Depression is a complex illness that can look very different in different people. Some depressed people can’t sleep at all while others can’t do much of anything except sleep. Many depressed individuals have little appetite and lose weight. Others gain weight. What helps the condition is going to vary for each individual also Unfortunately, there is no one-size-fits-all solution.

However, there are several solutions which are proven to ease depressive symptoms for many people. Quite often, what most successfully improves the condition is a multifaceted approach which may include several of the options discussed below.

Conventional Treatments

The two most common conventional treatments are talk therapy and medication. According to statistics, if we give one hundred depressed people medication, about thirty people will get completely better within a couple of months. Another twenty will improve, but still, feel slightly depressed. If we give the remaining fifty people a different antidepressant, about fifteen will see some decrease in symptoms and a few more will with a third medication.

Research shows that with talk therapy alone, the numbers are similar to the first rounds of antidepressants with roughly half of the people improving substantially. If psychotherapy and medication are combined, the chance of recovery almost doubles.

Talk Therapies

There are many forms of talk therapy which are scientifically proven to decrease depression. Research has determined that talk therapy can physically change the brain in long-lasting and meaningful ways. Here are a few:

Cognitive Behavioral Therapy ( CBT)

CBT is one common treatment for depression. CBT works to make individuals aware of underlying negative beliefs and thoughts that contribute to depression. During CBT, therapists and clients develop treatment plans to substitute destructive thought patterns for healthier and more adaptive ones.  CBT is one of the most studied and scientifically proven talk therapies.

Behavioral Activation Therapy (BAT) 

BAT is similar to CBT but focuses solely on a person’s behavior. The therapy aims to teach a person to act in ways that are more likely to help them and stop doing things that do not help their condition. For instance, one BAT change might be as simple as getting up every morning, making the bed, and showering. Research shows that when a person accomplishes small goals, it causes their brain to reward them with positive neurochemicals.

Mindfulness-Based Therapies

Currently, there are four recognized therapy models that are grounded in mindfulness which have been scientifically proven to change the brain’s physical form and function over time through neuroplasticity. These therapies have proven successful in reducing depression.

• Mindfulness-Based Stress Reduction (MBSR) has been shown to help people ease symptoms of stress, anxiety, depression, lessen chronic pain, improve quality of life for cancer patients, and more. It is the most researched mindfulness-based therapy. MBSR training helps a person become more aware of their habitual reactions and interrupt their typical patterns of emoting, thinking, and behaving.
• Mindfulness-Based Cognitive Therapy (MBCT) is a form of cognitive therapy that incorporates mindfulness practices, such as meditation and breathing exercises particularly to prevent depression relapse. Using these tools, MBCT therapists teach people how to disengage from negative thought patterns that contribute to the downward spiral into a depression. Research shows that MBCT can reduce depression relapse as much as 43%.
• Dialectical behavior therapy (DBT) is a cognitive-behavioral treatment that aims to provide clients with new skills to manage painful emotions and decrease conflict in relationships. DBT teaches people how to hold opposite perspectives at once. DBT was originally developed to treat borderline personality disorder. However, research shows DBT to be successful in treating eating disorders, bipolar disorder, post-traumatic stress disorder, and substance abuse.
• Acceptance and Commitment Therapy (ACT) is a type of psychotherapy that helps a person accept the difficulties inherent in life by integrating both cognitive and behavioral therapies. The treatment has been proven effective for improving a variety of mental health conditions, including anxiety, depression, substance dependence, chronic pain, psychosis, and people being treated for cancer.

Medication

Psychotropic medications, which affect the brain, are popular treatments for depression. Antidepressants are some of the most frequently prescribed drugs in the United States, second only to antibiotics. Commonly prescribed antidepressants include: 

• Selective serotonin reuptake inhibitors (Zoloft, Paxil, Prozac)
• Tricyclic antidepressants (Tofranil, Norpramin, Surmontil)
• Monoamine oxidase inhibitors (Nardil, Marplan, Parnate)

While medications can and do work for many people, studies show that they generally work little better than placebo and can have serious risks.

Lifestyle Practices

Lifestyle changes are simple but powerful tools to help a person ease depression. They can be a frontline approach in treatment. In many cases, just implementing lifestyle changes to support mental health can lessen or alleviate depression. Research has been done on many practices, ranging from sleep, diet, owning a pet to socializing, showing observational to strong relationships.

Of course, what works for each person is going to be different and is very likely going to be a combination of several things. You have to find what works for you. Below are four lifestyle practices which have proven effective for many people.

Meditation

While meditation can be a spiritual practice, it doesn’t have to be. You can think of it as a powerful mental health tool that allows you to change your brain. A lot of people have this idea that meditation means doing nothing mentally and emptying the mind of all thought. That’s not true.

Meditation is not about suppressing thoughts. It’s about learning to observe what you do think and to direct your attention. It is your attention that sculpts your brain.  Meditation helps a person become aware of their mind, learn to work with their thoughts, and allow the frontal lobe to control and calm the brain.

The brain benefits of meditation have been overwhelmingly validated by science. On a physical level, a person is learning to alter the way their brain functions by changing thought patterns. With repetition, these thinking habits permanently alter the brain’s form and function through neuroplasticity. A regular meditation practice can help your brain manage stress better and lower depression and anxiety.

Yoga

There’s mounting evidence that yoga helps manage depression, maybe as effectively as antidepressants for some people. One study with depressed participants, two groups practicing yoga, one with antidepressants and one without, reported more improvement than a third medication alone group. Other research showed that a regular practice over time alters the fundamental biochemistry of the brain by improving the levels of GABA, a neurotransmitter that tends to be low in people experiencing depression and anxiety. Many studies have shown that yoga reduces stress by lowering cortisol, the stress hormone.

Exercise

Research shows regular exercise can decrease and completely eliminate some depressive symptoms for some individuals. Exercise benefits your brain in many ways and actually changes your brain’s chemistry.

• Exercising calms the amygdala raising your fight-or-flight threshold.
• When you exercise you increase the ability of your brain to change, neuroplasticity, and the birth of new brain cells, neurogenesis.
• Exercise increases brain-derived neurotrophic factor (BDNF) production. BDNF is a protein produced inside nerve cells and acts as a fertilizer to help them function optimally, grow, and make new neurons.
• Exercise relaxes the resting tension in your muscles which breaks the stress feedback loop to your brain. Your brain figures if your body isn’t stressed, it doesn’t need to be either.

Diet

Science has confirmed that what you eat directly impacts your mental health – both good and bad. Your diet can contribute to depression. Depression has been linked to fast food and more specifically deficiencies in Omega-3, B-complex vitamins, and magnesium. Diet is such an important component of mental health that it has inspired an entire field of medicine called nutritional psychiatry.  One study concluded:

A dietary pattern characterized by a high intake of fruit, vegetables, whole grain, fish, olive oil, low-fat dairy and antioxidants and low intakes of animal foods was apparently associated with a decreased risk of depression. A dietary pattern characterized by a high consumption of red and/or processed meat, refined grains, sweets, high-fat dairy products, butter, potatoes and high-fat gravy, and low intakes of fruits and vegetables is associated with an increased risk of depression.”

So what should you be eating? Basically, eat plants, and lots of them, including fruits and veggies, whole grains (unprocessed), seeds and nuts, with some lean proteins. Avoid processed foods made with added sugars or flours and minimize animal fats, processed meats, and dairy. There are several good dietary guides available online, like the Mediterranean diet or Harvard’s introductory guide to a healthy diet.

Other Lifestyle Factors Which Can Effect Depression

• Sleep
• Dehydration 
• Social Relationships
• Sunshine and vitamin D

Neuromodulation Depression Treatments 

Alternative therapies may be used instead of or in addition to standard treatments and lifestyle changes. Practices which treat depression by modifying brain activity, called neuromodulation, have been found to be beneficial in relieving stubborn cases. Neuromodulation medicine techniques have been around since the 1960s, have drastically improved with the aid of computers, and are used to successfully treat many psychiatric disorders. For treating depression, neuromodulation techniques range from experimental to proven and noninvasive to surgical procedures.

You can read more about each of the practices below here:

• Trans-cranial magnetic stimulation (TMS)
• Neurofeedback
• Vagus nerve stimulation
• Electroconvulsive therapy
• Transcranial direct current stimulation

Natural Remedies

Natural remedies could include vitamins, minerals, and plants used as traditional medicinal treatments over the centuries. Science has found some validity to many of the methods.  Some of these include:

St. John’s wort – In 29 clinical trials involving 5,489 patients with major depression, St. John’s wort was just as effective as antidepressants and participants were less likely to drop out because of adverse effects. However, please note that St. John’s can interfere with many medications and can cause serious side effects when taken with antidepressants.

Zinc – Research from the last two decades has produced evidence connecting zinc dysregulation and deficiency to a multitude of neuropsychiatric conditions. Studies show zinc to be successful in treating major depression. Zinc is essential for all physiological systems and plays an essential part in modulating the brain and body’s response to stress.

Essential fatty acids –  Your brain needs essential fatty acids (EFAs) to function properly. Because your body can’t produce them, you have to get EFAs from your diet. Omega-3 fats are especially important to brain function. Studies are showing that omega-3 fatty acids can be beneficial in the treatment of mild to moderate depression. Supplementing with fish oil, consuming different oils, such as walnut, canola, hemp, and flaxseed oil, or eating fish, can elevate levels of omega-3 fatty acids and possibly help depression.

 Finding New Treatments

Ongoing research is exploring new, alternative methods to treat depression. Today, many mental health professionals and treatment centers are utilizing more holistic approaches encompassing several of the above practices with good results. Going forward, some of the most promising potential solutions are drugs inspired by psychedelic compounds such as psilocybin, the active ingredient in magic mushrooms, and ketamine, an anesthetic that has a history of being used as a recreational drug.

Contributing Author

Patrick Baily