When symptoms of depression do not seem to lessen after repeated attempts at medication, therapy, or a combination of both, you may be diagnosed with treatment resistant depression. It can be disheartening when relief seems nowhere in sight, but fortunately there are some options available for treatment resistant depression.
Medication Changes
Newer SSRI drugs like Prozac and Zoloft are usually among the first line of medications prescribed for depression. Unfortunately, about 60% of people do not benefit from their original prescription. In cases like this, it may be time to increase the dosage, or try something new completely. Some drugs are used in conjunction with first-line treatments, even if they are typically approved for entirely different disorders. For example, some people report improvements after their doctor adds an anti-seizure drug or stimulant to their medication regimen.
Electroconvulsive Therapy (ECT)
ECT, or “shock therapy,” has been used for years to treat depression, and is usually reserved for severe or treatment resistant cases. ECT sends electrical impulses into the brain, creating small seizures. The procedure is typically very effective, but requires sedation in a hospital setting. Some patients report short term confusion and memory loss following an ECT session.
A newer technique called transcranial magnetic stimulation, or TMS, uses a large coil to send short magnetic impulses to certain areas of the brain. TMS generally produces less severe side effects than ECT, and requires no anesthesia or sedation.
Lifestyle Changes
When medications and therapy do not seem to be providing due relief, it may be time to look at altering certain lifestyle habits. Drugs or alcohol could be causing feelings of depression, or at least making them worse. Perhaps stress or a lack of sleep is causing symptoms of depression. Stress management techniques such as yoga and meditation, along with improving sleep habits, can help end this cycle. Physical exercise has been proven to relieve symptoms of anxiety and depression by releasing “feel-good” brain chemicals.
It is always frustrating when no one seems to have the answer for what ails us, and treatment resistant depression is certainly no exception. But with over 30 brands of anti-depressant medications on the market, along with augmentative drugs to supplement with, patients who have not yet found relief can remain optimistic. Brain stimulation techniques like ECT and TMS are good options to discuss with a doctor for severe cases of depression which have not resolved after repeated attempts at medication and/or therapy.
Occasionally, there may be an underlying disorder mimicking treatment resistant depression, such as sleep apnea, fibromyalgia, or a hormone imbalance; it may be worth exploring some of these possibilities with a doctor.
Everything seems to take a little more effort when dealing with depression, but the sooner you can get to the bottom of it, the sooner you can finally find some much needed relief.
Sources: Web MD
Mayo Clinic
KevinMD.com