Treatment for depression

Psychological therapy for adults aged 18 and over

If you have an episode of depression you should be offered a psychological therapy. This should be either:

  • a therapy specially designed to treat bipolar disorder or

  • a therapy recommended in the NICE's guidance on depression, such as cognitive behavioural therapy (often called 'CBT' for short), interpersonal therapy or behavioural couples therapy. (See other NICE guidance for details of our guidance on depression.)

Psychological therapy for young people aged 13 to 17

You should be offered a psychological therapy lasting for at least 3 months, either one‑to‑one cognitive behavioural therapy (often called 'CBT' for short) or interpersonal therapy.

If this hasn't helped you after 4–6 weeks, your doctor should review your treatment and may offer to change your therapy to a different kind. If you also have another mental health problem they may offer you another psychological therapy especially for that problem.

If your depression is making your everyday life very hard, your doctor may offer you medication to take at the same time as you have psychological therapy.

Medication

NICE recommends the medication described in this section for adults aged 18 and over. It may also be offered to young people aged 13 and over. Young people should not usually take an antipsychotic for more than 3 months.

For more details about medication for young people and adults, see taking medication

If your depression is making your daily life very difficult, and you are not taking medication to treat your bipolar disorder, you should be offered fluoxetine (an antidepressant) together with olanzapine, or quetiapine on its own, depending on your preference and any experience you have had taking these medications in the past. If these medications don't work you may be offered lamotrigine on its own.

If you prefer, you may be offered either olanzapine without fluoxetine, or lamotrigine on its own.

If you are already taking lithium or valproate, your doctor should check your dose and increase it if necessary. They may also offer you fluoxetine together with olanzapine, quetiapine or lamotrigine, to take along with your lithium or valproate.

When your depression has improved

Your care team should discuss with you whether to continue your psychological therapy or medication for another 3 to 6 months.

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