In a recent report, Mind (National Association of Mental Health) revealed that 93 per cent of GPs in the UK have at times prescribed antidepressants due to a lack of alternative treatment options. What were they thinking?
There are many alternatives for depression that work well in addition to or in place of anti-depressants. For me it takes a combination of treatments to stay well; medication plus a healthy lifestyle ( good food, exercise, less coffee, more sunlight, avoiding stress).
Before I continue, let me make a clarifying point. A small proportion of people with depression have what is termed melancholic or biological depression. This includes people with bipolar disorder. For such people medicine is almost always needed to reach or remain in good health, while non-medical treatments are considered to be supplementary. For the more usual non-melancholic depression, treatments that use strategies other than medication are common.
Anyway, back to the merits of different treatments. If you want to look up one of the following terms the Medicine Net medical dictionary should have a definition.
The Centre for Mental Health Research (link below) did a survey of the scientific literature available, and ranked treatments according to the depth and quality of evidence supporting them.
Medical treatments
Antidepressants and electro-convulsive therapy are both ranked highly with strong scientific evidence for their effectiveness.
Psychological treatments
Cognitive behavioral therapy ranks highest with strong evidence for being very effective. Interpersonal psychotherapy, psychodynamic psychotherapy and bibliotherapy are all on the next tier. They are supported by scientific evidence as being effective, but the evidence is not as strong.
Lifestyle & Alternative Therapies
Exercise, light therapy and St John’s Wort are ranked on the second tier as useful treatments, with good evidence but not as strong as for, say, antidepressants. On the third tier there is a large group of other promising treatments with less evidence in support. It includes acupuncture, alcohol avoidance, massage therapy, relaxation therapy, vitamins and yoga.
The Black Dog Institute took a different approach, surveying what patients rated as the most helpful treatments. The leader of the study Professor Gordon Parker said that patients “do not necessarily share the views of professionals about effective therapies for depression”. Yes, we can be fairly incisive about what is or isn’t working!
2,692 individuals took part in the survey. Leaving aside medicines and “talk” therapies, people with depression rated exercise as being the most helpful. They considered yoga, meditation, relaxation and massage to be the next most beneficial. Acupuncture and homeopathy followed with moderate ranking scores, while the various herbal and Omega 3 preparations returned the lowest rankings.
So there you have it. My experience is that it takes more than drugs to get well. The more aggressively you pursue all of the the things that work for you, the more likely you are to maintain good health. Putting it into practice is the hard part!
Centre for Mental Health Research
Black Dog Institute (see the news release dated 18/2/07)
Previous post on green exercise
10 Responses 
Brain Blogging, Twelfth Edition | GNIF Brain Blogger 2 Jul 2007 @ 2:03 pm
[...] Bishop presents What Works For Depression posted at Finding Optimism, saying, “93% of GPs in the UK have at times prescribed [...]
kirsty gun 19 Aug 2007 @ 1:33 am
be interseted to read more
laura 20 Feb 2008 @ 4:57 pm
I completely agree, exercise is keeping me sane right now. It just works in a way the pills don’t…the pills do their job too but they aren’t a cure-all…
Jim 24 Apr 2008 @ 11:13 pm
I have been looking for something to fight this Depression for 20 years, now. My list of meds goes on and on, I have had several psychotherapists and had 13 ECT treatments. Now I am getting ready to get a Vagus Nerve Stimulator implanted. If anybody else has had any experience with this, I would really appreciate hearing about it.
THX,
Jim
Merri Ellen 9 Jun 2008 @ 10:38 pm
Walking even just 5 minutes a day made a huge difference for me! I purposely bought a house beside walking trails for this very reason – to exercise daily to beat depression!
jess 11 Sep 2008 @ 3:48 pm
Has anyone tried holly water? ….or a healer? while many people admit faith helps them through hard times, I just wonder what percentage of the depressed have renounced God or even religion itself. Where is God when we are in the midst of an attack, when our body shakes telling us we are having a depressive attack? Did God himself create the meds for the depressed? Why didn’t he create a real working pill? anyway……. I am just having one of those “depressive, wondering when it’ll be over” days.
Dottie 24 Feb 2009 @ 11:37 pm
Jeramiah 29: 11-13
Trewth 2 Mar 2009 @ 1:51 pm
I agree; sometimes depression can be biological. I have a thyroid problem, and whenever I forget to take my medication, by evening I am completely in the blues. I have listed some tips in my blog that have helped me over time.
Julie 24 Jun 2009 @ 6:41 pm
Hands down, exercise has been more effective than anything else. Work up to vigorous, intense exercise and it will make prozac look like sugar pills!
Beverly 19 Jul 2009 @ 4:28 am
What Works For Depression HELL IF I KNOW . MY HUSBAND HAS NO CLUE WHAT I GO THROUGH . I CAN”T AFFORD TO GO TALK TO SOMEONE . SO I TRY AND USE HIM . BAD IDEA . AS SOON AS I LAY MY TROUBLES ON THE TABLE . HE STARTS YELLING AT ME . AND TRYING TO ( ONE UP ME ) ABOUT HIS PROBLEMS . HE DOES NOT KNOW WHAT I GO THROUGH ON A GIVEN DAY . WHAT IT TAKES TO JUST WANT TO GET UP IN THE MORNING AND TRY TO DO EVERYDAY THINGS . HE WILL NEVER KNOW . HE THINKS IT IS AS SIMPLE AS TAKEN A BREATH . AND IT IS NOT .