A curated menu of treatments for depression

A structured, skill-building approach. CBT challenges automatic negative thoughts and reframes cognitive distortions, paired with behavioral activation. It remains the most replicated psychotherapy in the literature for depression.

A simpler, more approachable treatment distilled from CBT — re-engaging with pleasurable and meaningful activities to interrupt the cycle of withdrawal. Deceptively simple, and remarkably effective.

Focuses on grief, role transitions, interpersonal disputes, and social isolation — the social roots of mood. Tends to produce lasting improvement in relationship quality alongside symptom relief.

Rather than fighting difficult thoughts, ACT teaches psychological flexibility — holding pain lightly while moving toward what matters. Particularly suited to those for whom symptom-elimination approaches have not stuck.

The standard first-line medication. Selective serotonin reuptake inhibitors offer a reliable, well-tolerated baseline with a mild onset — allow 4–6 weeks for full effect. Best chosen and adjusted with a prescribing physician.

A dual-action option — both serotonergic and noradrenergic. Slightly broader than SSRIs, with particular utility when depression is accompanied by anxiety or chronic pain.

Distinctly energizing, working through dopamine and norepinephrine rather than serotonin. Notably without the sexual side effects common to SSRIs. Often chosen for fatigue-predominant depression and for those concerned about weight gain. Also carries a smoking-cessation indication.

A distinct mechanism — blocking alpha-2 autoreceptors to increase both norepinephrine and serotonin, with strong antihistamine sedation. Particularly suited to depression with insomnia, poor appetite, or weight loss. No sexual side effects; weight gain is a common trade-off.

Not a standalone treatment — an augmentation strategy for those with a partial response to an antidepressant. Low doses are added to an existing regimen to boost effect. Quetiapine is also sedating; aripiprazole and brexpiprazole tend to be more activating and weight-neutral. Metabolic monitoring is recommended.

The most underordered item on the menu. Aerobic exercise raises BDNF, endorphins, and serotonin in a single intervention. For mild-to-moderate depression it is comparable to antidepressants, with no prescription required.

An option for treatment-resistant depression. Magnetic pulses stimulate the left dorsolateral prefrontal cortex, rekindling circuits dimmed by depression. No systemic side effects; FDA-cleared and increasingly available. Pairs well with ongoing therapy.

The most powerful option on the menu, reserved for treatment-resistant, severe, or psychotic depression. Modern protocols administered under anesthesia look very different from the procedure’s historical reputation. Unmatched response rates when other treatments have been exhausted.

An essential foundation that conditions every other option on the menu. Consistent sleep timing, darkness, and a calm wind-down rhythm restore circadian regulation often disrupted by depression.

A CBT–meditation fusion developed specifically for recurrent depression. Especially effective for relapse prevention, and recommended for those with three or more prior episodes.

Particularly suited to seasonal depression (SAD). Morning exposure to 10,000-lux lamps recalibrates the circadian clock and suppresses morning melatonin. Rapid onset and minimal side effects.