Best medication for major depressive disorder and generalized anxiety disorder

Key takeaways:

• Clinical depression — officially called major depressive disorder — is one of the most common mood disorders.

• There are many different treatment options for depression, including therapy and medication.

• Depression can be successfully treated, and it’s important to seek care if you are experiencing symptoms.

Table of contents

Clinical depression (also called major depressive disorder or depression), is one of the most common mental health conditions. Over the course of a lifetime, it is estimated that 20% of people will experience depression. 

Depression can impact all parts of your life — including your physical health, your close relationships, and your job. Importantly, depression can be treated so your symptoms stay well-managed. 

This guide provides an in-depth look at the treatment options for depression, including medications and therapy. We’ll also look at other treatment options when those are not enough.

Depression is a serious mood disorder that can cause many symptoms, including feelings of numbness, emptiness, and sadness. It can cause withdrawal from normal activities and impact close relationships, school, and work. 

It’s normal to have feelings of sadness sometimes — but major depressive disorder is much more than that. It impacts your daily life and can lead to serious symptoms like self-harm or suicide. 

What are the symptoms of major depression?

Symptoms of depression may include several of the following. To be diagnosed as clinical depression, you need to experience these symptoms for at least 2 weeks:

• Feelings of sadness, emptiness, or anxiety

• Irritability

• Feelings of guilt or hopelessness

• Loss of interest in activities you used to enjoy

• Appetite changes and weight gain or weight loss

• Difficulty sleeping or sleeping more than normal

• Feeling tired or lack of energy

• Feeling worthless

• Difficulty concentrating or memory problems

• Having thoughts of suicide or thinking you would be better off dead

Some people also experience unexplained physical discomfort or pain as a result of depression. Physical depression symptoms can be more common in some cultures. 

What types of therapy can be used for depression?

Psychotherapy can be an essential part of treatment for major depression. It may be used on its own or together with antidepressant medication. Psychotherapy may help within a few weeks. Or, it can take longer depending on your situation. 

There are different types of psychotherapy that can help treat depression. The right one for you will depend on different factors. Some types of therapy shown to be effective for depression are:

• Cognitive behavioral therapy (CBT): CBT helps you identify and change negative thinking and behavioral patterns that can affect how you feel.

• Interpersonal therapy (IPT): IPT is another form of therapy for depression that focuses on improving your relationships with other people.

When it comes to a therapist, it’s important to find the right fit for you. There are different ways to find a therapist, such as searching online or asking for recommendations. There are also many teletherapy options. 

In some cases, therapy may include other people. For example, some may benefit from doing family or couples therapy to improve those relationships. Group therapy may help you connect with others going through similar experiences. 

What medications can be prescribed for depression?

There are many antidepressant medications to treat depression. You and your provider will work together to find a medication or combination of medications that reduce your symptoms. The types of medications used to treat depression include:

• Selective serotonin reuptake inhibitors (SSRIs) such as escitalopram (Lexapro), fluoxetine (Prozac), and sertraline (Zoloft). These are usually the first-choice medications for depression.

• Serotonin and norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta), venlafaxine (Effexor), and desvenlafaxine (Pristiq). These may be helpful when people also have chronic pain.

• Serotonin modulators like trazodone. This can also help with sleep difficulties.

• Atypical antidepressants like mirtazapine (Remeron) and bupropion (Wellbutrin). These may be used on their own or in addition to SSRIs or SNRIs.

• Mood stabilizersand atypical antipsychotics may sometimes be added to support other antidepressants (such as SSRIs or SNRIs). Your provider may recommend these if you’re not getting enough relief from an antidepressant alone. 

• Tricyclic antidepressants (TCAs) such as amitriptyline (Elavil), nortriptyline (Pamelor), or doxepin (Sinequan). These are older antidepressants and less commonly used due to their side effects. But for some people, TCAs may be the right medication, particularly when there is also insomnia or chronic pain.

• Monoamine oxidase inhibitors (MAOIs) such as phenelzine or selegiline. These are less commonly used as they tend to have more side effects, and an overdose can cause death.

Sometimes a medication won’t be helpful enough at first, or it may have side effects you don’t like. But it’s a good idea to give the medication enough time to see if it works for you. It may take up to 8 weeks to see symptoms improve on medication. 

Antidepressant medications should not be stopped abruptly. This can sometimes lead to discontinuation symptoms like nausea, headaches, trouble sleeping, and dizziness. Talk to your provider if you’re considering stopping your medication — they can help you create a plan.

Importantly, depression medications have the potential to worsen suicidal thoughts, particularly in young people (children or teens) or those with bipolar disorder. If this happens, seek emergency help. Call the National Suicide Prevention Lifeline at 1-800-273-8255 or text HOME to 741-741 to reach the Crisis Text Line. 

What treatments are available for ‘treatment-resistant’ depression?

Sometimes, antidepressant medication and therapy don’t work well enough. People may not improve even after trying different medications. This is sometimes called “treatment-resistant” depression or refractory depression. It may occur in up to 30% of people with depression. 

But treatment-resistant depression doesn’t mean you’re out of options. There are additional treatments available, including:

• Transcranial magnetic stimulation (TMS), which uses a magnet to stimulate particular areas of the brain to reduce depression symptoms

• Ketamine or esketamine (Spravato), which may be an option for depression when other treatments don’t help enough

• Other brain stimulation treatments such as electroconvulsive therapy (ECT), vagus nerve stimulation, magnetic seizure therapy, and deep brain stimulation

There are new-wave treatments that may grow in use over time, such as psilocybin (commonly known as magic mushrooms). This is a psychedelic compound that shows some promising benefits in treating depression. It’s not available to try everywhere yet.  

There may also be opportunities to join a clinical trial that’s researching depression treatments. This would give you the chance to contribute to science while also trying new medications that could be effective for depression. 

What’s the difference between inpatient and outpatient depression treatment?

Most commonly, major depression will be treated in an outpatient or office setting. You’ll regularly visit your provider in their office or via telehealth while being treated with medication and therapy. Outpatient care is generally flexible and lower cost. 

However, sometimes your depression may be severe and require more intensive treatment. Some examples of additional treatment options include:

• Intensive outpatient programs (IOP), where you commute to a treatment program a few days per week or for several hours each day

• Partial hospitalization programs (PHP), where you have longer and more structured treatment days at a clinical or treatment center but still live at your home

• Inpatient programs, where you live at a facility — such as a hospital or residential center — for the length of your treatment program

Each intensive outpatient or inpatient program will have its own structure. An IOP or PHP program might last for 30 days and require 5 to 8 hours of your time each day. Your provider will outline what you can expect. 

A stay at the hospital for inpatient treatment might last 72 hours or several days. Or you may go to a crisis residential treatment center, where you have more flexibility compared to a locked mental health hospital. 

What natural treatments can help for major depressive disorder?

Some natural and over-the-counter supplements may help for depression. It’s important to note that while these may help some mild forms of depression, they likely will not be effective in treating major depression. 

• St. John's wort is an herb that may be effective for depression, but it has side effects and medication interactions to discuss with your healthcare provider.

• Omega-3 fatty acids are important for brain health, and some studies have suggested that taking omega-3 may help with depression.

• SAM-e, or S-adenosyl-L-methionine, may increase neurotransmitters like serotonin and dopamine. This could help manage depression, but larger studies are needed.

• Light therapy may be helpful, especially for situational depression such as seasonal affective disorder.

It’s important to discuss natural remedies for depression with your healthcare provider. Over-the-counter supplements may have side effects or interact with your other medications. 

What lifestyle changes might help treat major depressive disorder?

There are some important lifestyle changes and daily habits that can help manage your depression symptoms. These include: 

• Exercise: Exercise can help reduce depression symptoms, especially in addition to medication. Keep in mind exercise can be anything from a walk around the block to playing basketball in your driveway.

• Healthy diet: A healthy diet full of fruits and vegetables may help with depressive symptoms. It’s especially important to get enough vitamins and minerals, including vitamin B12, folate, and magnesium.

• Sleep: Most people with depression have sleep difficulties. Focusing on getting enough quality sleep is an important part of treating depression. 

What’s the prognosis like for someone with depression? Can it be cured?

Most people do recover from major depression with treatment. But it’s important to note that you may not respond to your first treatment. About 50% of people recover from their first episode of depression. But depression will recur in 35% of people, and about 15% will have ongoing symptoms.

If you have symptoms of depression, it’s important to seek treatment as early as possible. Untreated depression can lead to further issues, including: 

• Social isolation

• Substance misuse 

• Physical health problems

• Relationship challenges

• Thoughts about death or suicide

• Higher risk for additional depressive episodes

Depression is a chronic condition — it’s not a type of illness that can be “cured.” The goal of depression treatment is to manage your symptoms and go into “remission.” In remission, your depression symptoms no longer get in the way of your daily life.  

Where can you find healthcare providers for depression treatment?

If you think you may have depression, reach out to a healthcare provider. You can start with your primary care provider (PCP). They might be able to provide a referral to a qualified mental health professional. 

If you don’t have a PCP, or aren’t sure where to start, ask friends and family for recommendations. If you are covered by health insurance, use your plan’s provider directory to look for mental health providers in your area.   

You can also start your search for mental health professionals online. Many providers offer either in-person or telehealth appointments. Check out the following databases: 

• Good Therapy

• Therapy Den

• Psychology Today

• QPoC Therapist Directory

• Gaylesta (LGBTQ therapists)

• InnoPsych (BIPOC therapists)

• Open Path Psychotherapy Collective (low-cost therapy)

You can also call SAMHSA for more resources near you at 1-800-622-HELP (4357). The National Alliance on Mental Illness (NAMI) also has a helpline you can call at 1-800-950-NAMI (6264).

The bottom line

Depression is one of the most common mental health conditions. It will likely impact you or someone you love at some point in your life. While it may be scary or overwhelming to seek help for depression, it’s important to know that many treatment options are available. Not only are there many medications, but there are also non-medication options and therapies that can help. Depression is treatable, and many can achieve remission and are symptom-free. 

If you or someone you know is having thoughts of suicide, you’re not alone and help is available. Call the National Suicide Prevention Lifeline at 1-800-273-8255 or text HOME to 741-741 to reach the Crisis Text Line. 

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GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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