Information about NICE clinical guideline 901Issue date: October 2009Understanding NICE guidanceInformation for people who use NHS servicesTreating depression in adultsThis booklet is about the care and treatment of people with depression in the NHS in England and Wales. It explains guidance (advice) from NICE (the National Institute for Health and Clinical Excellence). It is written for people with depression but it may also be useful for their families or carers or for anyone with an interest in the condition.The booklet is to help you understand the care and treatment options that should be available in the NHS. It does not describe depression or the treatments for it in detail. A member of your healthcare team should discuss these with you. There are examples of questions you could ask throughout this booklet to help you with this. You can get more information from the organisations listed on page 30. Technical words and terms printed in bold type are explained on pages 2829. NICE has also produced a booklet called Treating depression in adults with a long-term physical health problem (see www.nice.org.uk/CG91publicinfo).NICE clinical guidelines advise the NHS on caring for people with specific conditions or diseases and the treatments they should receive. Information about NICE clinical guideline 902Contents Your care3Depression5What should happen when I first talk to a healthcare professional?7Who will provide my treatment?10What treatments should I be offered?10Treatments for mild to moderate depression12Treatments for moderate or severe depression16How can I stay well in the future?24Information for families and carers26Explanation of technical words and terms28More information30About NICE31This is an update of advice on depression that NICE produced in 2004.The advice in the NICE guideline covers: The care, treatment and support that should be offered to adults (aged 18 and over) with depression, and their families or carers.It does not specifically look at:The care and treatment of people with both depression and a long-term physical health problem (NICE has produced separate advice about this; see www.nice.org.uk/CG91).Information about NICE clinical guideline 903Your careIn the NHS, patients and healthcare professionals have rights and responsibilities as set out in the NHS Constitution (www.dh.gov.uk/en/Healthcare/NHSConstitution/index.htm). All NICE guidance is written to reflect these. You have the right to be involved in discussions and make informed decisions about your treatment and care with your healthcare team. Your choices are important and healthcare professionals should support these wherever possible. You should be treated with dignity and respect.To help you make decisions, healthcare professionals should explain depression and the possible treatments for it. They should cover possible benefits and risks related to your personal circumstances. You should be given relevant information that is suitable for you and reflects any religious, ethnic or cultural needs you have. It should also take into account whether you have any physical or learning disability, sight or hearing problem or language difficulties. You should have access to an interpreter or advocate (someone who helps you put your views across) if needed. If your family or carers are involved, they should be given their own information and support. If you agree, they should also have the chance to be involved in decisions about your care. You should be able to discuss or review your care as your treatment progresses, or your circumstances change. This may include changing your mind about your treatment or care. If you have made an advance decision about any treatments that you do not wish to have, your healthcare professionals have a legal obligation to take this into account.Information about NICE clinical guideline 904All treatment and care should be given with your informed consent. If, during the course of your illness, you are not able to make decisions about your care, your healthcare professionals have a duty to talk to your family or carers unless you have specifically asked them not to. Healthcare professionals should follow the Department of Healths advice on consent (www.dh.gov.uk/consent) and the code of practice for the Mental Capacity Act. Information about the Act and consent issues is available from www.publicguardian.gov.uk If you are being treated under some sections of the Mental Health Act, healthcare professionals may override your decisions. They should only do this in specific circumstances and if it is in your best interests. If this does happen, they should fully explain the reasons why and your rights to appeal and advocacy. Information about NICE clinical guideline 905Depression Depression is a common mental health problem it affects nearly 1 in 6 people in the UK. The main symptoms of depression are losing pleasure in things that were once enjoyable and losing interest in oth