Depression is a life-threatening disorder that seems to be triggered by stress, hormones, genetic glitches, medical conditions, medication, and maybe even the kitchen sink. Its onset is predicted by insomnia, insomnia usually accompanies it, and insomnia is usually the last symptom to disappear. Maybe that's why, as Ruth Benca, M.D., Ph.D., and director of the sleep program at the University of Wisconsin-Madison, says, "All the things that are good sleep therapy are good depression therapy, too." Here are the strategies that can help you beat both. Check with your primary-care physician. Depression can be the side effect of a laundry list of illnesses – cancer, for one; sleep apnea, for another – and medications. So if you're feeling down for any length of time, your first step is your primary-care physician. See a psychiatrist. Depression can kill, and the medications frequently used to rebalance your brain chemicals can be tricky. So once your primary-care physician has ruled out medical conditions and medication as a cause of depression, even if you're comfortable with your primary physician's care, you might want to ask for a referral to a psychiatrist. Your primary-care physician may be able to deal with depression as a temporary side effect or the everyday blues, but it's a psychiatrist who is trained in the ins and outs of major depression and its treatment, and it's a psychiatrist who is most able to suggest the treatment option that, tailored to your particular situation and combination of issues, is most likely to succeed. Think about the Big 3. The three approaches doctors usually suggest for major depression are antidepressant medication and either cognitive behavioral therapy (CBT) or interpersonal psychotherapy (IPT), says James P. Krainson, M.D., a sleep medicine specialist at Miami's South Florida Sleep Diagnostic Center. "Most depression responds to medication," he adds. Since it's likely to be caused by a biochemical imbalance in your brain, a chemical can frequently help. Fortunately, however, depression responds well to all three treatments. In a review of studies conducted at Vanderbilt University, researchers found that medication had a rapid and robust effect, plus it prevented the return of symptoms for as long as it was taken. In the review, both CBT and IPT seemed to be just as effective as medication. In particular, IPT might help the individual work out personal issues, while CBT seemed to have an enduring effect that reduced the risk of future depressive episodes – a big concern among doctors. Combined treatment with both medication and therapy seemed the best choice, the researchers concluded, since combination therapy seemed to boost the effectiveness of each.