Introduction
If I were a medical advocate for an adult family member who has been diagnosed with depression, I would look at several different ideas on how to help that particular family member. In this article, I am going to look at various treatments that can be used for depression, such as medication, alternative remedies, therapies, and other possibilities. I will discuss some of the questions I would ask the doctor regarding the medications he was considering using. Then I will take a look at one medication that is used to treat depression. Finally, I will discuss what my decision for this family member would be and why.
Treatments For Depression
Monoamine Oxidase Inhibitors
Various treatments are used to treat major depression. Monoamine Oxidase (MAO) inhibitors help to block the reuptake of serotonin and norepinephrine. Monoamine Oxidase is an enzyme involved in the removal of these two neurotransmitters from the brain, so when this enzyme is inhibited, these neurotransmitters can become more active. MAOs are effective but can be rather dangerous, and a change in diet may be necessary in order to prevent heart trouble (Mayo Clinic, 2025a).
Tricyclic Antidepressants
Another class of drugs that are used to treat depression are called Tricyclic antidepressants. These medications seem to help certain people who other medications do not help. Like MAOs, they are serotonin and norepinephrine agonists in that they block the reuptake of these neurotransmitters. These medications are overall less risky than MAO inhibitors (Mayo Clinic, 2025b). It is questionable how effective Tricyclic antidepressants are on teenagers and children, as one experiment demonstrated that they are no more effective than placebos (Sommers-Flanagan & Sommers-Flanagan, 1996). It is questionable how effective Tricyclic antidepressants are on teenagers and children, as one experiment demonstrated that they are no more effective than placebos (Sommers-Flanagan & Sommers-Flanagan, 1996).
Specific Serotonin Reuptake Inhibitors (SSRIs)
Specific serotonin reuptake inhibitors (SSRIs) are generally a more popular choice for treating depression today. Some of these medications are fairly well known, such as Prozac and Paxil. They are used to treat both moderate and unipolar depression and are generally safe with few side effects. These medications are considered to be serotonin agonists as they block the reuptake of serotonin (Mayo Clinic, 2025c).
Serotonin and Norepinephrine Reuptake Inhibitors (SNRI)
Serotonin and Norepinephrine Reuptake Inhibitors (SNRI) affect the same neurotransmitters as Tricyclic antidepressants but with fewer side effects. They have fewer side effects because they have fewer nonspecific actions (Carlson 2008, pp 473).
S-adenosylmethionine (SAMe)
Some natural remedies may help with depression. One of these remedies is S-adenosylmethionine (SAMe). Studies that have been done on this medication seem to indicate that it is more effective in treating depression than a placebo. This may be due to being a serotonin agonist. It also has a lower risk of side effects than most prescribed medications. Unfortunately, not enough studies have been done to prove its effectiveness (University of Maryland Medical Center).
5-Hydroxytryptophan (5-HTP)
Some use a 5-Hydroxytryptophan (5-HTP) supplement to help ease depression, and studies have been done to verify this, although more high-quality studies still need to be done. 5-HTP is actually what tryptophan converts to before it becomes serotonin. However, unlike serotonin, it is able to cross the blood-brain barrier. There have been noted risks if 5-HTP is taken with other prescription antidepressants, and there haven’t been enough studies done to determine other possible side effects of 5-HTP (Wikipedia 2025a).
Omega 3 Fatty Acids
A large study has revealed that Omega 3 fatty acids may be helpful in treating those with unipolar depression as long as it isn’t accompanied with an anxiety disorder (Centre hospitalier de l’Université de Montréal, 2010). Omega-3 appears to be another serotonin agonist as it helps serotonin to flow more freely throughout the brain. Many Omega 3s can be derived from various foods such as fish and flaxseed, and they can be taken as a supplement (Johnson, 2010).
Transcranial Magnetic Stimulation
A similar method to ease depression, called transcranial magnetic stimulation (TMS), is used and is less risky than ECT. This is where a coil of wire is placed on the scalp, and a magnetic field is produced that produces an electrical current that goes to the brain. The downfalls of this treatment are that it may be painful for the scalp and can elicit seizures when it is repeated with high frequency (Carlson 2008, pp. 475).
Vagus Nerve Stimulation
Stimulation of the vagus nerve may help those who have depression that is not very easy to treat. To use this method, a pulse generator is put into the chest, and a wire that is attached to it is threaded under the skin and attached to where the left vagus nerve is located on the neck. Electrical signals are sent through the vagus nerve to the brain. This method isn’t effective with most people, but it does help some. It is also an expensive method that generally isn’t covered by insurance. Side effects are generally rare, but they are possible, such as heart problems, damage to the vagus nerve, and breathing problems, among other things (Mayo Clinic, 2025d).
Sleep Deprivation
Another treatment for depression is deprivation of REM sleep. Like most medications, this usually starts to show effects over the course of a few weeks. One advantage of this method is that it seems to have lasting effects once the deprivation is discontinued. This method may also speed up the effects of antidepressant medications (Carlson 2008, pp. 481-482).
Exercise
Exercise has been shown to help decrease the symptoms of depression. This is because it releases feel-good chemicals such as endorphins, reduces some immune system chemicals that may affect depression, and warms the body, creating a calming effect. It can also boost self-esteem, help one become more socially active, and ease stressful thoughts. There are many other health benefits that come from exercise, but there are also risks, such as injury and heart failure, if one doesn’t take proper precautions. One disadvantage of using this method is that many people with unipolar depressive disorder severely lack motivation and may have trouble getting started with an exercise program (Mayo Clinic, 2025e).
Therapy
Anyone who struggles with unipolar depression should receive therapy for help. One style of therapy that is often beneficial is cognitive-behavioral therapy (CBT). This therapy can help retrain one’s thinking about oneself and one’s surroundings. Irrational thoughts can play a part in increasing depression, such as “I am a total failure because I didn’t do well on this test.” In CBT, the therapist will help the patient dispute such agonizing thought processes. Other techniques may be given as homework, such as reading, recording certain thoughts as they occur, meditation exercises, among other things, to help improve the patients’ thought processes. There are many advantages to this, such as there are no side effects, it has been shown to be effective, and insurance companies often help cover the cost (Corey 2009, p. 282).
Questions For The Doctor
There are many questions that I would ask about the various drug therapies. First, I would ask how certain drugs affect neurotransmitters. Many antidepressant drugs seem to be serotonin agonists, but I would ask what other neurotransmitters are possibly affected. I would also ask if it could be risky to use natural supplements such as Omega 3s or 5-HTP alongside the medications. I would be concerned about the long-term effects that the drugs could have on the brain, so I would ask if there was a risk of the make-up of the brain being changed.
If the person who is being treated takes other substances regularly, such as alcohol or illegal drugs, I may ask what kind of effects antidepressant medications will have along with the use of these drugs. I would also like to know in what areas of the brain the drugs are affecting. If a drug is prescribed, I would like to know what other methods could be used to enhance the drug’s effectiveness, such as partial sleep deprivation, diet, and/or sun exposure. I would make sure to ask the obvious questions about side effects and what to do when an unwanted side effect occurs. I would like to know how the drugs would affect cognitive abilities such as memory and clear thinking. Another important question to consider is how addictive the drug is and how this addiction can be broken if necessary.
Wellbutrin
I am going to take a look at Wellbutrin (bupropion hydrochloride). This antidepressant differs from many other antidepressants because it doesn’t fall under the categories of Tricyclic antidepressants and SSRIs. Rather, it seems to be more chemically related to phenylethylamines. It is thought to be a dopamine-norepinephrine reuptake inhibitor with its primary behavioral effects related to the norepinephrine (Wikipedia 2011). It is used to treat major depressive disorder and has been shown to be effective in three placebo-controlled studies. However, controlled studies have not shown the effectiveness of long-term use.
Wellbutrin should not be used in people who are susceptible to seizures and should be administered in a way that will minimize such things as insomnia, agitation, and restlessness. A sedative-hypnotic may want to be administered during the first part of treatment to avoid such things as seizures. Some side effects of Wellbutrin include seizures, thoughts of suicide, panic attacks, headaches, insomnia, gastrointestinal disturbances, rashes, neuropsychiatric disturbances, and cardiovascular problems. Wellbutrin may have negative reactions if used with other drugs.
Caution should be used when co-administering Wellbutrin with other drugs that are metabolized by CYP2D6 isoenzyme. This is because Wellbutrin inhibits this isoenzyme. Caution should be taken when using certain antidepressants, antipsychotics, beta-blockers, and Type 1C antiarrhythmics. MAO Inhibitors should be avoided because they increase the toxicity of Wellbutrin. Drugs that lower seizures should be used with caution. Wellbutrin can lower alcohol tolerance, so alcohol should be avoided when using this medication. One interesting advantage that Wellbutrin has compared to other antidepressants is a low risk of sexual dysfunction, and it may even increase sexual function in those without clinical depression (Wikipedia 2025b).
What Decisions Would I Make
Making a decision for this family member would be rather tricky. It would depend on many factors such as their degree of depression, financial situation, lifestyle of the family member (for example, if he was an alcoholic, this would have to be taken into consideration), etc. I would probably recommend engaging in cognitive-behavioral therapy with a professional, as I believe this can help with various degrees of depression. Secondly, if medically able to, I would recommend setting up an exercise program. Even something as simple as a half-hour walk in the morning may be beneficial in relieving depression.
Diet would be another important factor. I mentioned earlier that while a diet high in carbohydrates may feel good initially, when that feeling wears off, the depression may get worse in the long run. Therefore, reducing simple carbohydrates in the diet and sticking with produce, whole grains, lean meats, and healthy fats may be beneficial in the long run.
Alleviating depression can be a very complex process, as people respond differently to different treatments. If it is not an emergency situation, the best way, I believe, to help with depression is through therapy combined with a change in lifestyle. If this doesn’t work, then other methods, such as medication, may need to be implemented in order to help a person feel better.
References:
Carlson, Neil R; “Foundations of Psysiological Psychology” Seventh Edition. 2008 Pearson Education Inc.
Centre hospitalier de l’Université de Montréal (2010, June 21). Treating depression with Omega-3: Encouraging results from largest clinical study. ScienceDaily.
Corey Gerald (2009) – Theory and Practice of Counseling and Psychotherapy, Eight Edition. Thomson Brooks/Cole.
Johnson, G. R. (2010) – Health Mad: Omega-3 Depression Cure
Mayo Clinic (2025a) – Monoamine Oxidase (MAO) inhibitors
Mayo Clinic (2025b) – Tricyclic Antidepressants and Tetracyclic Antidepressants
Mayo Clinic (2025c) – Selective Serotonin Reuptake Inhibitors
Mayo Clinic (2025d) – Vague Nerve Stimulation for Depression
Mayo Clinic (2025e) – Depression and Anxiety: Exercise Eases Symptoms
Sommers-Flanagan, John; Sommers-Flanagan, Rita; Efficacy of Antidepressant Medication with Depressed Youth: What Psychologists Should Know. Professional Psychology: Research and Practice, Vol 27(2), Apr, 1996. pp. 145-153.
University Of Maryland Medical Center (2011) – S-adenosylmethionine
Wikipedia (2025a) – 5-Hydroxytryptophan
Wikipedia (2025b) – Bupropion