How to Treat Severe Depression

If you feel sad or down for long periods of time, you may be experiencing severe depression and may consider the option of exploring how to treat severe depression.

It is normal and expected to feel sad or down after a negative experience, like losing a pet or a fight with a friend. You know the reason for feeling sadness and that it will subside within a few days. For some, feelings of sadness do not subside and instead linger for weeks, months, and even years. This is a sign of severe depression.

Major depressive disorder, casually referred to as severe depression, affects over 17.3 million Americans over the age of 18 nationwide and 1.9 million children between the ages of 3 and 17. And those numbers are based on reported, diagnosed cases. The number is likely much higher since not everyone seeks help for their depressive symptoms.

There are valid reasons why people are not diagnosed. One of the biggest reasons is that not everyone understands major depressive disorder, making it hard to realize that it is a sign of a mental health disorder. Therefore, they do not make an appointment with a doctor and suffer in silence.

What is Severe Depression?

Severe depression is a brain disorder, an illness just like any other illness. It is also called clinical depression or major depressive disorder. While mild and moderate depression is significant conditions, severe depression can impact and interfere with daily functioning.

Doctors use the American Psychological Association’s Diagnostic and Statistical Manual for Mental Disorders to diagnose severe depression. There are specific criteria that have been persistent for six months or longer and are causing problems personally, professionally, and socially.

Severe Depression Diagnostic Criteria

Below are the signs of severe depression. You must have at least five of the symptoms in a two-week period to be diagnosed with severe depression.

  • You feel sad, blue, or down most of the time.
  • You are easily agitated or irritable.
  • You have lost interest in activities you once enjoyed.
  • You avoid social activities.
  • Your weight has changed; either you have gained or lost weight.
  • You have sleep disturbances, like insomnia or oversleeping.
  • You feel aches and pains in your muscles, joints, and bones.
  • You lack motivation.
  • You have excessive fatigue.
  • You feel hopeless, guilty, worthless, or ashamed.
  • You worry excessively.
  • You can’t stay focused on tasks.
  • You have thoughts of suicide or that the world would be better off without you in it.

Extreme depression may also include hallucinations, delusions, and feelings of stupor. Some people develop substance use disorder when they start using alcohol or drugs to make themselves feel better or escape the symptoms of severe depression.

Who Gets Severe Depression?

There are multiple factors that, when combined, lead to severe depression. These factors differ for each person and can include genetics. There is a gene associated with depression, and it can be passed down from your family members. If you have family members with a history of depression, the gene may be passed on to you. Having the genes, however, does not guarantee you will automatically get severe depression.

Other risk factors play a role, too, like biochemistry or how the chemicals in your brain function. Experiencing past traumas, having low self-esteem, or living in a chaotic environment may also lead to depressive symptoms. Also, chronic medical conditions, stress, substance misuse, and negative relationships trigger depression. If you are on medications, check the side effects. Many prescribed medications have side effects of depression and anxiety.

How to Treat Severe Depression

Depression treatment is available. If you’ve tried treatment in the past but didn’t find that it helped, you may be experiencing something called treatment-resistant depression. If this is the case, you may want to ask your doctor about the benefits of ketamine therapy for depression as an alternative.

Related: What is Ketamine Therapy?

The first step to receiving treatment is to complete an evaluation with a psychiatrist, psychologist, or licensed mental health professional. They are specialists in depression. Meaning they have spent numerous extra hours training on how to treat your symptoms.

Here’s how to treat severe depression and want to expect in the future.

The Evaluation

The evaluation process takes several hours. It is a time when data is collected on you and your family’s mental, physical, and social health history. This is the time to discuss previous treatments you have tried that worked and did not work.

Once the evaluation is complete, a diagnosis will be assigned, and a treatment plan will be completed. There is no one-size-fits-all treatment program. Yours will include a combination of multiple therapies, which may include the following:


Depression is directly related to neurotransmitters in the brain. Serotonin and Norepinephrine are the two most commonly associated with depression. When out of balance, your mood is affected.

Antidepressant medication prescribed by a psychiatrist can help rebalance the neurotransmitters in the brain. Examples of antidepressant medications include Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs), Norepinephrine-Dopamine Reuptake Inhibitors (NDRIs), Tricyclic Antidepressants (TCAs), and Monoamine Oxidase Inhibitors (MAOIs).

Individual Therapy

Individual therapy combined with medication is evidenced to improve mood quicker than when either is used alone. Individual therapy refers to one on one meetings between you and a licensed mental health counselor. Various counseling modalities are used during treatment to help you progress further in meeting your goals.

Treatment modalities include motivational enhancement therapy, psychodynamic therapy, and cognitive-behavioral therapy (CBT), along with its many different sub-modalities, like trauma-focused CBT and dialectical behavioral therapy.

Group Therapy

Improving skills and gaining knowledge about depression are best provided in group therapy sessions. Here you and peers who also have depression participate in therapies like dialectical behavioral therapy informed skills groups. The focus is on components like mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness.

Treatment-Resistant Therapy

If you have tried antidepressants and multiple other forms of therapy to improve your depressive symptoms but have not had any improvements, you likely have treatment-resistance depression.

There are many advances in treatment in this area. A popular method is ketamine, which is approved in small doses administered in clinical settings by a psychiatrist. Ketamine-assisted therapy combines the drug with talk therapy for added benefits.

If you have symptoms of depression, whether mild, moderate, or severe, reach out for help today. There are solutions at every level to help ease your symptoms so you can get back to leading a productive, happy life.