Depression: Treatment Overview

Reviewed by the Office of Clinical Evaluation and Policy (OCEP), Evernorth

Depression is a common mental health disorder that affects millions of adults in the U.S. Around 21 million adults have had at least one major depressive episode in the past year. Symptoms of depression may include fatigue, inability to concentrate, change in sleep or appetite, a loss of interest or desire to engage in daily activities and hobbies, and feeling sad, empty, hopeless, guilty, worthless or anxious.

Although depression can be temporary, many people experience chronic depression that dampens their ability to complete tasks at work or school. Fortunately, depression is a treatable condition with medications and non-pharmacological options, like talk therapy and lifestyle changes.

Continue reading to learn more about depression treatments.

Talk therapy

Talk therapy, also known as psychotherapy, involves a healthcare provider identifying and helping a patient understand and cope with any underlying issues that are causing depression, such as a particularly traumatic event. Talk therapy sessions generally last 45 minutes to an hour and can be done on a weekly basis.

Talk therapy can also encompass different forms of therapy, such as interpersonal therapy or cognitive behavioral therapy. A healthcare provider or therapist may recommend reinforcing positive behaviors over destructive ones. They may also recommend fixing relationships with others that may be causing distress.

Medications

SSRIs

Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed drugs to treat depression. They work by increasing the levels of serotonin, an important neurotransmitter (chemical messenger), in the brain. Examples of SSRIs include escitalopram (Lexapro®), fluoxetine (Prozac®), and citalopram (Celexa®).

SNRIs

Serotonin and norepinephrine reuptake inhibitors (SNRIs) can increase the levels of serotonin and norepinephrine in the brain. Balancing these neurotransmitters is believed to help alleviate the symptoms of depression. Examples of SNRIs include venlafaxine (Effexor®) and desvenlafaxine (Pristiq®).

Tricyclic antidepressants (TCAs)

Tricyclic antidepressants (TCAs) are one of the first types of antidepressants to be developed. They work by increasing the levels of serotonin and norepinephrine in the brain. However, they generally have more side effects compared to newer antidepressants like SSRIs. Examples of TCAs include amitriptyline, nortriptyline (Pamelor) and imipramine.

Monoamine oxidase inhibitors (MAOIs)

Monoamine oxidase inhibitors (MAOIs) work by blocking an enzyme called monoamine oxidase, which the body uses to remove and recycle certain neurotransmitters. By blocking monoamine oxidase, MAOIs help increase the levels of serotonin, norepinephrine, and dopamine in the brain. However, MAOIs are an older group of antidepressants that can cause more side effects and interact with more drugs than newer antidepressants. Examples of MAOIs include tranylcypromine (Parnate®), phenelzine (Nardil®) and isocarboxazid (Marplan®).

Atypical antidepressants

These medications don't fit neatly into any of the other antidepressant categories. Examples of antidepressants in this category include trazodone, mirtazapine (Remeron®), vortioxetine (Trintellix®), vilazodone (Viibryd®) and bupropion Wellbutrin XL®.

Non-pharmacological treatments

Procedures

When depression is severe or hasn’t responded to other treatments, healthcare providers may perform procedures to help manage the condition. Examples of these types of procedures include: electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS) and vagus nerve stimulation (VNS).

Other treatments for depression

Lifestyle changes like getting enough sleep, exercising and eating a healthy diet may help support positive mindsets and behavior. Meditation and acupuncture are other examples of options that may help relieve symptoms of depression.

The cost of depression treatments

Most health insurance plans cover the cost of medications. Without health insurance, you may have to pay the full cash price of the medication. Still, there are other ways to save on the cost of antidepressant medications.

Inside Rx helps people access their prescriptions at a discounted cash price. The Inside Rx savings card can be used at over 60,000 pharmacies across the U.S. and Puerto Rico. Inside Rx users may save up to 80% on brand and generic drugs.