For some individuals experiencing depressive symptoms, it’s often tough to recognize or accept them, and sometimes even harder to get help. The sense of feeling vulnerable may prevent patients from seeing a therapist or even turning to antidepressants.

But a new study suggests that there may be another, more innocuous option in facing depression — an online intervention that employs “self-help” as therapy. The study, published in JAMA, focused on individuals who were beginning to see the telltale signs of depression, a group important to target in order to prevent major depressive disorder later on.

The researchers examined 406 adults with subthreshold depression, meaning they had some symptoms of depression but no diagnosis of major depressive disorder. The patients were 45 years old on average, and the majority (74 percent) were women. In the study, the participants were divided in half and either given a web-based, guided self-help intervention, which involved cognitive-behavioral and problem-solving therapy with an online trainer, or a web-based psychoeducation program. Everyone was still able to visit their primary care doctors whenever.

Twelve months later, 82 percent of the participants finished the telephone follow-up. It turned out that only 27 percent of patients in the online intervention group experienced major depressive disorder, compared to 41 percent in the group using the psychoeducation program online. Though it was a small study and a telephone survey may not be the most effective way to gauge results, it hints that combining online self-help interventions with access to regular physical care can be quite helpful in treating or preventing depression.

“Results of the study suggest that the intervention could effectively reduce the risk of major depressive disorder onset or at least delay onset,” the authors write. “Further research is needed to understand whether the effects are generalizable to both first onset of depression and depression recurrence as well as efficacy without the use of an online trainer.”

Major depressive disorder falls under the larger umbrella term of depression, and typically refers to individuals who feel depressed most days of the week. Experiencing fluctuations in weight, losing interest in things that once brought pleasure, and constantly being tired are symptoms of major depressive disorder. According to the latest researchers, major depressive disorder may be the leading cause of premature mortality and disability in developed countries by 2030.

The efficacy of online therapies for various mental health disorders — like post-traumatic stress disorder, anxiety, or insomnia — has always been in question, as standard care has typically involved in-person therapy. Whether online interventions are better than face-to-face counseling is difficult to tell without further research, but recent studies have shown that online-based help is surprisingly useful. For example, a study released earlier this year found that online cognitive behavioral therapy for insomnia actually helped ease depression symptoms. And while not all new mental health apps are being tested for their clinical efficacy, it’s only a matter of time before online self-help interventions become more popular.

However, the researchers will need to further their study by next examining the different types of online interventions — and whether they’re best used on their own, or combined with in-person cognitive behavioral therapy and/or antidepressants.

Source: Buntrock C, et al. JAMA, 2016.