Different types of depression treatments
Major depressive disorder can be treated with medication, psychotherapy, or brain stimulation, and many patients benefit from a combination. This overview compares the main options by mechanism, treatment burden, and published outcomes, and explains where transcranial direct current stimulation (tDCS) fits.
What is depression?
Depression, or Major Depressive Disorder (MDD) is a mood disorder that affects an estimated 4% of the population globally1. It can present with mild, moderate, or severe symptoms, all of which affect daily life and interfere with the patient’s ability to work, relationships, and overall quality of life. The more severe the symptoms, the more depression interferes with the person’s life.
How is depression treated?
Currently, there are a number of different treatments available for patients with depression. The most common ones include 1) Pharmacotherapy (antidepressant medication), 2) Psychotherapy, and 3) Neuromodulation (brain stimulation).
Pharmacotherapy
SSRIs, SNRIs, TCAs, and other classes
- Mechanism
- Antidepressant medication acts on neurotransmitter systems in the brain, mainly serotonin and noradrenaline, to reduce depressive symptoms.
- Delivery
- Oral tablets taken daily at home, prescribed and monitored by a physician or psychiatrist.
- Outcomes
- The response to antidepressants is individual and may be different depending on which medication is used. In real-world data from more than 3.7 million patients, the average remission rate was about 30%.2.
- Safety
- Common side effects include sleep disturbance, appetite and gastrointestinal changes, weight gain or loss, and sexual dysfunction.
- Considerations
- Antidepressants can also interfere with other medications and/or medical conditions, such as pregnancy, which is why it is important to take them as instructed by your doctor.
Psychotherapy
Including cognitive behavioral therapy (CBT) and interpersonal therapy (IPT)
- Mechanism
- Talking therapies that use psychological tools to help patients change patterns of thinking and behavior and develop new ways of processing emotions.
- Delivery
- Regular sessions with a trained psychotherapist, typically over 1 to 5 years.
- Outcomes
- In a real-world primary care sample of 435 patients with moderate to severe depression, CBT showed a 29% response rate and a 27% remission rate3.
- Safety
- Suitable for patients of all ages, including children, as it involves no physical intervention.
- Considerations
- Psychotherapy works through a different mechanism from medication and brain stimulation, so it is often used alongside them. Its effect tends to develop gradually, and it depends on access to trained therapists.
Neuromodulation
Neuromodulation uses electrical or magnetic stimulation to change the activity of targeted neural circuits. Techniques are grouped by whether they require surgery. You can read more about invasive neuromodulation in this article.
Invasive neuromodulation
A pulse generator, usually placed in the chest, is surgically implanted and connected by leads to electrodes at the target site. The main indications are:
- Deep brain stimulation (DBS): movement disorders
- Spinal cord stimulation (SCS): chronic pain
- Vagus nerve stimulation (VNS): epilepsy
Non-invasive neuromodulation
Electrodes or a stimulation coil are placed on the scalp, so no surgery is required.
For depression, the established non-invasive methods are electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation (rTMS). Transcranial direct current stimulation (tDCS) is a more recent option and is the method Sooma uses.
Electroconvulsive therapy (ECT)
Inpatient or day-hospital treatment
- Mechanism
- A brief electrical stimulus delivered through scalp electrodes induces a controlled seizure, which is thought to reset disrupted brain network activity.
- Delivery
- In hospital under general anesthesia and muscle relaxation, with a psychiatrist, an anesthesiologist, and trained ECT nurses present.
- Outcomes
- Improvement is usually seen after about 2 weeks (around 6 sessions). In the CORE study of 311 patients, remission rates were 62.1% for melancholic depression and 78.7% for non-melancholic depression4.
- Safety
- Common side ffects include confusion, nausea, headache, and jaw and muscle pain.
- Considerations
- ECT is generally considered safe, with the biggest risks being anasthesia related. However, there is a risk for memory loss and cardiac arrest.
Repetitive transcranial magnetic stimulation (rTMS)
Outpatient clinic treatment
- Mechanism
- An electromagnetic coil placed against the scalp produces magnetic pulses that induce electrical currents in targeted cortical areas. The current affects the brain by stimulating neurons to fire and transmit signals within the brain tissue.
- Delivery
- At a hospital or specialist clinic with a trained clinician, typically 20 to 30 visits over 4 to 6 weeks.
- Outcomes
- Response rates of about 40 to 50% and remission rates of about 25 to 30% are typically reported5.
- Safety
- Non-serious side effects include discomfort during stimulation, headache, light-headedness, and hearing loss.
- Considerations
- Regarded as safe, with a small risk of seizures that requires a clinician to be present. rTMS is well established for more severe presentations.
Transcranial direct current stimulation (tDCS)
Home-based or clinic-based treatment
- Mechanism
- tDCS is a non-invasive brain stimulation technique that delivers a low-intensity current (about 2 mA) to modulate cortical excitability. The stimulation increases or decreases (depending on aim) the likelihood of neurons to send electrical signals.
- Delivery
- The current is delivered to the brain from a small, portable battery-driven device via two electrodes. Patients can complete sessions at home or in a clinic.
- Sooma protocol
- 30-minute sessions, 5 times per week for about 3 weeks (active phase), followed by continuation sessions 3 times per week within a 6-month program.
- Outcomes
- A fully remote randomized sham-controlled trial of 174 patients showed a 57.5% remission with home-based tDCS. In follow-up, 76% maintained response at 6 months6.
- Safety
- TDCS is regarded as a safe treatment method and does not cause any serious adverse effects. Non-serious side effects include mild headache, an itching sensation on the stimulation area, and redness of the scalp.
- Considerations
- Can be used as a stand-alone treatment or alongside medication or psychotherapy. Contraindications include devices or metal objects on or inside the skull, acute eczema, or broken skin in the stimulation area.
Sooma depression therapy
Sooma tDCS™ is an EU MDR-approved brain stimulation device for depression treatment. It is indicated for major depressive disorder, as a stand-alone or adjunctive treatment, and was the first tDCS system certified under the EU MDR for depression. It is trusted by more than 300 clinics, universities, and hospitals, with more than 35,000 patients treated across over 35 countries. The system is designed for home use, which lets clinics extend care beyond the treatment room while patients follow a standardized protocol.
Sooma has been working closely with leading neuromodulation experts to develop this treatment solution for depression. Sooma’s latest outcomes (Sooma, 2019) showed a 61% response rate, and 20% remission rate on a sample of 302 patients. Additionally, they showed that in a total of 4022 treatment sessions, there were no serious adverse effects.
Talk to an expert
Learn more about how tDCS can improve your clinical outcomes.
- World Health Organization. Depressive disorder (depression). WHO fact sheet https://www.who.int/news-room/fact-sheets/detail/depression (2026).
- Alemi, F. et al. “Effectiveness of common antidepressants: a post market release study.” eClinicalMedicine, 2021. doi: 10.1016/j.eclinm.2021.101171
- Bugocki, O. et al. “Cognitive behavioral therapy for depressive disorders: outcomes from a multi-state, multi-site primary care practice.” Journal of Affective Disorders, 2021. doi: 10.1016/j.jad.2021.07.061
- Trifu, S. et al. “Efficacy of electroconvulsive therapy as a potential first-choice treatment in treatment-resistant depression (review).” Experimental and Therapeutic Medicine, 2021. doi: 10.3892/etm.2021.10716
- Miron, J. et al. “Repetitive transcranial magnetic stimulation for major depressive disorder: basic principles and future directions.” Therapeutic Advances in Psychopharmacology, 2021. doi: 10.1177/20451253211042696
- Woodham, R. et al. “Home-based transcranial direct current stimulation treatment for major depressive disorder: a fully remote phase 2 randomized sham-controlled trial.” Nature Medicine, 2024. doi: 10.1038/s41591-024-03305-y
This information is for educational purposes and is not personalized medical advice.
