Do I have to go on antidepressants?

Not necessarily. For mild-to-moderate depression, Australian guidance puts psychological therapy first, and for milder depression it works about as well as medication. Medication has a clearer role as symptoms become more moderate-to-severe, often alongside therapy. Free online CBT programs are another evidence-based option. There's a genuine menu here, and the right path depends on your symptoms, your history and your preferences — it's a decision to make with your GP, not a foregone conclusion.

Therapy, medication, or both — how do people choose?

It's guided by severity and by you. For mild-to-moderate depression and anxiety, psychological therapy (such as CBT) is usually the first recommendation. For moderate-to-severe depression, a combination of therapy and an antidepressant is often advised because together they tend to work better than either alone. Cost, access, past experience and personal preference all matter too. Seeing all the options laid out side by side — which is what the decision aids below do — makes the conversation with your GP much clearer.

Are there free or low-cost options?

Yes, and they're underused. A GP Mental Health Treatment Plan gives you access to Medicare-subsidised sessions with a psychologist. There are also genuinely free, evidence-based online CBT programs in Australia — THIS WAY UP (free when a clinician prescribes it) and MindSpot (free and therapist-guided) among them. These can be a strong starting point or a complement to other treatment. Your GP can help you set up a plan and point you to the right program.

How long do antidepressants take to work, and can I just stop when I feel better?

Antidepressants usually take about 2 to 4 weeks to start helping, with fuller benefit over 6 to 8 weeks — and side effects often appear before the benefit does, which is worth knowing so early days don't feel like failure. Importantly, antidepressants should not be stopped abruptly: stopping is done gradually, tapered under your GP's guidance, to reduce withdrawal-type symptoms. If you're thinking about stopping, that's a conversation to have with your doctor first, not a decision to make alone.

What if my anxiety is the main problem, not low mood?

Anxiety has its own well-mapped ladder of options: self-help and lifestyle measures, psychological therapy (CBT is first-line for most anxiety disorders), medication, or combinations — much like depression. Many of the same free programs and Medicare-subsidised pathways apply. The anxiety options decision aid below helps you sort which rung fits where you are, and what to ask your GP.

Decision aid

Depression & anxiety — therapy, medication, and choosing

By Dr HB Lo, FACRRM Reviewed 14 June 2026 4 min read

General information to help you prepare for your GP — not a diagnosis, not personal medical advice. It doesn't replace a consultation, and using it doesn't create a doctor–patient relationship.

If you're weighing how to treat depression or anxiety, there's a real menu — not just "go on tablets." Therapy, medication, free online programs and combinations all have a place.

In Australia the general pattern is: for milder symptoms, psychological therapy comes first and works about as well as medication; for moderate-to-severe symptoms, therapy and medication together are often recommended. There are also genuinely free, evidence-based options people often don't know exist.

This guide explains how those choices are weighed — general information, not personal advice. If you are in crisis right now: call 000 in an emergency, Lifeline on 13 11 14, or Beyond Blue on 1300 22 4636.

If you need help now: In an emergency call 000. For 24/7 support, call Lifeline on 13 11 14 or Beyond Blue on 1300 22 4636. The Suicide Call Back Service is 1300 659 467, and 13YARN (Aboriginal and Torres Strait Islander crisis support) is 13 92 76. You don’t have to be at your lowest to call — these lines are for anyone struggling.

A lot of people come to this decision braced for one of two outcomes: be told to “just think positive,” or be handed a prescription and sent on your way. Neither is how good care works. Depression and anxiety have a genuine menu of evidence-based treatments — talking therapy, medication, free online programs, and combinations — and the right one depends on how things are for you, not on a one-size answer.

This guide lays out how those choices are weighed in Australian general practice, so the questions you bring are the ones that fit your situation. None of it replaces a conversation with your own GP, and none of it tells you to start, stop or change a medicine.

The general pattern: severity guides the first step

Australian guidance follows a fairly consistent shape, set out in Therapeutic Guidelines and explained for patients by Beyond Blue:

For mild-to-moderate depression, psychological therapy (such as cognitive behavioural therapy, CBT) is usually recommended first — and for milder depression it works about as well as medication.
For moderate-to-severe depression, a combination of therapy and an antidepressant is often advised, because together they tend to work better than either alone.
For anxiety, CBT is first-line for most anxiety disorders, with medication and combinations available as needed, per HealthDirect.

That’s a pattern, not a prescription. Your symptoms, history, past experience and preferences all move where you start.

The options many people don’t know about — including free ones

Two things are genuinely underused. The first is the GP Mental Health Treatment Plan: your GP can prepare one that opens access to Medicare-subsidised sessions with a psychologist under the Better Access initiative, as HealthDirect describes.

The second is free, evidence-based online CBT. Programs such as THIS WAY UP (free when a clinician prescribes it) and MindSpot (free and therapist-guided) deliver structured, proven therapy you can do from home — a strong starting point or a complement to other treatment, as the Black Dog Institute and Beyond Blue outline. The anxiety options and therapy-versus-medication decision aids below help you see where these fit alongside the other rungs.

If medication is on the table — what’s fair to expect

If you and your GP are considering an antidepressant, a few honest facts help set expectations, drawn from HealthDirect:

They usually take about 2 to 4 weeks to start helping, with fuller benefit over 6 to 8 weeks.
Side effects often arrive before the benefit does — knowing this helps the early days not feel like failure.
They should not be stopped abruptly. Stopping is done gradually, tapered with your GP, to reduce withdrawal-type symptoms.

That last point is the one people most often get wrong on their own. If you’re thinking about stopping — because you feel better, or because of side effects — that’s a conversation to have with your doctor first. The starting and stopping antidepressant decision aids below are built to help you prepare exactly those conversations. They never tell you what to take or when to stop; they help you ask.

The questions worth taking in

Given how I’ve been, would therapy, medication, or both be the usual first step — and why?
Can you set me up with a Mental Health Treatment Plan, and which free programs would suit me?
If we try a medication, what should I expect in the first few weeks, and how will we review it?
If I ever want to come off it, how would we do that safely?

These are questions, not conclusions. The aim is a plan made with your GP, fitted to you.

What this is, and is not

This is general information to help you prepare for your GP — not a diagnosis, and not personal medical advice. It doesn’t tell you to start, stop or change any medicine; those decisions are made with your own doctor. For trustworthy Australian background, see HealthDirect and Beyond Blue.

And again, if things are hard right now: 000 in an emergency, Lifeline 13 11 14, or Beyond Blue 1300 22 4636. Reaching out is a strong move, not a weak one.

Related on this site: the depression explainer and the anxiety explainer go deeper on the conditions themselves, and the ADHD decision aid covers overlapping ground when attention or restlessness is also part of the picture.

If you want a thorough, unhurried work-up of your own picture, you can work with Dr Lo.

Author: Dr Hoe Bing Lo — AHPRA MED0001212640 · FACRRM. Fun Doctors Pty Ltd · ABN 83 404 436 330.

Tools to take to your GP

Each runs in your browser — nothing you enter is stored or sent anywhere. They help you prepare the questions and print a one-page summary to bring to your appointment. They don't diagnose or recommend a specific treatment.

Frequently asked questions

Do I have to go on antidepressants?

Not necessarily. For mild-to-moderate depression, Australian guidance puts psychological therapy first, and for milder depression it works about as well as medication. Medication has a clearer role as symptoms become more moderate-to-severe, often alongside therapy. Free online CBT programs are another evidence-based option. There's a genuine menu here, and the right path depends on your symptoms, your history and your preferences — it's a decision to make with your GP, not a foregone conclusion.
Therapy, medication, or both — how do people choose?

It's guided by severity and by you. For mild-to-moderate depression and anxiety, psychological therapy (such as CBT) is usually the first recommendation. For moderate-to-severe depression, a combination of therapy and an antidepressant is often advised because together they tend to work better than either alone. Cost, access, past experience and personal preference all matter too. Seeing all the options laid out side by side — which is what the decision aids below do — makes the conversation with your GP much clearer.
Are there free or low-cost options?

Yes, and they're underused. A GP Mental Health Treatment Plan gives you access to Medicare-subsidised sessions with a psychologist. There are also genuinely free, evidence-based online CBT programs in Australia — THIS WAY UP (free when a clinician prescribes it) and MindSpot (free and therapist-guided) among them. These can be a strong starting point or a complement to other treatment. Your GP can help you set up a plan and point you to the right program.
How long do antidepressants take to work, and can I just stop when I feel better?

Antidepressants usually take about 2 to 4 weeks to start helping, with fuller benefit over 6 to 8 weeks — and side effects often appear before the benefit does, which is worth knowing so early days don't feel like failure. Importantly, antidepressants should not be stopped abruptly: stopping is done gradually, tapered under your GP's guidance, to reduce withdrawal-type symptoms. If you're thinking about stopping, that's a conversation to have with your doctor first, not a decision to make alone.
What if my anxiety is the main problem, not low mood?

Anxiety has its own well-mapped ladder of options: self-help and lifestyle measures, psychological therapy (CBT is first-line for most anxiety disorders), medication, or combinations — much like depression. Many of the same free programs and Medicare-subsidised pathways apply. The anxiety options decision aid below helps you sort which rung fits where you are, and what to ask your GP.

Source quality

Sources grouped by evidence tier. Australian primary tier first; international where Australia is silent or lagging. How tiers work.

T1 AU primary 9 sources

If you want a thorough, unhurried work-up of your own — not a generic answer — you can work with Dr Lo.