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Summary: The most effective treatment for depression follows a holistic, integrated, whole person model that addresses all factors that affect the development, treatment, and successful recovery from the disorder for each individual.

Key Points:

  • The most effective treatment for depression prioritizes symptom reduction while improving overall quality of life.
  • Each person is unique, which means the way they develop depression and recover from depression is specific to their past mental health history, current health status, and future goals for recovery.
  • To understand what specific treatment modalities can best help a person with depression, a full psychiatric assessment is essential.

The Importance of an Accurate, Early Diagnosis

The first step in finding, accessing, and receiving the most effective treatment for depression is receiving an accurate diagnosis. The best way to receive and accurate diagnosis is to arrange a full psychiatric assessment – often referred to as a biopsychosocial assessment – administered by an experienced, licensed, and qualified mental health professional.

Here’s something to keep in mind:

The sooner a person with a mental health disorder, including major depressive disorder, receives an accurate diagnosis and evidence-based care, the better the outcome.

An early and accurate diagnosis can streamline the treatment process and help patients experience symptom relief and meet their recovery goals more quickly. A complete biopsychosocial assessment that allows an early, accurate diagnosis includes the following components. The assessing provider will ask detailed questions three key areas:

Biological:

  • Full individual medical history
  • Family medical history
  • Current physical problems or medical diagnoses
  • Current medication(s)

Psychological:

  • Personal psychological/psychiatric history:
    • Any previous or current psychiatric medications
    • Any previous or current psychiatric treatment
    • Experience of trauma
    • Recent major life events
    • Recent stressful events/traumatic events
  • Family psychological/psychiatric history
    • Any previous or current mental health disorders in family
    • Any previous or current behavioral disorders in family

Social:

  • Factors that increase risk of depression
  • Factors that decrease risk of depression
  • Work and school history
  • Gender and sexual identity/expression
  • Current ability to meet commitments/responsibilities/obligations in family, school, and/or social life

Once a person receives a full biopsychosocial assessment and a diagnosis of major depressive disorder (MDD) – or the assessment rues out the presence of MDD – they can receive a referral for evidence-based treatment from an experienced mental heath professional.

The Most Effective Treatment for Depression Focuses on Overall Health and Wellbeing

This is what we mean when we say the most effective treatment for depression follows a holistic, integrated, whole person model. This approach aligns with the modern, 21st century idea of health and wellness, which recognizes that health is a broad concept that means more than not being sick right now.

The constitution of the World Health Organization (WHO) defines health as follows:

“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

They expand and apply this concept to mental health, as well. Here’s how the WHO defines mental health in the publication “World Mental Health Report: Transforming Mental Health for All”:

“Mental health is a lot more than the absence of illness: it is an intrinsic part of our individual and collective health and well-being. Mental health is a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn and work well, and contribute to their community. Ultimately, there is no health without mental health.”

With these concepts in mind – total health, integrated treatment, person-first ethos – let’s take a look at the components of a treatment plan for depression created by a high-quality treatment center.

What’s in an Integrated Treatment Plan for Depression?

Integrated, holistic treatment plans for depression include a combination of individual, family, and group psychotherapy, lifestyle changes, complementary/auxiliary supports, lifestyle changes, education, and medication if indicated.

Components of a treatment plan may include, but are not limited to, the following.

Integrated, Evidence-Based Treatment for Depression: What to Expect

  • Individual counseling/therapy:
    • Dialectical behavior therapy (DBT)
    • Cognitive behavior therapy (CBT)
    • Acceptance and commitment therapy (ACT)
    • Motivational interviewing (MI)
  • Group counseling/therapy:
    • DBT for groups
    • CBT for groups
    • Educational groups
    • Skill building groups
  • Family counseling/therapy
    • When family participates in treatment, outcomes can improve
    • Healthy boundaries and communication
    • Conflict resolution
  • Auxiliary/complementary approaches:
    • Yoga
    • Meditation
    • Stress-reduction techniques
    • Mindfulness
    • Exercise
    • Sleep Hygiene
  • Artistic/expressive techniques:
    • Visual art: seeing or doing
    • Music: listening or learning
    • Writing: journaling or creative
  • Medication (if needed):
    • Antidepressants
    • New and emerging medications off label
      • Spravato®
    • Brain modulation techniques:
      • Transcranial magnetic stimulation (TMS)
      • Deep brain stimulation (DBS)
      • Electroconvulsive therapy (ECT)
      • Vagus nerve stimulation

It may be clear that the most effective treatment for depression varies by the individual.

There is no best, one-size-fits-all treatment for depression. However, the integrated, holistic approach consistently superior results, compared to plans that aren’t integrated, whole-person, and holistic.

The contents of the bullet points above represent a menu of options that a provider may offer. In practice, the patient and provider meet and engage in a collaborative process to determine an appropriate course of treatment that provides the highest likelihood of treatment success.

In depression treatment, the patient decides what success looks like.

At the beginning of treatment, patient and provider meet and establish:

  1. A positive treatment alliance based on honesty and trust.
  2. Specific short- and long-term goals for treatment.
  3. A plan for how to achieve those goals, i.e. determining which available therapies/techniques resonate best with the patient, and offer the highest likelihood of treatment success.
  4. A process that allows for timely assessment of progress, assessment of what works and what doesn’t, and changing/adapting/fine tuning the treatment plan based on progress/absence of progress.
  5. The need for an open mind, belief that treatment can work, and a willingness to commit to the process of healing and growth.

By those criteria, the most effective treatment for depression is one that matches the diagnosis – mild, moderate, severe, with or without specifiers like anxiety or paranoia – and one that the patient believes will help them meet their goals and is most likely to adhere to. Therefore, the most effective treatment for depression depends on the individual, and the factors we mention above that make them – and their depressive disorder – unique.

A Note on New and Emerging Medications and Therapies

Over the past several years, researcher have examined the mental health benefits of medications like ketamine, Spravato®, MDMA, psilocybin, and other substances formerly considered recreational psychedelics or party drugs.

While these medications offer hope for specific patients with specific diagnoses in specific circumstances, we encourage people with depression to take a pragmatic, measured approach to what they hear about these medications. For instance, we recently published the following article on our blog:

Is Psilocybin Safe and Effective for Treatment Resistant Depression (TRD)?

Please be aware of how we answer that question:

Yes, psilocybin is safe and effective for treatment resistant depression (TRD) when combined with psychotherapy and delivered in a clinical context under the direct supervision of experienced and qualified medical and mental health professionals.

We’re emphasizing this point for two important reasons:

  1. We want people to avoid getting caught up in media hype and discourage them from freelancing/improvising their mental health medication with illegal and potentially dangerous substances.
  2. We want to remind everyone that recovery from depression and other mental health disorders takes time, effort, and commitment.

When thinking about treatment for depression and treatment for mental health in general, taking care of the basics of total health – based on WHO definition – is the foundation upon which specialized mental health treatment can succeed. By the basics of total health, we mean eating a nutritious and balanced diet, getting good sleep every night, engaging in some form of exercise or activity on most days, learning how to manage stress, and engaging in the basics of self-care.

Perhaps most important of all, however, is staying connected to other people. If you have depression, please seek support. The drive to isolate and avoid others may be powerful, but something else is more powerful: genuine human connection.

If you need support for depression, please seek help from compassionate humans. They’re the most important part of the entire equation. Remember this:

Where mental health is concerned, connection is protection.

Finding Help: Resources

If you or someone you know needs professional treatment and support for depression, please contact us here at Crownview Co-Occurrring Institute: we can help. In addition, you can find support through the following online resources: