Clinical Psychology
and Psychotherapy

Clinical Psychology and Psychotherapy

Depressive Disorders: Treatment


The treatment of depressive disorders is based on the symptoms of the patient and the severity of the symptoms. Important components are psychotherapy and pharmacotherapy. Depending on the symptoms also complementary methods such as light therapy, sleep deprivation, or sports and exercise therapy are used.

For some patients and their families participating in a support group or group therapy may be helpful.

In very severe, treatment-resistant depression may brain stimulation techniques such as electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation, transcranial magnetic stimulation, vagus nerve stimulation or deep brain stimulation be an therapeutic option.

Mild depressive episode

In an initial, mild depressive episode it is an option - when it is likely that the symptoms subside without specific therapy due to the surrounding conditions and the resources of the patient - to await the further course for a few days. If the symptoms persist after two weeks or continue to worsen, a treatment should be initiated.

Psychotherapy is often the preferred treatment method. Pharmacotherapy for mild depressive episodes is only recommended, if it is the particular desire of the patient, if the patient has responded well to a history of drug treatment, if the symptoms continue after other interventions or if the patient has a history of episodes of moderate or severe depression (cf. APA 2010, DGPPN 2009, NICE 2009).

Moderate depressive episode

For the treatment of acute moderately severe depressive episodes psychotherapy OR pharmacotherapy is recommended. Psychotherapeutic approaches include the cognitive-behavioral therapy ("behavior therapy") and the psychodynamic therapy (cf. APA 2010, DGPPN 2009, NICE 2009).

Major depressive episode

For the treatment of major depressive episodes the combination of  psychotherapy AND pharmacotherapy is recommended (cf. APA 2010, DGPPN 2009, NICE 2009).

Very severe, treatment-resistant depression

In the case of a very severe, treatment-resistant depression, who has not responded to treatment with psychotherapy and psychotropic drugs, electroconvulsive therapy may be helpful. Since the electroconvulsive therapy is performed under general anesthesia, the contraindications for anesthesia have to be considered (cf. APA 2010, DGPPN 2009, NICE 2009).

© Sandra Elze, M.D. & Michael Elze, M.D.
Prien am Chiemsee / Rosenheim,


Further Reading...


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Depressive Disorders: Treatment

Bajbouj M, Heuser I (2005). Antidepressive Stimulationsverfahren Vagusnervstimulation, repetitive transkranielle Magnetstimulation und Elektrokonvulsionstherapie zur Behandlung depressiver Störungen. Nervenarzt  76 (1): 28-35.
Abstract >>

Depressive Disorders: Guidelines

American Psychiatric Association - APA (2010). Practice Guideline for the treatment of patients with major depressive disorder. 3rd edition. Arlington: APPI.

DGPPN, BÄK, KBV, AWMF, AkdÄ, BPtK, BApK, DAGSHG, DEGAM, DGPM, DGPs, DGRW (Hrsg) für die Leitliniengruppe Unipolare Depression (2009). S3-Leitlinie/Nationale VersorgungsLeitlinie Unipolare Depression - Kurzfassung, 1. Auflage. Berlin, Düsseldorf: DGPPN, ÄZQ, AWMF.
Online-Version >>

National Institute for Health an Clinical Excellence - NICE (Hrsg) (2009). Depression - The treatment and management of depression in adults. Clinical guideline 90. London: NICE.
Online-Version >>

National Institute for Health an Clinical Excellence - NICE (2003). Guidance on the use of electroconvulsive therapy. Technology Appraisal Guideline 59. London: NICE.
Online-Version >>


Depressive Störungen: Therapie  Depressive Disorders: Treatment  Depressive Disorders: Treatment

© Sandra Elze, M.D. & Michael Elze, M.D.
Prien am Chiemsee / Rosenheim,


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© Sandra Elze, M.D. & Michael Elze, M.D.
Prien am Chiemsee / Rosenheim,
Last updated: 03-24-2016

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