Depression

There isn’t very much evidence on the effectiveness of going to a complementary therapist for depression. A lot depends on the skill of the practitioner and how you feel about working with them. Complementary therapies are not widely available through the NHS, so a typical session could cost you from £40 to £80. Nevertheless, some people say they have found having time with a practitioner very helpful.

You should always look for a practitioner who is properly trained and registered with the relevant professional body.

Summary
Acupuncture is a traditional form of treatment that began in China thousands of years ago. Thin needles are inserted into the skin at special points on the body, which practitioners believe will help restore health. The treatment sometimes also involves heat, pressure, electrical currents or soft-laser light. In the UK, acupuncture is most commonly used for pain relief.

Evidence
There have been a lot of studies on the effects of acupuncture, but most of them have been in China using daily acupuncture, which is not used in the UK. There is no good research evidence about the effects of acupuncture on depression.

Safety
Acupuncture is generally safe if practised by a trained acupuncturist. The most common side-effects are slight discomfort (common) and bruising (occasionally).

Cost
A session may cost £40-£60. Frequency of treatment will depend on you and your practitioner.

Find out more
The following professional organisations can help you find a qualified practitioner:
Acupuncture Association of Chartered Physiotherapists
British Academy of Western Medical Acupuncture
British Acupuncture Council
British Medical Acupuncture Society

Summary
AT classes require time and discipline, but may have greater benefits than simple muscle relaxation. In AT classes you learn to create feelings of warmth and heaviness throughout your body, and this is said to bring about very deep physical relaxation, mental peace and a quietening of negative thoughts. AT uses simple phrases that you repeat to yourself as you release tension from each part of your body.

Evidence
There is some evidence that AT might be helpful to people with low mood or depression. The research suggests that it is more effective if you learn the method in a class.

Safety
AT is best learned from an experienced teacher in a small class. There are no safety issues, though anyone with a long-term mental health problem should get advice from their psychiatrist before starting AT.

Cost
You will have to pay for the classes but once you have learned this technique you can practise it at home at no cost.

Further information
The British Autogenic Society (BAS) is the professional and educational organisation for autogenic therapists in the UK.

Summary
Exercise definitely has positive effects on the brain and physical activity is one of the best anti-depressants. It takes a few weeks to make a difference, and it seems to be more effective if you do it with other people. It improves the way your brain works in all kinds of ways and it may even help prevent dementia.

There are three types of exercise. Vigorous exercise classes, such as aerobics, stepping and walking, make the heart and lungs work harder. Strengthening exercises make muscles work against resistance. Stretching exercises, such as tai chi, qigong and yoga, are slower. Although they won’t necessarily make you fitter, they have a wonderfully relaxing effect on the body and mind, and they make your joints more flexible.

If you haven’t been active for some time, you should start slowly and build up. If you have heart or chest problems, get medical advice first.

You don’t have to use the gym to exercise. Even 30 minutes of brisk walking every day is enough to make a useful difference to your mood. There are walking groups in many areas.

Evidence
There is good evidence that exercise helps lift depression in adults. Even a single exercise class can lift your mood. And research has shown that 16 weeks of regular classes can be as effective as medication. More research is needed to find out what type of exercise is best, and how much exercise has the best effect.

Safety
Supervised exercise programmes are safe for most people. Anyone with severe osteoporosis, joint problems, acute back pain or recent injuries should avoid strenuous exercise.

Cost
Many different types of exercise programmes are provided, at a small cost, by your local council. Private classes will cost more. The monthly cost will depend on how regularly you attend classes.

Further information
Classes and exercise programmes are run in most areas by both local authority leisure services and private gyms.

Summary
There are many different types of massage, some more vigorous and going deeper into the muscles than others. Massage has traditionally been used for relaxation. It may be just on one part of the body (for example, the back and shoulders), or it can be done on the whole body. Aromatherapy massage uses pleasant-smelling essential oils.

Evidence
Some research suggests that massage by trained therapists helps depression. One small study showed that using essential oils may also help but more research is needed to prove this.

Safety
Massage is safe if carried out by qualified massage therapists, and it rarely causes problems. Vigorous massage should be avoided if you have blood disorders, some forms of cancer, skin problems or are on blood-thinning medications (such as warfarin). Allergies or skin irritation can occur with some essential oils used in massage.

Cost
Monthly cost will depend on how regularly you receive treatments.

Further information
It is important to find a qualified practitioner such as one registered with The General Council for Soft Tissue Therapies.

Summary
When people think of ‘talking therapies’ they usually mean either counselling or psychotherapy. Counselling and psychotherapy aim to help people change thoughts, feelings and attitudes. Counsellors help you talk about difficult feelings and understand conflict. It can be helpful just to have time alone with a counsellor to talk in confidence about how you feel. Spending time reflecting on problems often brings insight and puts things into perspective. Psychotherapy helps people learn better ways of thinking or behaving that can reduce their symptoms, disability and distress. Some psychotherapists are trained to help you explore possible causes of distress or symptoms in your past. Cognitive behavioural therapy (CBT) is the type of psychotherapy that is currently most widely available in the NHS.

Instead of exploring causes of distress or symptoms in the past (like many other types of therapy), CBT looks for ways to improve your state of mind right now. The therapist does this by helping you spot unhelpful thought processes and change them. The Royal College of Psychiatrists says “CBT can help you to change how you think (‘cognitive’) and what you do (‘behavioural’)”. For instance, CBT can help you make sense of what seem like overwhelming problems by breaking them down into smaller parts. This makes it easier to see how they are connected and how they affect you.

Cognitive-behavioural therapy (CBT) is the psychological treatment most widely available in today’s NHS to help treat depression. This is because there is a lot of good research showing that it helps people recover from depression.

Evidence
There is good evidence that CBT can help ease depression. But not everyone benefits from this type of treatment and some people benefit from CBT best when used in conjunction with other types of treatment.

Safety
CBT techniques are generally safe if carried out by or under the guidance of a qualified counsellor or psychologist.

Cost
In most areas your GP can refer you for CBT or a psychological therapist in the NHS. There are often long waiting lists. A session of CBT or psychological therapy may cost between £20-£50. Frequency will depend on you and your therapist. A typical course of CBT lasts between 6-12 weekly sessions

Further information
It is important to find a qualified counsellor or psychologist. Contact The British Psychological Society.

Summary
Yoga, as taught in the UK, generally includes physical postures or stretches, breathing techniques, meditation and relaxation. There are several different types of yoga. Some of them are mainly based on the physical exercises (some types are much more strenuous than others). Others focus more on meditation.

Evidence
There is some research to show that yoga can help people with depression. Going to yoga classes probably helps most.

Safety
Yoga is generally safe when practiced appropriately and at the right level. Classes are run for different ability levels so look for one that is right for you. Yoga stretches should be increased slowly. If in doubt, check with your doctor, osteopath or physiotherapist. Avoid with severe osteoporosis or acute joint or back pain, or recent injuries.

Cost
You will have to pay for the classes but once you have learned this technique you can practise it at home at no cost.

Further information
Classes are run in most areas by both private tutors and by adult education services. To find a qualified teacher near you see also the The Yoga Alliance
and the The British Wheel of Yoga.