Depression Treatment

How is Depression Diagnosed?

Depression is diagnosed through a detailed analysis of symptoms, how long they have been present, how often they occur, and how they affect everyday life. Symptoms are generally considered for diagnosis when they are present most of the day, nearly every day, for at least 2 weeks. At least one symptom is usually a persistent low mood or a loss of interest or pleasure in activities.

During an evaluation, a healthcare provider may ask when the symptoms started and how they interfere with daily activities. They may also recommend a physical examination or laboratory tests to rule out medicines or health conditions, including thyroid disorders and viral infections, that can cause symptoms similar to depression.

How is Depression Treated Based on Severity?

The treatment approach for depression depends on the severity of symptoms, the person's overall health, and their individual needs. The table below outlines the commonly used treatment approaches for depression:

Types of Depression and Their Treatment

Depression can take different forms, with each type requiring its own treatment approach. Below are the types of depression and their treatments:

Stages of Depression and Their Treatment

Depression can develop differently in individuals. The table below depicts the phases and outlines treatment options possible at each phase:

Note: A doctor can assess the symptoms and recommend appropriate treatment based on the individual's condition.

Medications for Depression Treatment

Medicines for depression are prescribed based on the person's symptoms, severity, medical history, and response to treatment. Commonly used medicines for depression may include:

• Selective Serotonin Reuptake Inhibitors (SSRIs): Help treat depression and are commonly recommended as a first-line treatment.

• Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs): Affect serotonin and norepinephrine reuptake and may be prescribed when SSRIs do not provide enough benefit.

• Tricyclic antidepressants (TCAs): Help treat major depression and may be considered when first-line medicines have not worked.

• Monoamine Oxidase Inhibitors (MAOIs): Inhibit monoamine oxidase and may be used when other antidepressant treatments have not worked.

• Bupropion: Affects norepinephrine and dopamine reuptake and may help treat major depression, particularly when a patient experiences low energy or fatigue.

• Mirtazapine: May increase the availability of serotonin or norepinephrine and is used to treat depression.

Note: Do not start, stop, or change the dose of any depression medicine without medical advice. Always consult your physician before making any adjustments to your medication regimen.

Other Treatments for Depression

Other treatments for depression may be used alongside standard care and can include:

• Brain Stimulation: May be considered for severe depression. Types of brain stimulation include electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS).

• Complementary Therapy: These approaches may be used alongside standard treatment to support well-being, particularly for mild or ongoing symptoms. Examples include acupuncture, massage, hypnosis and biofeedback.

• In-patient Psychiatric Care: May be recommended when depression becomes severe and requires close medical supervision or when there are serious safety concerns.

Note: These treatments are generally used alongside standard depression care and should be discussed with a healthcare professional before starting.

Ayurvedic and Alternative Treatments for Depression

Some Ayurvedic and alternative approaches may be used alongside standard depression treatment to support mental well-being and help manage symptoms. Such Ayurvedic treatments for depression may include:

• Ashwagandha: Reduces stress and improves resilience.

• Brahmi: May enhance cognitive function and help calm the mind.

• Jatamansi: May support emotional stability and help alleviate mental exhaustion.

• Abhyanga: Daily oil massage may soothe the nervous system and release built-up stress.

• Shankhpushpi: Helps with anxiety and promotes peaceful sleep.

• Meditation and Pranayama: Calms the mind and reduces anxiety.

• Yoga: Supports overall mental health.

Note: Never substitute frontline psychiatric care with alternative therapies for depression. Always consult both your psychiatrist and a qualified Ayurvedic Practitioner to ensure safety.

Home Care Tips for Depression

Simple daily habits can support recovery and make it easier to manage depression. These may include:

• Group tasks into a loose routine.

• Use 4-7-8 breathing to lower anxiety.

• Keep a digital therapy calendar.

• Pair your antidepressant with morning coffee.

• Track daily mood daily.

• Spend some time with your hobbies.

• Call your doctor if symptoms worsen.

Latest Treatment for Depression in India

Recent treatment approaches for depression include repetitive transcranial magnetic stimulation (rTMS), which uses magnetic pulses to stimulate areas of the brain involved in mood regulation. Another approach is neurofeedback therapy, which provides real-time feedback on brain activity to help a person regulate brain function and behaviour.

Ketamine therapy may provide rapid relief for some people with severe or treatment-resistant depression when used under psychiatric supervision. Other approaches, such as psychedelic-assisted therapy using substances like psilocybin and MDMA, are still being studied in clinical trials. Light therapy, which involves exposure to a specialised bright-light box, is mainly used for Seasonal Affective Disorder (SAD).

How Long Does Depression Treatment Take?

The duration of depression treatment depends on the type of treatment and how an individual responds. The table below provides an approximate timeframe for when different depression treatments may start showing results or how long they may continue:

Note: These are approximate durations. The actual length of treatment may vary depending on the severity of depression, treatment response, and individual needs.

Depression Treatment Side Effects

Side effects depend on the type of depression treatment used and can vary from person to person. Some commonly reported effects of antidepressant medicines may include:

• Blurred vision

• Drowsiness

• Dizziness

• Dry mouth

• Headache

• Hypomania (bipolar disorder)

• Lack of energy

• Mood changes (anxious, agitated or numb)

• Nausea

• Insomnia

• Weight change/ Appetite shift

• Sexual dysfunction

Note: Consult your doctor if you experience troublesome or persistent side effects.

Lifestyle Changes for Managing Depression

To complement formal therapy, some simple, sustainable changes in your daily lifestyle are important to combat depression. Here are a few that may be useful:

• Stay physically active

• Eat a balanced diet

• Maintain a regular sleep schedule

• Take regular breaks from prolonged sitting

• Avoid smoking

• Limit alcohol consumption

• Maintain social connections

• Follow a consistent daily routine

Triggers That Can Worsen Depression Symptoms

Certain situations and habits may make depression symptoms harder to manage. Such triggers include:

• Seasonal changes / reduced sunlight

• Chronic illness

• Perfectionism

• Changes in relationships, such as a breakup or divorce.

• Social isolation

• High, unmanageable work stress

• Poor and highly disrupted sleep schedule

• Alcohol or illegal substances consumption

Depression Treatment Cost in India

In India, depression treatment costs can be anywhere from about ₹500 to ₹4,000 per session or more. However, the total cost depends on how severe the depression is, the type of recommended therapy and medicines used. Some patients may require counselling and medicines, while others may need hospitalisation or advanced psychiatric interventions.

The approximate costs include up to ₹4,500 per visit for a psychiatrist consultation, ₹1,500 to ₹4,000 per session for a clinical psychologist, ₹1,200 to ₹3,500 per session for Cognitive Behavioural Therapy, ₹8,000 to ₹18,000 for Electroconvulsive Therapy (ECT), ₹27,000 per day for psychiatric hospitalisation, and ₹20,000 to ₹1.5 lakh per month for rehabilitation programmes.

Note: These treatment costs are estimates only. Actual costs may vary based on the city, hospital, and severity of the condition.

Does Health Insurance Cover Depression Treatment in India?

Yes. Health insurance can help cover eligible expenses arising from depression treatment in India. Coverage includes hospitalisation, therapy, psychologist consultations, regular therapist, and psychiatric visits.

Some insurers require you to serve a waiting period if depression has already been diagnosed before purchasing the policy. It is considered a pre-existing disease and coverage may begin only after completing a waiting period of up to 3 years.

The actual benefits available depend on the policy's coverage, terms and conditions. A sum insured of around ₹5 lakh - ₹10 lakh or more can be considered to provide a reasonable financial cushion for eligible treatment expenses.