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What is Treatment Resistant Depression?

October 14th, 2024

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Despite having tried various treatments and depression medications, are you still struggling with depression symptoms? You're not alone. Many people struggle with treatment-resistant depression, a condition where traditional depression treatment methods like medication and therapy don't provide significant relief. Keep reading to explore what treatment-resistant depression is, its causes, and the available treatment options. Let's get started!

What is Treatment Resistant Depression?

Treatment-Resistant Depression (TRD) refers to a form of depression that does not respond adequately to standard depression treatments, such as antidepressant medications or psychotherapy.

Typically, a diagnosis of treatment resistant depression is considered when a person has tried at least two different antidepressant medications, at the recommended doses and duration from their provider, without experiencing significant improvement in their depression symptoms.

People with treatment-resistant depression may continue to experience persistent feelings of sadness, lack of interest, fatigue, and other depression symptoms despite undergoing standard depression treatment methods.

Is Treatment Resistant Depression Common?

Yes, treatment-resistant depression is relatively common. It affects about 30% of individuals diagnosed with Major Depressive Disorder (MDD). This means that nearly one-third of people with MDD do not respond adequately to standard treatments, such as antidepressant medications or therapy.

While this can be discouraging, it also highlights the importance of exploring alternative treatments like TMS therapy, medication combinations, or specialized therapies to find the right path to managing your depression symptoms.

If you or a loved one is experiencing treatment-resistant depression, know that there are multiple options available to help manage symptoms and improve quality of life.

Why Do I Still Feel Depressed After Taking Depression Medications?

If you find that your depression medication is not working, speak to your psychiatrist or psychiatric provider. They will go over how regularly you are taking your medications to ensure you are taking them as directed for maximum efficiency.

They may also increase your dosage, add another medication, switch you to a different medication, or have you test your current medication for a longer period of time to reach the therapeutic threshold.

It is likely that your provider will also discuss your lifestyle to gather more information and be able to efficiently find the right medications or other forms of depression treatments for you. For instance, they will ask you about your sleeping habits, substance use, and exercise routine just to name a few.

Treatment Resistant Depression Treatment

Treatment resistant depression can be challenging to manage and may leave you feeling discouraged. However, there are additional treatment options available, including Transcranial Magnetic Stimulation (TMS therapy), electroconvulsive therapy (ECT), medication combinations, and newer therapies like Esketamine.

Seeking care from a mental health professional such as a psychiatrist or psychiatric provider is essential to safely explore and find the right depression treatment strategy for you. Let’s go over each of these depression treatment options in more detail below:

TMS Therapy For Depression

Transcranial Magnetic Stimulation therapy (TMS therapy) is a non-invasive treatment that uses magnetic pulses to stimulate specific areas of the brain associated with mood regulation. Unlike traditional antidepressant medications, which work throughout the entire body, TMS therapy directly targets the brain regions involved in depression.

This makes it an excellent option for individuals experiencing treatment-resistant depression—those who have not found relief through standard depression treatments like medications and psychotherapy.

TMS therapy is highly effective because it can "wake up" underactive areas of the brain that may be contributing to depression symptoms. TMS treatment is a safe procedure, generally well-tolerated, and does not involve anesthesia, allowing patients to return to their normal activities immediately after each TMS session.

For individuals struggling with persistent depression, TMS for depression offers hope as a proven alternative treatment that focuses on the brain's specific needs.

If you are dealing with treatment-resistant depression, talk to your provider about TMS treatment for depression. TMS could be the breakthrough depression treatment you’ve been searching for, and our TMS clinic provides leading TMS therapy in Chicago.

Head to our TMS therapy self assessment test to take quiz, our experts will then analyze your results and reach out to let you know if you are a good candidate for TMS treatment.

Electroconvulsive Therapy For Depression

Electroconvulsive Therapy (ECT) is a medical treatment that involves applying brief electrical stimulation to the brain while the patient is under anesthesia. It is known to be an effective treatment for severe depression, particularly for individuals experiencing treatment-resistant depression.

ECT works by inducing controlled seizures in the brain, which can help reset neural pathways and improve mood regulation. Modern ECT is a safe and effective treatment option performed by medical professionals.

However, as with any medical procedure, there are potential risks involved. It can be especially beneficial for those with severe depression symptoms, including suicidal thoughts, psychotic depression, or depression with extreme physical symptoms. Most psychiatrists will typically suggest patients try TMS therapy before opting for ECT since TMS therapy is non-invasive treatment with little to no risks.

Medication Combinations

Psychiatrists may also explore medication combinations as a potential treatment option for treatment resistant depression. When standard antidepressants alone do not provide sufficient relief, combining two or more medications can sometimes enhance their effectiveness.

A psychiatrist or psychiatric provider will carefully review the patient's medical history, current depression symptoms, and any previous treatments before recommending specific combinations.

The goal of using medication combinations is to target different aspects of depression and brain chemistry that a single medication might not address.

By combining medications, psychiatrists aim to optimize treatment outcomes, reduce symptoms, and improve overall well-being. This approach requires close monitoring by the provider to adjust dosages and manage potential side effects, ensuring the treatment is tailored to the individual’s needs.

Ketamine/Esketamine

Ketamine and its derivative, esketamine (a stronger version of Ketamine), have emerged as promising options for individuals struggling with treatment-resistant depression. Unlike traditional antidepressants, which can take weeks to show effects, ketamine and Esketamine often provide rapid relief, sometimes within hours.

Ketamine is typically administered intravenously in a clinical setting, while Esketamine is available as a nasal spray. Esketamine was FDA approved for those with treatment resistant depression in 2019. Both treatments work by targeting the brain's glutamate system, which plays a key role in mood regulation.

This unique mechanism of action can help "reset" the brain's pathways and improve depressive symptoms in a way that standard medications might not. These treatments are usually part of a comprehensive care plan, combined with therapy and other support to maximize long-term benefits.

Major Depressive Disorder Therapies

It's important to note that therapy plays a crucial role in treating Major Depressive Disorder (MDD) and can be an excellent addition to medication or other treatments like TMS therapy. Two of the most effective therapy options for MDD are Cognitive Behavioral Therapy (CBT) and Dialectical Behavioral Therapy (DBT).

  • Cognitive Behavioral Therapy (CBT) focuses on identifying and changing negative thought patterns that contribute to depressive symptoms. By learning to challenge these thoughts, individuals can develop healthier ways of thinking and coping, which can lead to improved mood and overall well-being.
  • Dialectical Behavioral Therapy (DBT) incorporates elements of CBT but also emphasizes mindfulness, emotional regulation, and distress tolerance. DBT is particularly helpful for those who experience suicidal thoughts, self-harm behaviors, intense emotional swings, or have difficulty managing stress.

Incorporating therapy into a comprehensive depression treatment plan can enhance the effectiveness of medications, TMS therapy, or other treatment options. It provides individuals with tools and strategies to manage their depression symptoms more effectively, promoting long-term mental health.

Treatment Resistant Depression Treatment in Chicago - TMS Near You & More

If you’re struggling with treatment-resistant depression, Clarity Clinic is here to help. We offer a range of treatment options, including TMS therapy for depression, medication management, therapy for depression, and PHP/IOP programs designed to support your journey toward better mental health.

With mental health clinic locations in Chicago's Loop, River North, Lakeview Belmont, and Lakeview Broadway neighborhoods, as well as clinics in Arlington Heights and Evanston, we are conveniently located to serve patients throughout Chicago and in surrounding suburbs such as Oakbrook, Northbrook, Schaumburg, Winnetka, and Naperville, IL.

Book an appointment with our expert psychiatrists and clinicians to explore personalized depression treatment options that work best for you. Whether you are wanting to try TMS therapy near you or looking for the best depression medication to target your symptoms, Clarity Clinic is here to help.

Book an Appointment!

Related Readings:

Treatment Resistant Depression: Your Questions Answered

Is there any hope for treatment-resistant depression?

Yes, there is hope! Many alternative treatments, such as TMS therapy, medication combinations, specific talk therapy, and newer options like ketamine, can be effective for treatment-resistant depression.

What happens when medication doesn't work for depression?

When medication doesn't work, a psychiatrist may explore other treatments, such as changing medications, combining medications, TMS therapy, psychotherapy, or newer treatments like ketamine.

What are the symptoms of treatment-resistant depression?

Symptoms of treatment resistant depression are going to be the same as symptoms of Major Depressive Disorder (MDD). These include persistent feelings of sadness, fatigue, hopelessness, difficulty concentrating, and more. The only difference is that those with treatment resistant depression show a lack of response to at least two different antidepressant treatments and might experience a more severe form of MDD symptoms.

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