Depression is marked by low mood or sadness, changes in sleeping and eating patterns, loss of interest in activities previously enjoyed, and feelings of worthlessness or hopelessness. If you are experiencing depression, you know how impactful it can be. Thankfully, there is hope. Depression is highly treatable, with most people finding relief through personalized care plans involving therapy and medication.

If you’ve tried depression treatment before and didn’t find success, a new therapist or a better fitting psychiatric provider could be the key to feeling better. If you don’t respond well to medication, there are still other options, with alternative treatments like TMS and Spravato® offering hope when traditional approaches haven’t been successful.

Therapy for Depression

Therapists are trained to help people deal with depression, helping them untangle any underlying beliefs or behaviors that may be adding to symptoms, then learn new coping skills for moving forward. Being shown unconditional positive regard by a therapist can remind someone that they are not alone, building a foundation from which they can make positive changes.

Many therapists utilize an “eclectic” approach to depression therapy, meaning that the clinician pulls from multiple modalities, tailoring their care plan to the needs of each individual. Therapy for depression is highly collaborative, involving shared goal setting, frequent feedback and adjustment to care, and exploring personal narratives together to work toward healing.

Here are some types of therapy commonly used to treat depression:

• Cognitive behavioral therapy (CBT): The front-line therapy for depression, CBT helps people understand the connections between their thoughts, feelings, and behaviors. Then they can notice how changing their behaviors and thought patterns can positively shift their mood.
• Interpersonal therapy (IPT): Depression often leaves people feeling isolated and misunderstood. IPT takes a close look at someone’s relationships then teaches them new relational and communication skills, which can ultimately boost mood.
• Dialectical behavioral therapy (DBT): DBT is a highly structured, skills-based modality that helps people with depression think through the elements of their life that they can change and work to accept the things they can’t.
• Mindfulness-based cognitive therapy (MBCT): Adding mindfulness practices along with other coping skills can help people with depression learn how to better focus on the present moment instead of ruminating on the past or worrying about the future.
• Supportive therapy: Sometimes people just need to feel seen and heard. The heart of most therapy modalities, supportive therapy means simply offering a listening ear and helping someone see their worth, something that depression can often mar.

How Will I Know Therapy Is Working?

It can take some time to start feeling better after starting therapy for depression, and change might feel gradual. However, outside of sessions, you may notice yourself start to interrupt and refute the negative thought patterns you’ve been having, feel slightly more energy, or pick back up with some of the hobbies you lost interest in during the depressive episode. You might also have an easier time identifying your emotions and connecting to them more deeply.

You should have an open dialogue with your therapist about your goals for therapy, what progress looks like, and what is and isn’t working over time. If you feel like you’re not making much progress, you should be honest with your therapist and see if they have any ideas for what to shift in your sessions that could help. Or, they may refer you to another professional if they feel that you could make more progress with someone else.

Medication for Depression

Medication for depression works by boosting the absorption of certain neurotransmitters in the brain responsible for mood, typically serotonin, norepinephrine, and/or dopamine. A psychiatric provider can help determine whether medication is a good fit for your depression treatment needs, and which type makes sense based on your symptoms, other medications you may be taking, and the impacts of any potential side effects.

Common medications for depression include:^1,2,3

• Selective serotonin reuptake inhibitors (SSRIs): SSRIs are the most commonly prescribed antidepressant, as they are generally effective and well tolerated with few side effects. They work by blocking the reabsorption of serotonin, leaving more available for the brain to process.
• Serotonin-norepinephrine reuptake inhibitors (SNRIs): SNRIs target both serotonin and norepinephrine receptors in the brain. While serotonin is directly linked to mood, norepinephrine is produced in the adrenal glands, impacting focus and energy levels.
• Tricyclic antidepressants (TCAs): TCAs activate several neurotransmitter receptors in the brain, increasing the levels of both serotonin and norepinephrine. While they were once commonly prescribed for depression, they have far more adverse effects than SSRIs and SNRIs and are typically only prescribed when other medications haven’t been successful.
• Monoamine oxidase inhibitors (MAOIs): MAOIs block the enzyme monoamine oxidase in the brain, which is responsible for clearing out excess serotonin, norepinephrine, and dopamine, making these neurotransmitters more available for reabsorption. However, they also have many adverse effects and are typically only prescribed when front-line treatments aren’t effective.
• Other medications: A psychiatric provider may prescribe a different medication than those listed above, including Wellbutrin (buproprion), Auvelity (dextromethorphan-bupropion), Trazodone, or Mirtazapine, all of which can be used to treat depression symptoms.

Finding the Right Depression Medication

Before prescribing an antidepressant, your psychiatric provider will ask you several questions about your symptoms, whether any close relatives have found success on an antidepressant, and what side effects might bother you. They will also take into account any other medications you’re currently taking, any health conditions you have, and whether you are pregnant, trying to get pregnant, or are currently breastfeeding.

Typically, you’ll start to feel the effects of medication within four to six weeks, especially if you take it consistently and as recommended.¹ Take note of any side effects you experience. They may dissipate after a time, or they might not, so tracking them as you experience them can help you and your prescriber determine whether this is the right medication for you.

If you experience any side effects you can’t live with, contact your prescriber right away but don’t discontinue use without talking to them first. They’ll likely help you transition to a new medication or try a different dosage until you find the right fit.

Alternative Treatments for Depression

Most people respond well to medication and therapy, finding a significant reduction in symptoms after a couple of months of treatment.³ However, some people try multiple medications without relief, which we refer to as difficult-to-treat depression.

For these people, there is still hope. TMS and Spravato® are both FDA approved for treating depression when other medications haven’t been successful.

• Transcranial magnetic stimulation (TMS): TMS is an incredibly low-risk and noninvasive procedure that uses magnets to stimulate areas of the brain that may be underactive due to depression. It can be a good fit for people who don’t respond well to medication, as it has very few side effects.
• Esketamine treatments: The FDA recently approved Spravato® as the first esketamine nasal spray for hard-to-treat depression. It works by boosting glutamate in the brain, a neurotransmitter that heightens overall communication between different nerve cells.

Other Ways to Cope with Depression

If you suspect that you or a loved one is dealing with depression, you should seek out professional mental health treatment. A therapist can help you process your feelings and find strategies to help you feel better, and a psychiatric provider can help determine whether medication would also be helpful for your symptoms. On top of a professional treatment plan, you can boost your recovery with some self-care strategies, like promoting good sleep, movement, and social support.

Here are some coping strategies for depression that can be part of your well-rounded treatment plan:

• Stay active: Physical activity boosts endorphins, chemicals that promote a general sense of well-being and act as a natural painkiller. Doctors recommend at least 150 minutes of moderate physical activity a week, but even 10 to 15 minutes a day can make a huge difference in how you feel.³
• Avoid substances: Many people turn to alcohol and other substances to cope with their low mood, but doing so can further impair brain function and make it harder to heal long-term.⁴
• Get enough sleep (but not too much): Sleep and mood have a bidirectional relationship, meaning that one can affect the quality of the other. While depression can often impact sleep, try to up the quality as much as possible by sticking to a bedtime routine, avoiding screen time before bed, and limiting caffeine and alcohol in the evenings.⁵
• Develop a mindfulness practice: Mindfulness can help shift rumination and worried thoughts back to the present moment. It also promotes emotional regulation, a skill that is often at a deficit for those with depression.⁶
• Seek social support: Depression can make people feel isolated and alone. It’s important to purposefully counteract these feelings by still seeking out connection with loved ones, even when you don’t feel like it. Tell a trusted friend how you’ve been feeling so they know to check in on you from time to time.
• Eat nourishing foods: Depression can lower motivation and impact appetite. It’s important to ensure that you’re getting adequate nutrition, adding fruits and vegetables to your meals so your brain and body get enough vitamins and minerals.
• Try light therapy: Especially if you have seasonal affective disorder, upping your contact with sunlight, either through actual exposure or through a special light therapy box, can boost mood and increase your vitamin D levels.

How Northeast Health Services Can Help with Depression

Northeast Health Services is dedicated to providing compassionate, convenient mental healthcare to our neighbors across Massachusetts. Each of our clinics offer both therapy and psychiatry services, with care teams working together to ensure each client’s treatment plan is tailored to their needs. Many of our clinics across the state also offer alternative treatments for depression, namely TMS and Spravato®.

If you’re ready to seek help for depression, you can call 508.794.8711 or fill out a brief form to schedule your first appointment.

 

Footnotes:

1. Antidepressants. (2025). Medline Plus. https://medlineplus.gov/antidepressants.html
2. Commonly prescribed antidepressants and how they work. (2023). Medline Plus Magazine. 
   https://magazine.medlineplus.gov/article/commonly-prescribed-antidepressants-and-how-they-work
3. Antidepressants: Selecting one that’s right for you. (2022). Mayo Clinic. 
   https://www.mayoclinic.org/diseases-conditions/depression/in-depth/antidepressants/art-20046273
4. Finding Help for Co-Occurring Substance Use and Mental Disorders. (2025). National Institute of Mental Health.
   https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health
5. How sleep affects mental health (and vice versa): What the science says. (2025). Stanford Medicine News Center.
   https://med.stanford.edu/news/insights/2025/08/sleep-mental-health-connection-what-science-says.html
6. Parmentier, F. B. R., García-Toro, M., García-Campayo, J., Yañez, A. M., Andrés, P., & Gili, M. (2019). Mindfulness and Symptoms of Depression and Anxiety in the General Population: The Mediating Roles of Worry, Rumination, Reappraisal and Suppression. Frontiers in psychology, 10, 506. https://doi.org/10.3389/fpsyg.2019.00506