Depression: where to find help and what treatment options exist

Depression is one of the illnesses for which effective treatments exist. Yet, as mentioned in this blog's first article, nearly half of those affected in France receive no care at all. This article brings together who to turn to, the treatments available, and the helplines, so that the first step is as simple as possible.

If you are having thoughts of suicide or are in immediate danger, in France call 3114, free and available 24/7, or 15 (SAMU) or 112 in an emergency. Outside France, look up your local equivalent — in the US, that's 988. You are not alone, and talking to someone now can help.

The primary care doctor, an accessible first point of contact

There's no need to see a psychiatrist right away to talk about your symptoms. In France, the primary care doctor remains the first point of contact for the vast majority of people seeking help for depression. They can assess the situation, offer initial support, and refer you, if needed, to a mental health professional.

The first appointment can feel hard to start. You don't need to find the exact right words: simply saying “I haven't been doing well for several weeks” is enough to open the conversation. Bringing the result of a questionnaire like the PHQ-9, or a few notes on how you've been feeling and for how long, can help. The doctor will ask about mood, sleep, energy, appetite, dark thoughts, and your life circumstances. They may also suggest tests to rule out other causes, such as a thyroid disorder or anemia.

Other entry points exist. In France, community mental health centers (CMP), present in every local area, offer free consultations with psychiatrists, psychologists, and nurses, even though wait times can be long. The Mon soutien psy program allows people to see a partner psychologist, covered by national health insurance, for a limited number of sessions per year. Students have access to university health services, and employees can turn to occupational health doctors, bound by medical confidentiality. In a crisis, hospital emergency rooms and psychiatric emergency units are open day and night. Outside France, similar primary-care and community mental health options are usually available through your local health system.

The main therapeutic approaches

• Psychotherapy, particularly cognitive-behavioral therapy (CBT), whose effectiveness for depression is well documented, alone or combined with medication
• Medication (antidepressants), considered particularly for moderate to severe episodes, always prescribed and monitored by a doctor
• Social support and physical activity, which don't replace treatment in severe forms, but whose beneficial effect on mood is documented, alongside proper care

The choice between these options, or their combination, is decided together with a healthcare professional, based on symptom severity and each person's situation.

The French National Authority for Health's (HAS) 2017 guidelines propose a stepped strategy. For a mild episode, supportive or structured psychotherapy is offered first. For a moderate episode, psychotherapy, an antidepressant, or both may be offered. For a severe episode, combining an antidepressant with psychotherapy is recommended, with a psychiatric opinion. The World Health Organization (WHO) likewise recommends psychological interventions, such as CBT, interpersonal therapy, or behavioral activation, as a first-line approach, and antidepressants for moderate to severe forms in adults.

A few pointers help in approaching antidepressant treatment with peace of mind. Its effect isn't immediate: it generally takes two to four weeks to feel an improvement, sometimes longer, while some side effects can appear within the first few days and often fade afterward. Once improvement is achieved, treatment is usually continued for several months, often six months to a year, to reduce the risk of relapse. Antidepressants don't create dependence in the sense of an addiction, but they shouldn't be stopped abruptly: stopping is done gradually, with the doctor. If a first treatment doesn't work, other drugs or combinations can be tried. For treatment-resistant depression, specialized options exist, such as transcranial magnetic stimulation or other treatments offered in hospital settings.

Physical activity deserves special mention. A large analysis published in the BMJ in 2024 (Noetel et al.), pooling more than 200 trials, found that walking, running, yoga, or strength training improved depressive symptoms, with a stronger effect the more sustained the activity. Starting small, with a few minutes of walking a day, is already useful. The What's my activity/sedentary level? tool can help you find your starting point. Regular sleep, a balanced diet, and cutting back on alcohol, which worsens mood over the medium term, round out proper care.

Support and helpline resources

In France:

• 3114: France's national suicide prevention line, free, confidential, available 24/7. It is for people in distress, but also for worried loved ones and people bereaved by suicide.
• SOS Amitié (09 72 39 40 50): anonymous listening, day and night, by phone, and by chat or messaging on its website.
• Fil Santé Jeunes (0 800 235 236): for young people aged 12 to 25, free and anonymous, by phone or chat.
• Psycom (psycom.org): reliable information on mental health and a directory of local resources.
• Your primary care doctor is, in every case, a simple and direct entry point to appropriate support.

In the United States, the 988 Suicide & Crisis Lifeline responds day and night by phone, text, or chat. In other countries, crisis numbers vary. Your doctor and local emergency services are always an option, and the International Association for Suicide Prevention (IASP) maintains a directory of national helplines.

Loved ones have a role to play too. If you are worried about someone, in France you can call 3114 to find out how to approach and help them (in the US, 988 offers similar guidance for people worried about someone else). Telling them you've noticed they're not doing well, listening without judgment, and offering to go with them to see a doctor are simple gestures that matter. Talking about suicide with someone in distress doesn't give them the idea: it shows them, instead, that they can talk about it.

Why not wait to talk about it

Depression, like many illnesses, responds better to treatment the earlier it's addressed. The common feeling of not “deserving” help, or of having to “cope alone,” is often itself part of the illness's symptoms: it doesn't reflect the actual situation.

The longer an episode lasts, the more it affects work, relationships, sleep, and physical health, and the longer recovery can take. Conversely, early treatment often shortens the episode and reduces the risk of relapse. There is no severity threshold you need to reach to be allowed to seek help.

What to remember

Depression can be treated, and the options are numerous and adaptable to each situation. Most people who are treated see their symptoms improve markedly, even though the path sometimes takes time and a few adjustments. A high result on a screening tool like the one offered on Hygietest isn't a fate to face alone: it's a concrete invitation to talk about it, to a doctor or to one of the resources above.

To assess your symptoms, take the “Am I depressed?” test.