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Cognitive behavioural therapy (CBT)Â helps you understand your thoughts and behaviour and how they affect you.
CBT recognises that events in your past may have shaped you, but it concentrates mostly on how you can change the way you think, feel and behave in the present.
It teaches you how to overcomeÂ negative thoughts, for example being able to challenge hopeless feelings.
CBTÂ is available on the NHS for people with depression or any other mental health problem that it has been shown to help.
You normally have aÂ short courseÂ of sessions, usually six to eight sessions, over 10 to 12 weeks on a one-to-one basis with a counsellor trained in CBT. In some cases, you may be offered group CBT.
Computerised CBT is a form of CBT that works through a computer screen, rather than face-to-face with a therapist.
It's deliveredÂ in a series of weekly sessions and should be supported by a healthcare professional. For instance, it's usually prescribed by your GP and you may have to use the surgery computer to access the programme.
Ask your GP for more information or read more about online CBT and the courses availableÂ here.
IPT focuses on your relationships with other people and on problems you may be having in your relationships, such as difficulties with communication or coping with bereavement.
There's some evidence that IPT can be as effective asÂ antidepressantsÂ or CBT, but more research is needed.
In psychodynamic (psychoanalytic) psychotherapy, a psychoanalytic therapist will encourage you to say whatever is going through your mind.
This will help you to become aware of hidden meanings or patterns in what you do or say that may be contributing to your problems. Read more about psychotherapy.
CounsellingÂ is a form of therapy that helps you think about the problems you are experiencing in your life to find new ways of dealing with them. Counsellors support you in finding solutions to problems, but do not tell you what to do.
Counselling on the NHS usuallyÂ consists of sixÂ to 12 hour-long sessions.Â You talk in confidence to a counsellor, whoÂ supports you and offers practical advice.
Counselling isÂ ideal for people who are basically healthy but need help coping with a current crisis, such as anger, relationship issues, bereavement, redundancy, infertility or the onset of a serious illness.
Your first port of call should be your GP, who can refer you for NHS talking treatments for depression available locally.
In some parts of the country, you alsoÂ haveÂ the option of self-referral. ThisÂ means that if youÂ prefer not to talk toÂ your GP, youÂ canÂ go directly to a professional therapist.
ToÂ find outÂ what's available in your area,Â see our counselling and psychological therapies directory.
AntidepressantsÂ are medicines that treat the symptoms of depression. There are almost 30 different kinds available.
Most people with moderate or severe depression benefit from antidepressants, but not everybody does.Â You mayÂ respond to one antidepressant but not to another,Â and youÂ may need to try two or more treatments beforeÂ youÂ find one that works for you.
The different types of antidepressant work about as well as each other. However,Â side effects varyÂ between different treatments andÂ people.
When you start taking antidepressants, you should see your GP or specialist nurse every week or two for at least four weeks to see how well they are working. IfÂ they are working, you'll need toÂ continue taking them at the same dose for at least four to six months after your symptoms have eased.
If you've had bouts of depression in the past, youÂ mayÂ need toÂ continue toÂ take antidepressants for up to five years or longer.
Antidepressants aren't addictive, but you mayÂ get some withdrawal symptoms if you stop taking them suddenly or you miss a dose (see below).
If your GP thinks you would benefit from taking an antidepressant, you'll usually be prescribed a modern type called aÂ selective serotonin reuptake inhibitor (SSRI). Examples of commonly used SSRI antidepressants are Seroxat (paroxetine), Prozac (fluoxetine)Â and Cipramil (citalopram).
They help increase the level of a natural chemical in your brain called serotonin, which is thought to be a "good mood" chemical.
SSRIsÂ workÂ just as wellÂ as older antidepressants and have fewer side effects.
They can, however, cause nausea and headaches, as well as aÂ dry mouth and problemsÂ having sex. However, all these negative effects usually improve over time.
Some SSRIsÂ aren't suitable forÂ children under the age of 18. Research shows that the risk ofÂ self-harm and suicidal behaviour may increase if they're taken by under-18s. Fluoxetine is the only SSRI that canÂ be prescribed for under-18s, and even then only when a specialist has given the go-ahead.
This group of antidepressants is used to treat moderate to severe depression.
TCAs, which includes Imipramil (imipramine) and amitriptyline,Â have been around for longer than SSRIs.
TheyÂ work by raising the levels of the chemicals serotonin and noradrenaline in your brain. These both help lift your mood.Â
They're generally quite safe, but it's a bad idea to smoke cannabisÂ if you are taking TCAs because it can cause your heart to beat rapidly.
Side effects of TCAsÂ may include a dry mouth, blurred vision, constipation, problems passing urine, sweating, light-headedness and excessive drowsiness, but vary from person to person.
The side effectsÂ usually ease afterÂ seven to 10 days, as your body gets used to the medication.
New antidepressants, such as Efexor (venlafaxine),Â Cymbalta or Yentreve (duloxetine)Â andÂ Zispin SoltabÂ (mirtazapine), work in a slightly different way from SSRIs and TCAs.
Venlafaxine and duloxetineÂ are known as SNRIs (serotonin-noradrenaline reuptake inhibitors). Like TCAs,Â they change the levels of serotonin and noradrenaline in your brain.
Studies have shown that an SNRI can be more effective than an SSRI, thoughÂ they're not routinely prescribed asÂ they can lead to a rise in blood pressure.
Antidepressants are not addictive in the sameÂ way thatÂ illegal drugs and cigarettes are, but when you stop taking them you may have some withdrawal symptoms, including:
In most cases these are quite mild and last no longer than a week or two, but occasionallyÂ they can be quite severe. They seem to be most likely to occur with paroxetine (Seroxat) andÂ venlafaxine (Efexor).
Withdrawal symptoms occur very soon after stopping the tablets, so can easily be told apart from symptoms of depression relapse, which tend to occur after a few weeks.
Common questions about antidepressants answered:
St John's wort is a herbal treatment that some people take for depression. It's available from health food shops and pharmacies.
There's some evidence that it may help mildÂ to moderate depression, butÂ it's not recommended by doctors. This is because the amountÂ of active ingredients varies among individual brands and batches, soÂ you can neverÂ be sureÂ what sort of effect itÂ will have on you.
You shouldn'tÂ take St John's wort if you are pregnant or breastfeeding, as we don't know for sure that it's safe.
Also, St John's wort can interact with the contraceptive pill, reducing its contraceptive effect.Â Read more about St John's wort.
Sometimes electroconvulsive therapy (ECT) may be recommended if you have severe depression and other treatments, including antidepressants, haven't worked.
During ECT, you'll first be given an anaesthetic and medication to relax your muscles. Then you'll receive an electrical "shock" to your brain through electrodes placed on your head.
You may be given a series of ECT sessions. It is usually given twice a week forÂ three to sixÂ weeks.
For most people,Â ECT is good forÂ relieving severe depression, but the beneficialÂ effect tends to wear off after several months.
Some peopleÂ get unpleasant side effects, including short-term headaches, memory problems, nausea and muscle aches.
Read more information about electroconvulsive therapy (ECT) on the Mind website.
If you've tried several different antidepressants and had no improvement, your doctor may offer you a type of medication called lithium in addition to your current treatment.
If the level of lithium in your blood becomes too high,Â it can become toxic. You will therefore need blood tests every three months to check your lithium levels while you're on the medication.
You'll also need to avoidÂ eating a low-salt diet because this can also cause the lithium to become toxic.Â Ask your GP for advice about your diet.
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