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Rehab for Depression: What are my Treatment Options?

Most people think of rehab as a place you go to get treatment for substance use disorders. But did you know that many rehabs also treat mental health and mood disorders, like depression?

Many people seek help with mental health challenges at treatment centers every year, and may choose an inpatient, outpatient, or online format depending on their circumstances. While there’s no one formula for treating depression, choosing a rehab program that best suits your unique needs, values, and goals can help you ease distress and shift from surviving to thriving.

Depression is a serious mental health disorder that often requires professional help. If left untreated, it can worsen to a potentially unmanageable stage—and in some cases, it can be life-threatening. The Department of Health and Human Services discusses how depression increases the risk of suicide,1 with risk being proportionate to the severity of depression.

If you’re having thoughts about suicide or self-harm, contact the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255). Trained counselors are available for a confidential chat 24 hours a day.

In this article, we’ll explore signs of depression and examine your options for treatment:
when to consider getting professional help
types of rehab for depression
common approaches to treating depression

When is it Time to Seek Professional Help?

Depression affects over 40 million adults in the U.S.2 But sadly, it often goes undiagnosed and undertreated. Early detection and treatment of depression offers several benefits,3 including longer remission times and improved social skills.

It’s a good idea to consider getting professional help if you notice telltale signs of depression4 that persist for at least two weeks, as outlined by the U.S. National Institute of Mental Health (NIMH):

  • hopelessness or pessimism
  • irritability
  • continuous feelings of sorrow, worry, emptiness, or guilt
  • changes in appetite or weight
  • lost of interest and pleasure in activities you used to enjoy
    decreased energy
  • difficulty concentrating, remembering events, or making decisions
    difficulty sleeping or oversleeping

If you feel like depression is negatively impacting your day-to-day life, you have several options for treatment. This includes inpatient (residential) rehab, intensive outpatient programs (IOPs), partial hospitalization programs (PHPs), and teletherapy. Each treatment type presents unique benefits, which we’ll explore further below.

A qualified mental health professional can also help you determine which type of treatment is most beneficial for you.

Depression and Co-Occurring Disorders

Depression and other mental health conditions frequently occur alongside substance use disorders. According to the National Alliance on Mental Illness (NAMI), substance abuse is twice as prevalent among those who suffer from mental illness.5 This situation is referred to as having “co-occurring disorders” or a “dual diagnosis.”

Mental health conditions may cause people to turn to drugs or alcohol to relieve their symptoms temporarily—and it also works the other way around. Because alcohol and drugs alter brain chemistry, people may experience new or worsened mental health symptoms as a result of substance use. In these cases, successful recovery requires simultaneously treating each condition. Thankfully, many rehab centers specialize in co-occurring disorder treatment, giving patients the opportunity to sustainably address both issues.

Types of Rehab Programs for Depression

Inpatient Rehab (Residential Rehab)

Inpatient, or residential, rehab provides 24-hour clinical care in a secure environment, making it preferable for those who require a higher level of care, perhaps due to the severity of their depression.

This treatment format offers the opportunity to fully devote yourself to getting better for a period of time. If you haven’t had success with less intensive depression treatment programs, you might benefit from the highly structured schedule and immersive environment that inpatient rehabs offer.

Following are some indicators that residential rehab for depression may be the best treatment option for you:

Your depression is resistant to treatment. Treatment-resistant depression6 is defined as depression with symptoms that persist after standard treatment with 2 or more medications. Residential settings offer around-the-clock access to a team of mental health professionals working to learn what strategies work best in relieving your depression. Many residential programs also offer the opportunity to try holistic or complementary therapies that might be just what you need to learn effective coping skills and find relief.

You need a change of environment or perspective. Inpatient rehabs allow clients to break away from possible environmental triggers and focus solely on getting well. Specialized programming can also provide opportunities to try new therapies and activities. This, in turn, can lead to a shift in perspective7 that fosters positive thinking.

You’ve had serious thoughts of, or attempts at, suicide. If you’re thinking about or have attempted suicide,8 it’s vital to get intensive mental health treatment immediately. Because suicidality requires a higher level of care and enhanced safety protocol, only certain rehabs admit these patients.

For more information on suicidal ideation, see our article: What to do When Someone You Love is Suicidal.

Outpatient Programs

Outpatient depression rehab options include intensive outpatient programs (IOPs) and partial hospitalization programs (PHPs). With both of these approaches, clients return home each day after treatment. These programs allow you to work around your job, school, or childcare routines while devoting a set amount of time each week to progressing towards your treatment goals.

In a partial hospitalization program, you’ll spend a significant amount of time in treatment—usually ranging from 4 to 8 hours per day, 3 to 5 days per week. This option may be used as a bridge between residential and outpatient care, and is sometimes recommended as a way to reduce the recurrence of severe symptoms. Clients in PHPs can retain important aspects of their daily routines while receiving full-time care.

Intensive outpatient programs typically involve less clinical hours than PHPs, but are more intensive than simply attending therapy sessions on your own. In an IOP, clients attend treatment on a part-time basis for about 9 to 15 hours per week, with many centers offering evening and weekend schedules that cater to working adults. IOP sessions are often based on group therapy.9

Below are some benefits of non-residential programs:

Outpatient rehab is often more cost-effective than residential. The higher cost of inpatient rehab can be a barrier for some. Since outpatient programs are often less expensive, they can provide a more accessible (but still intensive) option for those who are concerned about cost or have limited insurance coverage.

You can keep up with daily responsibilities while receiving full- or part-time depression treatment. Many people have family, work, or school obligations they simply can’t leave behind for an extended period. With PHP and IOP options, clients can receive intensive depression therapy that works with their schedule and allows them to live at home.
Sometimes, however, severe depression symptoms prevent people from being able to keep up with their daily responsibilities. For others, factors in their home life may contribute to depressive episodes. In cases like these, it may be useful to step away from your usual patterns for a period of time to focus on getting well.

Outpatient rehab could be a good option if you have a positive home environment. Studies have shown that having a strong support system positively affects your mental health.10 If your biological or chosen family, partners, friends, or others in your community can reliably support your recovery journey, it may be helpful to choose a treatment format that will allow you to stay in contact with them.

Teletherapy

Teletherapy uses remote technology as the means of communication between the therapist and the client. This can include both 1-on-1 and group therapy sessions, attended by video conferencing, phone calls, or chat.

According to the mental health awareness nonprofit Mental Health America, “before the pandemic, studies had already shown that teletherapy is effective for many mental health concerns.”11 Since COVID-19, even more rehabs now offer remote treatment options.

Could teletherapy be an effective depression treatment option for you? Let’s take a look at some of its benefits.

Teletherapy is more affordable than residential rehab. In addition to lower program costs, you may be able to save in other areas like transportation and childcare. Having more convenient, regular check-ins with your therapist may also help you manage your symptoms better and thus save money by minimizing the need for more intensive care. One study of veterans who received treatment remotely showed that regular teletherapy helped reduce their healthcare expenses12 over the course of a year.

Teletherapy can help you stay on track during COVID-19 restrictions. Life during the pandemic has proven to be an ever-changing roller coaster of spikes, mandates, and restrictions. With teletherapy, these changes don’t have to mean a disruption to your treatment progress. You can continue to attend sessions safely from the comfort of home (or any location convenient to you). This can also help protect vulnerable individuals from exposure to illness.

Teletherapy can be a viable option if your depression is not too severe. If you’re able to function well enough to carry out your day-to-day tasks, and you feel safe and supported in your home environment, remote treatment may make sense as a way to increase convenience and reduce the costs associated with in-person care.

Common Approaches to Treating Depression

In general, medication and talk therapy are the most common first-line approaches to treating depression. And while there’s much debate about which of these is most effective, according to the American Psychological Association, “there is some evidence that combining psychotherapy and medications13 may be more effective than either treatment alone.”

Each person’s experience of healing from depression is different, and you may find that one, both, or neither of these treatments works best for you. That’s why it’s important to learn about the range of treatment methods that are available, so you can start to seek professional advice and check in with yourself about what makes the most sense for your life.

Medication

Your doctor or psychiatrist may prescribe one (or eventually, several) of a variety of antidepressant medications. These typically fall into one the following categories:

Selective serotonin reuptake inhibitors (SSRIs): These are the most commonly prescribed form of antidepressant, and include Fluoxetine (Prozac), Paroxetine (Paxil), Citalopram (Celexa), Escitalopram (Lexapro), and Sertraline (Zoloft). SSRIs work by increasing serotonin levels in the brain.

Serotonin and norepinephrine reuptake inhibitors (SNRIs): These affect serotonin and norepinephrine in the brain. SNRI medications include Venlafaxine (Effexor), Desvenlafaxine (Pristiq), and Duloxetine (Cymbalta).

Atypical antidepressants, such as Mirtazapine (Remeron) and Wellbutrin (Bupropion), are sometimes prescribed when SSRIs or SNRIs haven’t been effective.

While many of these have similar effects, they each have a unique profile, and side effects may vary from brand to brand. If you want to find out whether medication is right for you, your first step is to consult with a treatment professional. A qualified clinician can work with you to prescribe, monitor and manage your medication regimen and find out what most effectively relieves your symptoms.

Talk Therapy

Talk therapy, or psychotherapy, involves talking with a mental health expert about your depression and how it affects your life. This form of treatment can be very effective in helping you reduce depression symptoms and cope with them when they occur.

Cognitive-behavioral therapy (CBT) is among the most common forms of talk therapy used in clinical settings. “Cognitive” refers to thoughts, while “behavioral” focuses on the actions arising from those thoughts. CBT is founded on the premise that inaccurate or unhelpful thought patterns cause undesirable behaviors. It seeks to transform thinking to help people see an overall improvement in how they feel.

Dialectical behavior therapy (DBT) is based on CBT, but also incorporates mindfulness techniques to help people increase their tolerance of uncomfortable emotions and gain self-acceptance. Therapy sessions focus on identifying states of mind and teaching coping skills based on meditation practice.

Interpersonal psychotherapy (IPT) is a type of psychotherapy that focuses on enhancing function within interpersonal relationships to alleviate depressive symptoms. A key idea is that psychiatric symptoms might be thought of as a response to challenges in daily connections with others.

An abundance of other talk therapies are also used in depression treatment. When you enroll in a rehab program, you’ll start with an initial assessment and set goals with your therapist for the course of your treatment. Depending on the program you attend, different therapies may be available.

Holistic and Complementary Therapies

Complementary and holistic therapies are non-traditional treatment approaches that many rehabs employ alongside standard methods like psychotherapy. These can help clients discover aspects of themselves by providing opportunities to try new ways of thinking and being. As such, they can provide important personal insight in ways talk therapy alone may not be able to.
Examples of complementary treatment methods include:

  • mindfulness
  • behavioral activation
  • art therapy
  • music therapy
  • yoga
  • experiential and recreational therapies

Alternative Therapies for Treatment-Resistant Depression

Several rehabs are able to provide alternative treatment options that may be helpful when conventional methods are not effective. Some people find that they’re more responsive to alternative therapies for treatment-resistant depression14 where more conventional methods have failed. These might include the following:

  • transcranial magnetic stimulation (rTMS)
  • psychedelics such as ketamine-assisted therapy (KAT), ibogaine treatment, and psilocybin treatment
  • a combined approach that includes multiple methods

Lifestyle Changes

Small changes to your daily habits can have a big impact on how you feel. Along with professional treatment, research also shows that simple lifestyle changes can provide relief from depression symptoms.15 These can help you sustain remission after rehab, and may include the following:

  • regular movement and exercise
  • sleep hygiene
  • mood-supporting nutrition
  • spending time outdoors
  • cultivating social skills and relationships

An added benefit of residential treatment is that patients spend enough time in a recovery-focused setting to set a new cadence for their daily routines. Aftercare support specialists can also help to make sure you’re maintaining these changes when you return home.

In Times of Darkness, Professional Depression Treatment Offers Hope

There is no one-size-fits-all approach to treating depression. If you’re struggling with this disorder, the good news is that you have plenty of avenues to choose from. Your primary care physician, therapist, or personal support network can be a good starting point for identifying options and deciding which will serve you best.

If you’ve decided to get help for your depression, you’ve already made an important first step. To learn more about depression rehabs and see program information, reviews, facilities, and more, visit our directory of depression treatment programs here.

Reviewed by Rajnandini Rathod

 

  1. Division (DCD), D. C. (2013, February 9). Does depression increase the risk for suicide? HHS.Gov. https://www.hhs.gov/answers/mental-health-and-substance-abuse/does-depression-increase-risk-of-suicide/index.html []
  2. Facts & statistics | anxiety and depression association of america, adaa. (n.d.). https://adaa.org/understanding-anxiety/facts-statistics []
  3. Aron Halfin, M. D. (2007). Depression: The benefits of early and appropriate treatment. https://www.ajmc.com/view/nov07-2638ps092-s097 []
  4. Depression. (n.d.). National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/topics/depression
    []
  5. Understanding dual diagnosis | nami: National alliance on mental illness. (n.d.). Retrieved February 1, 2022, from https://www.nami.org/Blogs/NAMI-Blog/October-2017/Understanding-Dual-Diagnosis []
  6. Little, A. (2009). Treatment-resistant depression. American Family Physician, 80(2), 167–172. https://www.aafp.org/afp/2009/0715/p167.html []
  7. Blaschka, A. (n.d.). If you want to change your life, change your environment. Forbes. https://www.forbes.com/sites/amyblaschka/2018/09/27/if-you-want-to-change-your-life-change-your-environment/ []
  8. Home. (n.d.). https://suicidepreventionlifeline.org/ []
  9. Treatment, C. for S. A. (2006). Chapter 4. Services in intensive outpatient treatment programs. Substance Abuse and Mental Health Services Administration (US). https://www.ncbi.nlm.nih.gov/books/NBK64094/ []
  10. Harandi, T. F., Taghinasab, M. M., & Nayeri, T. D. (2017). The correlation of social support with mental health: A meta-analysis. Electronic Physician, 9(9), 5212–5222. https://doi.org/10.19082/5212 []
  11. Teletherapy during covid-19: What the research says. (n.d.). Mental Health America. Retrieved February 1, 2022, from https://mhanational.org/teletherapy-during-covid-19-what-research-says []
  12. Walker RJ, Acierno R, Frueh BC, et al. Cost-effectiveness of Behavioral Activation for Depression in Older Adult Veterans: In-Person Care Versus Telehealth. The Journal of Clinical Psychiatry. 2018:79(5). https://www.researchgate.net/publication/327271527_Cost-Effectiveness_of_Behavioral_Activation_for_Depression_in_Older_Adult_Veterans_In-Person_Care_Versus_Telehealth []
  13. How do i choose between medication and therapy? (n.d.). Https://Www.Apa.Org. Retrieved February 1, 2022, from https://www.apa.org/ptsd-guideline/patients-and-families/medication-or-therapy []
  14. Yoon, R. S. Y., Ravindran, N., & Ravindran, A. (2018). Complementary and alternative therapies for treatment-resistant depression: A clinical perspective. In K. Shivakumar & S. Amanullah (Eds.), Complex Clinical Conundrums in Psychiatry: From Theory to Clinical Management (pp. 123–142). Springer International Publishing. https://doi.org/10.1007/978-3-319-70311-4_12 []
  15. Sarris, J., O’Neil, A., Coulson, C. E., Schweitzer, I., & Berk, M. (2014). Lifestyle medicine for depression. BMC Psychiatry, 14, 107. https://doi.org/10.1186/1471-244X-14-107 []

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