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West London NHS Trust > Patients and carers > Mental and physical health conditions > Depression > Treatment of depression

Treatment of depression

Depression is usually treated with a combination of talking treatments, self-help and medication. When a person first starts taking an antidepressant they see their WLMHT care team every one to two weeks. This is because it takes between two and four weeks for the medication to take effect, and the team monitors the medication’s effect.
Severe depression is treated differently to mild or moderate depression.

Mild or moderate depression

A person will not normally be given antidepressants to start with. The WLMHT care team will want to see how they respond to talking treatments and emotional support. The emphasis is on working together with a person to develop their skills in managing their symptoms.

Severe depression:

A combination of an antidepressant and a talking treatment is usually suggested by the WLMHT team. The antidepressant can make it easier for the person to talk to therapists and get real benefit from the treatment.

Talking treatments

There are several different types of talking treatments that can be very positive for people with depression. Here, the WLMHT care team assesses a person’s symptoms, and discusses with them the best ways to address their depression. At all times, a person’s feelings and wishes are respected by the care team.
In a relationship built on respect and support, a trained therapist helps a person explore their personality and realise their strengths. Together, they set achievable goals so that a person can build a satisfying life.
The team can help a person discover or re-discover a sense of identity separate from their depression. This, in turn, can help them overcome the way in which the depression has affected their ability to work, study, have relationships and participate in society.
Cognitive behaviour therapy focuses on changing negative patterns of thinking that result in repeated patterns of negative behaviour. A therapist challenges negative thoughts so that a person can learn new ways of responding to particular situations.
Interpersonal therapy looks at specific issues and explores relationships with other people.
Other talking therapies can help a person find new ways of dealing with specific problems. For example, a counsellor supports a person to find solutions, but does not tell them what to do.


Having good relationships, financial security, employment, a social life and the right home are all important to mental wellbeing. These can give a person with depression the resilience they need in stressful situations. The WLMHT care team will encourage a person to find ways to be part of their local community through, for example, employment, volunteering, education and social events.
Physical activity also boosts mental wellbeing. Depending on the severity of the symptoms, relaxation techniques and exercise can help. Joining a self-help group is another good way of finding support and advice from others experiencing similar anxieties.
The WLMHT care team likes to encourage a person to include carers and friends in their treatment, if appropriate. Having their support can be very helpful.


Antidepressants work by increasing the levels of the natural mood-enhancing chemicals present in the brain. Antidepressants increase these levels gradually and it can be at least two weeks before a person begins to experience improvements in their symptoms.
Antidepressants are usually taken for another four to six months after symptoms have eased. A person with a history of depression may continue to take them for up to five years, or longer.
Antidepressants are not addictive but mild withdrawal symptoms, such as stomach upsets and dizziness, are quite common if they are stopped suddenly, or a dose is missed.

Electroconvulsive therapy

The WLMHT may suggest this if antidepressants and talking treatments have not helped. It’s been shown to relieve severe depression.