Finding Depression Treatment Options That Work for You

Depression treatment isn't one-size-fits-all. What helps one person recover from a depressive episode may not address another person's needs or circumstances. Finding the right approach means looking beyond a diagnosis to understand what you're experiencing, your history, what's contributing to it, and what you hope will change.

There are several depression treatment options, including psychotherapy and medication (NIMH, 2024). Depending on your needs and concerns, treatment may initially focus on easing symptoms, then involve examining relationships, longstanding patterns, or questions about purpose and fulfillment.

In my Seattle psychiatry practice, I take an individualized, evidence-based approach to depression treatment. My goal isn't only to help you feel better in the short term, but to support you in living a more satisfying and meaningful life.

How to Choose Between Depression Treatment Options?

When I help patients explore different depression treatment options, we begin by understanding the nature of their individual depression and how it's affecting their life. The severity and duration of symptoms matter, but so do your medical history, previous treatment experiences, personal preferences, current circumstances, identity, and lived experience.

For example, someone experiencing depression after a significant loss may have different needs than someone who has struggled with low mood for years without understanding why. Someone else may find that depression has developed alongside chronic stress, relationship abuse, or a major life transition.

These experiences can overlap, and there isn't always one identifiable cause. A comprehensive diagnostic assessment can clarify what's happening and guide treatment decisions.

It's also important to consider whether other factors may be contributing to your symptoms. Certain medical conditions and medications can produce symptoms similar to depression, while bipolar disorder can involve depressive episodes that require a different treatment approach. The goal of an initial evaluation is to develop a clearer understanding of your situation and identify a treatment plan that's a good fit for you.

Psychotherapy for Depression

Many different types of psychotherapy are used to treat depression. Depending on the approach, therapy can help you recognize unhelpful patterns, develop new ways of responding to difficult emotions, improve relationships, work through past experiences and trauma, or explore existential questions about your purpose.

Traditional cognitive behavioral therapy (CBT) helps people identify and reconsider thought patterns that contribute to depression. Third-wave CBT approaches, including acceptance and commitment therapy (ACT) and mindfulness-based cognitive therapy (MBCT), also focus on how you respond to difficult thoughts and emotions. These approaches help you recognize thoughts without automatically accepting them as facts or trying to eliminate them. For example, instead of treating "Nothing is ever going to change" as the truth, you can learn to notice the thought without letting it dictate your choices.

Third-wave CBT also emphasizes taking meaningful action even when your mood hasn't improved. This might mean reconnecting with a friend, returning to a creative activity, or making time for something that reflects your values. The goal isn't to force positivity but to stay connected to what matters while working through depression.

Other approaches, including psychodynamic and existential psychotherapy, may help you understand deeper emotional patterns and questions about identity, values, and meaning. As you gain more insight into those aspects of your life you may recognize changes that you want to make to your career, relationships, how you spend your time, or how you relate to yourself.

Ultimately, the most useful approach depends on your needs and what you're hoping to accomplish in treatment.

When to Consider Medication

Antidepressant medication is another established depression treatment option. Depending on the severity of your symptoms and your medical history, medication may be recommended alongside psychotherapy.

Antidepressants can help reduce depressive symptoms, although their effects vary from person to person. Finding an appropriate medication involves considering potential benefits, side effects, other medications you're taking, and how you've responded to treatment in the past. It also takes time to determine whether a medication is helping.

Medications used to treat depression include (Mayo Clinic, 2022):

• Serotonin and norepinephrine reuptake inhibitors (SNRIs)
• Selective serotonin reuptake inhibitors (SSRIs)
• Tricyclic antidepressants
• Atypical antidepressants

Medication isn't a sign that you've failed to manage depression or that it is entirely biological. Depression is complex, and medication can be useful for some people. At the same time, taking medication doesn't mean you stop exploring the psychological, relational, or situational factors that are impacting your well-being.

I take a conservative, evidence-based approach to psychiatric medication. I consider medication when it may be appropriate and useful, and discuss the potential benefits and drawbacks with patients rather than assuming medication is always necessary or that it should be avoided altogether. My goal is to collaborate with you to create a treatment plan that makes sense for you, based on your medical history, symptoms, preferences, and goals.

What If Depression Treatment Isn't Working?

Sometimes, the first treatment you try doesn't provide enough relief. You might notice some improvement without feeling like yourself again, or you struggle to identify any meaningful change. This doesn't necessarily mean your depression is untreatable. It may mean your treatment needs to be adjusted, given more time, or swapped for another approach.

If you're taking medication, your prescriber can help you evaluate its effects and discuss whether a change is appropriate. If you're in therapy, it may be worth revisiting your goals, discussing your current challenges, or considering whether another type of therapy would be a better fit.

For persistent or treatment-resistant depression, additional options may be available, including combining treatments or exploring specialized interventions such as transcranial magnetic stimulation (TMS) (NIMH, 2024).

Building a More Meaningful Life Beyond Depression

Relieving depression can create room to reconsider what you want from your life. When you're no longer using most of your energy to get through the day, you may find yourself asking questions that previously felt out of reach.

What makes life feel worthwhile to you?

Which relationships do you want to nurture?

Are you pursuing goals because they matter to you, or because you believe you're expected to?

This doesn't mean depression is simply a crisis of meaning or that finding your purpose will make it disappear. Depression can have biological, psychological, social, and medical contributors, and effective care needs to account for that complexity. But, exploring meaning can complement symptom-focused treatment. It may help you identify what you want to move toward and incorporate to add fullness to your life. Treatment can help you make these changes and address your immediate concerns and longer-term goals.

Depression Treatment in Seattle | Dr. David Zacharias

You deserve holistic depression treatment that honors your identity and lived experience. At Existential Psychiatry, I offer individualized psychiatric care for adults in Seattle, including diagnostic assessment, therapy, and medication management. I take into account your medical and social history, strengths, current challenges, and goals to help us create a treatment plan that works for you.

If you have questions or would like to explore depression treatment options, please contact Existential Psychiatry to schedule a free consultation. I'd love to speak with you!

Written by Existential Psychiatry Staff

References

• Mayo Clinic. (2022). Antidepressants: Selecting one that's right for you. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20046273
• NIMH. (2024). Depression. National Institute of Mental Health. https://www.nimh.nih.gov/health/publications/depression