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Tolstoy once wrote that all happy families are exactly the same, but each unhappy family is unhappy in its own way. It is the same with individuals: depression means something different for each person, and what may work for one may not for another. We have 2 basic treatment modalities: drugs that help the brain to feel good, and psychological treatments that teach depressed patients how to cope and escape negative thoughts. Generally people do best when offered both, as shown by a systematic review in
. Two recent studies look at the role of the telephone in the management of depression: a cluster randomised trial in
, in which clinicians were available for telephone advice under the supervision of a psychiatrist, and a 3-group RCT, also from the US but with a different design, in
. Both showed the value of telephone support, especially in the early stages of treatment. Another trial which used cognitive behavioural therapy by phone showed its value in insomnia (