle your symptoms. Therapy goals may include:
Finding a job that enhances your well-being or improving your current work situation Improving your relationships with family and friends Increasing self-care behaviors Managing your household (cleaning and organizing) Successfully employing coping mechanisms and feeling relief from symptoms
Psychotherapy is not the only recommended option for people with severe depression. Symptoms of severe depression include thoughts or plans of suicide, psychosis, impairments in basic functioning, and poor judgment that may result in self-harm. Patients with such symptoms should see a psychiatrist and may require hospitalization.
Positive Effects of Treatment
Changes you can expect to experience when major depressive disorder treatment is effective include:
Decreases in feelings of sadness or hopelessnessFeeling better able to handle stressFewer negative thoughtsImproved ability to cope with daily livingImproved sleepImprovements in moodLess anxietyLess irritabilityMore interest in activities you previously enjoyedMore motivation
Even if you are noticing improvements in your depressive symptoms, it is important to keep an eye out for signs of relapse. Talk to a doctor or mental health professional if you notice that your depressive symptoms are returning or worsening at any point during your treatment.
When to Ask for Additional Help
If you do not notice any improvement in your symptoms or they seem to be getting worse, talk to a doctor or mental health professional. There are a number of other options available for treatment-resistant depression including:
Electroconvulsive therapy (ECT): The use of ECT has been a source of controversy within psychiatry, but it has been shown to be effective in the treatment of depression. In this process, patients are placed under general anesthesia. Then, a small and painless electrical current is delivered to the brain. This causes a brief seizure which can help relieve depressive symptoms. Patients typically receive ECT in sessions over a period of a few weeks. People may feel relief from their symptoms fairly quickly, but they may also experience side effects including memory loss, confusion, headaches, and nausea. Vagus nerve stimulation (VNS): This involves a surgical procedure to implant a device that sends electrical signals to the vagus nerve as a way to improve mood. Deep brain stimulation (DBS): DBS involves implanting electrodes in areas of the brain associated with emotion. Side effects and risks include bleeding, nausea, breathing problems, seizures, and stroke. Repetitive transcranial magnetic stimulation (rTMS): This involves placing a device against the skull to transmit magnetic waves into specific areas of the brain. Patients remain awake during these sessions and do not experience any pain.
Other Steps You Can Take
Making lifestyle changes is an important part of treating major depressive disorder. There are a number of things that you can do to help supplement your treatment and find relief. Some of these changes can help alleviate symptoms in the short-term and aid your long-term recovery.
Exercise May Be Helpful
Research has shown that regular physical activity can not only help prevent depression, it can also help alleviate symptoms. The idea that exercise may actually help treat depressive symptoms has been the subject of debate, but some evidence suggests that the beneficial effects may have actually been underestimated. A meta-analysis of the research concluded that exercise has a large and significant beneficial effect on depression (including major depressive disorder), supporting the idea that exercise is an evidence-based depression treatment.
Stick to a Schedule
It can also be helpful to resume some of the activities that you enjoyed before you began experiencing symptoms of depression. Depression can not only cause you to lose interest in the things you used to be passionate about; it can also make it difficult to stay on top of daily chores like doing the dishes or laundry. Seeing these things pile up makes it even more difficult to feel upbeat and motivated. So when you are trying to manage your symptoms, focus on doing small things each day that will help restore your routines and sense of normalcy. If you have fallen out of a routine, create some sort of schedule that provides structure in your day.
Get Enough Sleep
Insomnia and other sleep disturbances are common symptoms of depression. You may want to try relaxation techniques or even attend cognitive behavioral therapy specifically to address your insomnia, which may be effective for some people with depression. In some cases, a doctor may prescribe a medication to help you sleep.
A Word From Verywell
When undergoing treatment for major depressive disorder, it is important to communicate with a doctor or therapist about how you are feeling, and give your treatment time to work. If you are on medication, be sure to follow the prescribed dosage as directed. If your symptoms worsen or you experience other side effects, talk to a doctor immediately. Major depressive disorder is a serious condition, but it is treatable. It may take some time to find the right approach for your needs, but understanding what you can expect in terms of treatment effects can help you better recognize how your treatment is working.
