Non-drug treatments for depression

Depression is one of the most common illnesses in the UK, and is thought to affect about 1 in 10 people at some point in their lifetime. Some people will be offered antidepressant medicines, and for many people these are helpful. But what are the alternatives, and do they work?

Talking therapies

Talking therapies are the most commonly recommended non-drug treatments for depression. There are a number of types, but the one most often used in the NHS is cognitive behavioural therapy, or CBT.

CBT

CBT looks at how your behaviour and your thinking patterns affect the way you feel. You work with a therapist to think about and examine the beliefs you may hold, and make positive changes that can affect how you feel about yourself and your life.

CBT helps people to challenge unhelpful thoughts or behaviours - for example, thinking 'I always make a mess of things' - and helps you to set up more helpful, truthful patterns of thinking. So you might be asked to challenge how true that thought is, and perhaps replace it with something like: 'I find certain tasks challenging, but I'm good at other things.'

CBT is delivered either one to one or in groups. Some people have CBT online, or use books that explain CBT and take you through exercises. Research showed that CBT seems to work as well as some antidepressant medicine for many people with moderate to severe depression. It also seems good at helping people to avoid a recurrence of depression.

Professor Stephen Lawrie, head of psychiatry at Edinburgh University, says: "CBT works for most people, but it's not a panacea." People with more deep-seated problems, or for those with more severe depression, may not be able to engage with CBT until their symptoms have been eased, perhaps with antidepressants. He adds: "I see people who are so depressed that they cannot think clearly any more. They get to the stage where talking treatments can't reach them and they need medication. But in the main, for the vast majority of people with depression, CBT is effective."

There are other types of therapy, but few of them have been shown to work as well as CBT. "A few other therapies have been proposed, but none have acquired the evidence base of CBT," says Professor Lawrie.

Mindfulness

Another type of therapy gaining popularity is mindfulness-based therapy, often combined with CBT.

Dr Adrian Skinner, a clinical psychologist from Yorkshire, says: "Mindfulness is a modern reworking of many ideas derived from meditation." It's a way of bringing the mind into the present, away from the chatter of worry or unhelpful thoughts.

A study in the medical journal The Lancet suggests it may help to prevent depression from coming back. Professor Lawrie describes mindfulness as "very promising". He says it is "very effective to keep people well, once they'd had treatment for depression, and got better."