Depression Treatment Options: What NIMH Says Can Help

Written by the Lyte Psychiatry clinical team. Clinically reviewed by Ana G., LPC, and medically reviewed by Dr. Akinwande Akintola, MD, supervising physician. Last reviewed: November 4, 2026.

The main depression treatment options are psychotherapy, antidepressant medication, or both together. When those do not help enough, the National Institute of Mental Health (NIMH) describes further steps, including medication combinations, esketamine and brain stimulation therapies such as rTMS and ECT. Most people improve with treatment, though finding the right fit can take time and adjustment.

This overview is for adults who have been diagnosed with depression, suspect they have it, or are supporting someone who does. It explains, in plain language, what each type of treatment is, when it tends to be used and what questions to ask. It does not rank treatments or recommend one for you.

This article is general information, not a medical recommendation. Do not start, stop or change any medication without talking to your prescriber.

Is depression treatable?

Yes, depression is treatable, and most people who get care improve. As of October 2026, the American Psychiatric Association states that between 70% and 90% of people with depression eventually respond well to treatment.

The word "eventually" matters. NIMH notes that finding the best treatment may take trial and error. A first plan is a starting point, and it is normal to adjust it based on how you feel and what side effects you notice.

Treatment also tends to work best when it is regular. Keeping appointments, taking medicines as prescribed and telling your clinician about side effects all give the plan a fair test.

If you recently screened positive for depression and are unsure what comes next, see what to do after a positive depression screening.

What types of psychotherapy treat depression?

Several structured talk therapies are used to treat depression. NIMH describes two common ones: in cognitive behavioral therapy (CBT), people learn to challenge and change unhelpful thoughts and behaviors, and in interpersonal therapy (IPT), the focus is on relationships and life events that affect mood, and the reverse.

• CBT often includes tracking thoughts, testing them against evidence and scheduling activities that bring a sense of pleasure or accomplishment.
• IPT looks at role changes, conflicts, grief and isolation, and how they connect to mood.
• Other approaches, such as behavioral activation or problem-solving therapy, may be part of a plan depending on the clinician and the person.

Our guide to CBT for depression explains what sessions look like in more detail.

How do antidepressants fit into treatment?

Antidepressants are medications that can reduce depression symptoms, and they are often used alongside therapy. MedlinePlus explains that antidepressants may take several weeks to work and advises never stopping them on your own.

NIMH adds that problems with sleep, appetite and concentration often improve before mood lifts. The NIMH page on mental health medications notes that early side effects are common and often fade, and it describes an FDA warning about suicidal thoughts in young people early in treatment, which is why close follow-up matters.

Questions about a specific medicine, side effects or whether to continue belong with your prescriber. Some people wonder whether they still need therapy once medication helps; our article on therapy when medication is working covers that.

What happens if the first treatment does not work?

If the first treatment does not help enough, there are several next steps, and needing them is common. NIMH explains that clinicians may adjust a medication, switch to another, or combine an antidepressant with a different type of medication that may make it more effective.

It helps to know that depression treatment options are not a ladder you must climb in a fixed order. Many people use therapy and medication together from the start, and others add one to the other later. The order depends on severity, preferences, past response and other health conditions.

Before changing course, a clinician may also revisit the basics:

• Has the medication been given enough time?
• Are side effects or missed doses getting in the way?
• Could another condition, such as a thyroid problem, sleep disorder or substance use, be contributing?
• Would adding or changing psychotherapy help?

What is treatment-resistant depression?

NIMH says treatment-resistant depression occurs when a person does not get better after trying at least two antidepressants. It is a label for planning, not a verdict that depression cannot improve.

NIMH describes esketamine as a medication approved by the U.S. Food and Drug Administration (FDA) for treatment-resistant depression that typically acts within a couple of hours. Ask your clinician whether it is appropriate for you and how it would be given. For a fuller explanation, read what treatment-resistant depression means.

What are brain stimulation therapies?

Brain stimulation therapies use electrical or magnetic energy to affect brain activity, and they are usually considered when other treatments have not worked. The NIMH overview of brain stimulation therapies, last reviewed March 2024, describes several types:

• Electroconvulsive therapy (ECT) uses an electric current to induce seizure activity. NIMH notes it is usually considered when illness has not improved after other treatments, and side effects can include headache, confusion and memory loss around the time of treatment.
• Repetitive transcranial magnetic stimulation (rTMS) uses an electromagnet to deliver repeated low-intensity pulses. NIMH reports it is FDA-cleared for treatment-resistant depression; common side effects include scalp discomfort and mild headaches.
• Vagus nerve stimulation (VNS) involves an implanted device and, NIMH says, is not intended as a first-line treatment.
• Deep brain stimulation (DBS) for depression is described by NIMH as still experimental.

Do natural products or lifestyle changes help?

Lifestyle steps can support recovery, but NIMH states that the FDA has not approved any natural products for treating depression. NIMH advises not using vitamin D, St. John's wort or other supplements before talking with a health care provider, partly because some interact with medicines.

NIMH does suggest everyday steps that can help alongside treatment: trying to be active, even with short daily walks, connecting with people, and avoiding alcohol, nicotine and drugs, including medications not prescribed for you. It also says to go easy on yourself while treatment takes effect.

How do you choose a plan with your clinician? Step by step

You choose a plan by sharing a clear picture of your symptoms and goals, then deciding together. The NIMH page on psychotherapies suggests asking what approach a therapist will use, what the goals are, and whether medications are an option.

1. Write down your main symptoms, when they started and how they affect work, sleep and relationships.
2. List past treatments, what helped and what side effects you had.
3. Bring a list of all medicines and supplements you take.
4. Say what matters most to you, such as fewer side effects, fewer visits or working on relationships.
5. Agree on how you will measure progress and when you will check in.

A useful question to ask: "What would make us change this plan, and when would we know?" Bringing a family member or friend can also help you remember the discussion and weigh depression treatment options afterward.

Example: a person who had side effects with a past medicine might say they want to start with weekly therapy and revisit medication in a month. A clinician can explain the trade-offs so the choice is an informed one.

When should you get help sooner? Red flags

Get help right away if depression comes with thoughts of suicide, self-harm or feeling that others would be better off without you. Call or text 988, or call 911 if someone is in immediate danger.

NIMH notes an FDA warning about suicidal thoughts in young people early in antidepressant treatment, which is why new or worsening symptoms should be reported quickly.

Contact your prescriber promptly if you notice new agitation, severe restlessness, or a sudden change in mood after starting or changing a medicine, and do not stop a medicine on your own. Book a sooner visit if you cannot get out of bed, are not eating, or are missing work or school for days at a time. Family members can help by noticing these changes and offering a ride to an appointment.

Depression care in Texas: what to know

In Texas, depression care is available through private practices, primary care, and county-based public mental health authorities. Telehealth can widen choices, and a research recap on telehealth.hhs.gov reports studies finding no significant differences in quality between remote and in-person care for conditions including depression.

Lyte Psychiatry offers telehealth visits to patients who are physically located in Texas at the time of the visit. Treatments that require specialized equipment, such as brain stimulation, are provided at dedicated centers, so ask any clinician how they would coordinate if you need one.

Getting support in Texas

Lyte Psychiatry offers therapy, psychiatric evaluation and medication management in Texas. In-person visits are available at Lyte Psychiatry's clinic in Pantego, in the Dallas–Fort Worth area. All Lyte Psychiatry services are available in Spanish.

Most new patients are seen within 1–2 business days. Weekend appointments are limited. Availability, insurance and clinician fit require confirmation. Learn about depression care, medication management, or telehealth in Texas.

Lyte Psychiatry is an outpatient practice. It does not provide inpatient care, crisis or after-hours coverage, medically supervised detox, or intensive outpatient or partial hospitalization programs.

If you are in a mental-health crisis in the United States, call or text 988. Call 911 for immediate danger.

Educational information, not a diagnosis or individual treatment plan.