Information for the public
How can I stay well in the future?
If an antidepressant has helped you, your healthcare professional should encourage you to continue taking it for at least 6 months after you feel better. This reduces the risk of your depression coming back. They should then discuss with you whether you need to stay on medication after this.
If you are at risk of becoming unwell again, or you have had depression several times in the past, your healthcare professional should advise you to continue taking antidepressants for at least 2 years. They should discuss with you whether you need to stay on medication after this. Depending on your preference and what treatments you have tried in the past, they should also discuss other possible options with you, including taking another medicine in addition to your antidepressant or having CBT.
If you have had depression several times in the past, and have found current treatment with an antidepressant and a second medicine to be helpful, your healthcare professional should advise you to continue to take this combination of medicines, as long as you are not having distressing side effects. If one medicine is stopped, it should be the second one. If you are offered lithium to help you to stay well, it should usually be in addition to an antidepressant, because healthcare professionals are not sure how well lithium works on its own for people with depression.
Psychological treatments can help you to stay well if there is a risk your depression may come back. You should be offered one-to-one CBT (see table, psychological treatments for depression) if you become unwell again or if your depression has improved but you still have some symptoms. You should be offered a treatment called mindfulness-based cognitive therapy if you are currently well but have had three or more episodes of depression in the past. This treatment usually takes place in groups and consists of eight weekly sessions lasting 2 hours each. A further four sessions may be offered in the 12 months after the end of treatment.
Information for families and carers
Families and carers can play an important part in supporting a person with depression, particularly if their symptoms are severe. If your family member or friend has depression, their GP or other healthcare professional should ask them whether they would like you to be involved in their care.
If your family member or friend agrees, you should be given information on depression and on how you can support them throughout treatment.
You can help your family member or friend by watching out for any negative thinking, changes in behaviour (such as avoiding social activities and contact with other people, or not looking after themselves properly), hopelessness, changes in mood and thoughts about suicide they may be experiencing. This is particularly important during very stressful periods or when their treatment is just starting or being changed.
As a carer, you may need help and support yourself. Healthcare professionals should give you information about local family and carer support groups and other voluntary organisations, and help you to make contact with them. Anyone with a caring role has the right to a carer's assessment.
Questions for families and carers
How can I support a person with depression?
Can you provide any information about depression?
What should I do if I am concerned about my family member or friend?
What support is available for family members and carers of a person with depression?
Are there any local family or carer support groups?