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The three most common treatments for depression are psychotherapy, medication, and electroconvulsive therapy. Psychotherapy is the treatment of choice for people under 18, while electroconvulsive therapy is used only as a last resort. Care is usually given on an outpatient basis, whereas treatment in an inpatient unit is considered if there is a significant risk to self or others. Physical exercise is recommended for management of mild depression,[154] and has a moderate effect on symptoms.[155] It is equivalent to the use of medications or psychological therapies in most people.[155] In the older people it does appear to decrease depression.[156] Stopping smoking has benefits in depression as large as or larger than those of medications.[157] Treatment options are much more limited in developing countries, where access to mental health staff, medication, and psychotherapy is often difficult. Development of mental health services is minimal in many countries; depression is viewed as a phenomenon of the developed world despite evidence to the contrary, and not as an inherently life-threatening condition. |
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