Managing Treatment-Resistant Depression

People suffering from severe depression may find that antidepressants are extremely beneficial in alleviating symptoms. Many rely on their medications because they allow them to get back to normal and enjoy their lives normally. However, there are times when traditional, standard medications do not work anymore. It gives them little to no comfort at all. If you notice that your condition is not improving despite taking your medications religiously, you may have treatment-resistant depression.

What is treatment-resistant depression?

Treatment-resistant depression (TRD) is a type of depression that has failed to respond to at least two different treatment methods. TRD is not a rare occurrence. According to the Journal of Clinical Psychiatry, 30.9% of people who undergo treatment for major depressive disorder also have TRD.

Anyone with depression knows how difficult it is to manage the condition. There will be many instances when you feel hopeless and scared of what will happen next. TRD exacerbates it because this means that you have to look for another treatment that will work and be long-lasting.

While there is still so much to learn about this depression, there are now studies, findings, and advanced approaches that will help understand and manage TRD. It is all about being consistent and persistent in finding the best combination of treatments that will work for you. Work with your doctor and discuss your options.

What causes treatment-resistant depression?

There are a number of theories and studies that explain why TRD happens. One common factor that they have found has to do with the person’s biology. Even with major depressive disorder, not all people who are diagnosed with it have the same symptoms. This can also happen to treatments. Every person responds differently to medications. Treatments that work for most people may not have positive effects on one person.

Researchers observed that certain groups of people, like women and senior citizens, have a higher risk of developing TRD than others. It may be linked to biological and physiological factors. People who are frequently under-stressed and often have recurring depression are also susceptible to TRD.

A recent report suggests that the cause of TRD is low levels of serotonin and norepinephrine, which are needed to make brain circuits. If so, that would explain why antidepressants, which increase levels of serotonin or norepinephrine, would not be a one-size-fits-all cure for depression. There are also studies that claim that tachyphylaxis could be another cause of TRD. Those who have been on antidepressants could possibly experience it at one point.

How to manage TRD?

Just because you have TRD does not mean that there is no hope for you to get better. Work closely with your doctor to find the right dose, type of medication, or combination of medications to which your body will respond positively. Here are some strategies that you and your doctor could try.

Increase the dose of your medication.

Remember that each person responds to medication in different ways. Perhaps your medication will work once the dosage is increased. Raise this option with your doctor and ask if it is possible. But never change your prescribed dosage without your doctor’s approval.

Give your medications time to work.

Antidepressants do not give results right away. It may take a while. It takes around four to eight weeks for your medications to be fully effective. For some people, it will take longer than two months. If this bothers you, tell your doctor. Your doctor will help you find the most effective treatments for you.

Change the antidepressants you are taking.

If your medications are still not working after several months of taking them, go to your doctor right away. It may take several tries to find which antidepressants will work for you. Usually, doctors prescribe two antidepressants at the same time, and they need to determine the right combination of antidepressants for you. Switching to another class of antidepressant could also help.

Consider augmentation therapy.

This is adding a second medication to your first-line antidepressants. This is not usually an antidepressant. Some augmentation medications include lithium, thyroid hormone, second-generation antipsychotics, and bupropion.

Consider psychological counseling.

Most people with depression turn to therapy and counseling as another treatment. Psychotherapy combined with antidepressants increases the chance of overcoming depression. It is a big help in finding the healthiest and most effective ways to cope with the condition. Psychotherapy for depression includes cognitive behavioral therapy, family therapy, interpersonal psychotherapy, and dialectical behavioral therapy.

Mindshift Psychological Services offers psychotherapy sessions for people with depression. Dealing with TRD could be exhausting and challenging, but there are always treatment options that will work for you. Depression is treatable and manageable. You may experience bumps along the way, but for sure, you are going to get well.

Visit our website to learn more about us. You may also contact us at (714) 584-9700.