Depression treatment depends on the patient's age, comorbidities, medications, and response to previous treatment for depression. The goal of treatment is to shorten the recovery period of the disease, to prevent its recurrence, to restore lost or diminished functions, and to prevent vital risks that may occur due to suicide.

Depression treatment depends on the patient’s age, comorbidities, medications, and response to previous treatment for depression.

The goal of treatment is to shorten the recovery period of the disease, to prevent its recurrence, to restore lost or diminished functions, and to prevent vital risks that may occur due to suicide.

Treatment options for depression: 

  • Medication,
  • Psychotherapy,
  • Exercise,
  • Combined therapy,
  • ECT (Electroconvulsive therapy).

The safest, most effective, economical and acceptable treatment should be applied according to the patient’s age and accompanying diseases.

General principles in the treatment of depressive disorders: 

  • Correct diagnosis,
  • Determination of treatment goals,
  • Appropriate antidepressant selection
  • Evaluation and treatment of additional medical conditions,
  • Determining the risk of suicide,
  • Ensuring compliance with treatment,
  • Evaluation of the treatment process,
  • Side effect monitoring of antidepressants,
  • Evaluation of the obtained answer,
  • Evaluation of the need for psychotherapy.

Medication for depression: 

Enzyme or receptor blockers and reuptake inhibitors are used as antidepressant drugs. The effectiveness of the treatment begins in 1-3 weeks. They should be used for 4-6 weeks in order for their effectiveness to be evaluated. If adequate response is not obtained, another drug should be used.



These drugs can show varying levels of side effects. These side effects can be caused by the drug itself or by the process of starting and stopping the drug. During the process of changing or discontinuing medication, discontinuation of the drug should be done gradually.

Antidepressant drugs:

  • MAO (monoamine oxidase) inhibitors: They are the first used antidepressants. It acts by blocking monoamine oxidase A and B enzymes. But it can cause dangerous increases in blood pressure and have serious drug interactions. For example, moclobemide.
  • TSA (tricyclic antidepressants): It acts by suppressing serotonin, noradrenaline and dopamine reuptake pumps. However, it has side effects such as sedation, weight gain, vision problems, dry mouth, dizziness, and low blood pressure. Suicidal use can also be seen in patients with depressive disorder. For example opipramol, clomipramine, amitriptyline, maptorilin.
  • SSRI (selective serotonin reuptake inhibitors) : It acts by blocking serotonin reuptake receptors. Compared to TSA drugs, they have less side effects and are tolerable. Examples are sertraline, fluoxetine, paroxetine, fluvoxamine, citalopramine.
  • Others: Different antidepressant drug options are available, such as selective noradrenaline reuptake inhibitors (reboxetine), noradrenaline and dopamine reuptake inhibitors (bupropion), serotonin and noradrenaline reuptake inhibitors (venlafaxine, milnacipran).

Psychotherapy: It can be used alone or in combination with medication to treat depression. In some patients, it can give as good results as drug therapy. The risk of discontinuing treatment is lower than drug treatment. In combination with other treatments, the efficacy of treatment increases. Psychotherapy options:

  • psychodynamic psychotherapies,
  • behavioral activation therapy,
  • cognitive behavioral therapy,
  • interpersonal relationship therapy,
  • Problem solving therapy.

Exercise: Some studies show that exercise programs can be as effective as drug treatments in some patients. Coping and management strategies such as meditation-based cognitive therapy, peer support, exercise, good nutrition, relaxation practices, making time for enjoyable activities, and setting small attainable goals also help in the treatment of depression.

Combined therapy: Studies show that psychotherapy in addition to drug therapy reduces the risk of relapse, increases the effectiveness of treatment, and accelerates adaptation to daily functions, especially in moderate-severe depression.

ECT (Electro-convulsive therapy): The patient is first given anesthesia, then succinylcholine is administered. Then, by giving electric current with two electrodes, he is given a seizure for 15-45 seconds. It is an effective (90%) method. It can be applied in patients who do not respond to drug therapy. However, there may be memory problems and muscle pains after treatment.

Treatment options according to the severity of depression: 

Mild depression:

  • Follow-up (without treatment for 2 weeks, it is evaluated whether the patient recovers on his own)
  • Exercise (walking etc.),
  • Peer, family, friend support, reading help books, cognitive behavioral therapy support.
  • Speech therapy for mild to moderate depression.

Moderate to severe depression:

  • Medication,
  • Psychotherapy (talk therapy, cognitive behavioral therapy, psychodynamic psychotherapy, peer groups etc.),



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