Antidepressant medications must be proven both safe and effective to be allowed on the market by the Food and Drug Administration. Unfortunately, there is no requirement that medications be compared with each other, so doctors often do not know the relative worth of different medications for different sorts of depression. There is also no legal requirement that psychotherapies, such as psychiatric counseling, be tested for effectiveness and safety, and very few psychotherapies have been put to the test of clinical trials. This is a very controversial area, especially since economic interests clash. The two major treatments are medication and psychotherapy.
Psychotherapies attempt to help the patient correct life conditions thought to lead to depressions.
For instance, interpersonal therapy tries to help people to improve their interpersonal relationships so that life becomes more rewarding. Simple emotional support and behavioral activation can reassure demoralized patients, who are guided into more energetic efforts to improve their lives. Psychoanalysis once attributed depression to deep unconscious emotional conflicts, but this viewpoint was never proved and has become less popular recently with the successes of medication and short-term psychotherapies. All these treatments benefit less severe illnesses, but for severe conditions they are insufficient. Patients with only a moderate burden of symptoms, whose life is not impaired, often get better without medication.