Depression treatment

For less severe depression

NICE recommends starting with a talking or activity-based treatment, such as:

• guided self-help, using a book or online course with support
• group cognitive behavioural therapy (CBT) or behavioural activation
• group exercise
• mindfulness or meditation groups

Antidepressants are not usually offered first for less severe depression, unless you prefer them.

For more severe depression

You may be offered:

• individual CBT or behavioural activation
• an antidepressant
• CBT and an antidepressant together, which is often the most effective
• counselling or psychodynamic therapy

Antidepressants

• SSRIs, such as sertraline, citalopram or fluoxetine, are usually tried first
• they take 2 to 4 weeks to start working
• side effects often ease after the first few weeks
• you usually carry on for at least 6 months after you feel better
• you should be reviewed within 2 to 4 weeks of starting, or sooner if you are under 25

If treatment does not help

Your GP may change the medicine or dose, add a therapy, or refer you to a community mental health team. For very severe depression, other treatments may be considered.