Do I Need Medication for Depression?

I'm a generally happy person and fairly active, but I've recently been feeling depressed. Is there anything I can do to fight depression without medication or going to a doctor?

Gail Saltz, M.D.

Gail Saltz, M.D.

Psychiatrist, columnist, bestselling author, and television commentator Gail Saltz, M.D., has been called "a voice of wisdom and... Read more

There are definitely ways to fight depression without going on medication. Whether or not you should take medication has a lot to do with the severity of your symptoms. Studies show that medication isn’t really all that effective for mild to moderate depression. It is however, effective for moderate to severe depression. Additionally it is important to know that depression has a 15 percent mortality rate, meaning that as many as 15 percent of people with depression will commit suicide. If you are having substantial symptoms such as thoughts of harming or killing yourself, or even the feeling that life is not worth living then you MUST be seen by a psychiatrist immediately and you likely will need medication. Other symptoms of moderate to severe depression include troubling sleeping, lack of appetite and feeling like you don’t enjoy anything and can’t concentrate to the point that your functioning is impaired. You should be evaluated and will need to consider medication.


If, however, your symptoms are milder you find you feel sad, tired, unmotivated or irritable, you can definitely consider a drug-free approach. Exercise has been found to be very effective for mild to moderate depression because it can make a substantial difference in your mood. This doesn’t mean a stroll around the block; it means at least a half hour of vigorous exercise to get your heart rate up. Engaging in energizing tasks, such as social outings, volunteering or anything that relaxes you can also lift your mood.


Going a step further, many types of psychotherapy are extremely effective for depression, ranging from cognitive behavioral types (examining your irrationally sad thoughts in an attempt to correct them to be consistent with reality) to psychodynamic types (understanding what internal conflicts and past experiences lead to developing this sadness). Talk to your family and friends so you feel supported and understood.


Specific deep breathing techniques have been found to be effective for mild to moderate depression. This has to be learned by either taking a course or getting a special CD that teaches you how to do this deep rhythmic breathing. I recommend Respire-1 by Coherence.


For people whose depression has a seasonal component (meaning happens the same time each year) may benefit from light therapy, which is a special light box or bulb that you sit in front of for a prescribed amount of time each day.


If you think you are depressed and aren’t able to motivate to try any of these things, then you really do need to see a doctor. Depression is a treatable disease that if left untreated can really do harm.