Keep active. Being more active is associated with lower levels of depression. Outdoor activity seems to be particularly important in staving off depression in older men.
Review your eating habits. Recent research has suggested that people who are depressed may have low levels of certain essential fatty acids, which are found in fish oils. It has therefore been suggested that people with depression should change their eating habits, for example eating more oily fish such as sardines, or should take fish oil supplements.
Investigate herbal medicine. St John's Wort ( Hypericum perforatum) can help many people with mild to moderate depression. Before taking St John's Wort check with your doctor or pharmacist especially if you are taking other kinds of medication, for example for heart disease, epilepsy, asthma or migraine.
Take control. Some people find it helps if they have some control over what happens. This helps to guard against the kind of 'hopelessness' which is associated with depression. Activities that involve making a 'fresh start' have been shown to help people recover from long-lasting depression. Similarly, learning to set small or manageable goals can give you a sense of achievement and make you feel better.
There are a number of self-help books, guides, and software programmes which can help you to learn ways of coping with mild to moderate episodes of depression.
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Drug treatments
Anti-depressant drugs act by increasing the activity of those brain chemicals which affect the way we feel. Anti-depressants are thought to help 2 out of 3 of people with depression.
Tricyclic antidepressants, such as dothiepin, imipramine, and amitryptyline are often prescribed for moderate to severe depression. These usually take up to two weeks to start working and may have side effects.
Newer antidepressant drugs (SSRIs and SNRIs) target specific chemical 'messengers' in the brain. The most well-known SSRI is fluoxetine (Prozac) but there are several other brands. These newer drugs are popular because they tend to have fewer side effects than older drugs.
Lithium carbonate is sometimes prescribed to people with severe depression. High levels of lithium in the blood are dangerous so anyone taking lithium must have regular blood tests.
If you are prescribed drugs for depression you will probably be advised to take them for at least six months - or longer if you have a previous history of depression. You may experience withdrawal effects if you stop taking antidepressant drugs, particularly if you stop suddenly. These effects can include headache, nausea, dizziness and even hallucinations. Always consult your doctor before stopping taking anti-depressants. Do not stop taking medication suddenly as the withdrawal effects may be severe.
Talking treatments
Cognitive behavioural therapy (CBT) is a type of 'talking' treatment. It is based on the fact that the way we feel is partly dependent on the way we think about events (cognition). It also stresses the importance of behaving in ways which challenge negative thoughts - for example being active to challenge feelings of hopelessness.
Interpersonal therapy (IPT) focuses on people's relationships and on problems such as difficulties in communication, or coping with bereavement. There is some evidence that IPT can be as effective as medication or CBT but more research is needed.
Counselling is a form of therapy in which counsellors help people think about the problems they are experiencing in their lives and find new ways of coping with difficulties. They give support and help people find their own solutions, rather than offering advice or treatment.
Electroconvulsive therapy (ECT)
ECT is a controversial treatment which is intended only to be used for people with severe depression who have not responded well to medication or other treatments. The person receiving ECT is given an anaesthetic and drugs to relax their muscles. They then receive an electrical 'shock' to the brain, through electrodes placed on the head. Most people are given a series of ECT sessions. Some people say that ECT is very helpful in relieving their depression, although others have reported unpleasant experiences, including memory problems.
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Written in 2000
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