Depending upon the causes of your depression, you and your therapist will decide what approach will be most effective for you. All licensed therapists are trained in a particular approach, and some therapists are skilled in more than one. You may choose to try cognitive behavioral therapy, interpersonal therapy, or psychodynamic therapy, all of which are described in this section.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT), which is usually done on an individual and not a group basis, has proven to be very helpful in treating depression. The National Institute for Mental Health's Science Update from May 2007 reports that for those who were unsuccessful in treating depression with an antidepressant medication, switching to or adding CBT is generally as effective as switching to or adding another medication. You'll read more about CBT in a later chapter of the same name.

If you choose CBT as a treatment option, you can expect weekly therapy sessions that are supplemented with practice exercises you do on your own.

Interpersonal Therapy

Interpersonal therapy (IPT) is frequently used to treat depression. When you are depressed, you aren't able to relate to others as well as you did before depression set in. IPT helps you reach out beyond yourself, and ending those feelings of isolation. You'll work on communication skills, appropriate expression of feelings, and learn how to speak up for yourself so you get what you need. Another goal of IPT is to help diffuse conflict.

Psychodynamic Therapy

“How did you feel about that?” asks the psychiatrist, as the patient reclines on the couch, reaching deep inside to pull out the situation that started his downhill slide into depression. That's the Hollywood image of psychodynamic therapy, also known as psychoanalysis. It's been the basis of more than one movie — the most recent being Analyze This and Analyze That with Robert DeNiro as the conflicted mobster and Billy Crystal as the long-suffering but empathetic shrink.

This sort of pseudo-psychiatry has been the subject matter of all kinds of jokes and parodies. These portrayals do not represent the way this kind of therapy really works. In psychodynamic therapy, you and your therapist will work together to find the unconscious processes that are shaping your behaviors.

Psychotherapy

In general, psychotherapy involves talking about how you're feeling. In fact, it's often called “talk therapy.” Your therapist is there to guide you and help you. How you feel affects how you act. When you are feeling better, you are able to interact more positively with those around you, be they family, friends, or work associates. Your therapist guides you on your journey to sort out what's important from what's not. Then, you'll get an action plan to help you act on what you've learned.