Unfortunately, many people with depression often find that despite adhering to medications and therapy designed to treat depression, their depression symptoms do not improve.
In this case, an individual may get diagnosed with treatment-resistant depression, which is more common than most people think.
Attending counselling or psychotherapy and taking a course of antidepressants often eases peoples’ depression symptoms; many people who adhere to this type of treatment have positive health outcomes and go on to live rewarding and fulfilling lives despite living with mental illness.
However, some people do not respond to standard treatments, or their depressive symptoms go away for a while, only to return.
Many people in this group may get diagnosed with treatment-resistant depression and often require profound introspection and exploration to treat their major depression symptoms.
Primary care doctor
As with most things, the first port of call will usually be an individual’s primary care doctor.
Suppose the doctor has already prescribed antidepressants, and the depressive symptoms persist. In that case, they will likely refer the patient to a health care provider who specializes in treating and diagnosing mental health issues.
Hard to treat depression
When treating chronic depression and resistant depression, a psychiatrist will review the patient’s history; this often involves asking a series of questions to determine what may be causing a person to experience severe depression. All this involves:
- Reviewing the patients’ current medication, this includes any therapies and medications they’ve already tried.
- Discussing whether the medications are getting taken as prescribed
- Asking about life events and situations that may be contributing to poor mental health
- Exploring any physical conditions, such as physical illnesses, can make depression worse, such as chronic pain, thyroid disorders and heart problems.
- Exploring the possibility of other mental health conditions, including dysthymia (mild but long-term depression), a personality disorder or bipolar disorder.
Symptoms of treatment-resistant depression can range from mild to moderate to severe and often require several therapeutic approaches before noticing any improvement.
Managing treatment-resistant depression can prove challenging until an appropriate solution gets found, but people mustn’t lose hope.
Fortunately, there are plenty of treatment options for resistant depression on today’s market, and it’s a case of finding out which one suits each individual.
Moreover, it may take some time before the doctor and patient find the proper dosage and combination medication that works.
Some of the treatment options suggested by a person’s doctor in this scenario are likely to be:
- Changing antidepressants: Research suggests that the first antidepressant they try isn’t always suitable for many people. You may need to go on several trials of antidepressants to find out which one works best.
- Including another antidepressant type: Sometimes, your doctor may prescribe two types of antidepressants simultaneously. The medications can target a much more comprehensive range of brain chemicals linked to mood and may improve depression symptoms quicker.
- Giving your current medications more time to take effect: Medications such as antidepressants can take between four to eight weeks to take full effect and for the side effects to become more manageable. In many cases, all this can take a lot longer.
There are plenty of ways of treating treatment-resistant depression and major depressive disorder that doesn’t just involve using prescribed antidepressant medication.
Psychological counselling such as psychotherapy can be beneficial when managing mood disorders and when treating patients with treatment-resistant depression.
In clinical practice, therapy sessions combined with medication work best and can help to improve symptoms for the patient quite significantly.
Psychotherapy can be an incredibly effective treatment for resistant depression as it allows people to:
- Deal with and manage past emotional trauma
- Learn effective stress management techniques and coping skills
- Address any issues with substance abuse if this is a co-occurring issue
- Manage relationships in a healthier way
If psychological counselling doesn’t seem to be working, then other forms of therapy may be just as effective for mood control and managing depressive symptoms, such as:
- Cognitive-behavioural therapy
- Acceptance and commitment therapy
- Dialectical behavioral therapy
- Interpersonal psychotherapy
Spravato Nasal Spray
When taken in conjunction with an oral antidepressant, Spravato nasal spray is a prescription medication used alongside antidepressants and effectively treats treatment-resistant depression.
Research suggests that those who take Spravato experience significantly reduced depression symptoms at four weeks compared to those who took a placebo and antidepressant medicines.
Because of the side effects, Spravato is only available at certified Spravato treatment centres under the strict guidance of a licensed professional.
Another albeit slightly more controversial treatment for resistant depression is electroshock therapy.
Electroconvulsive therapy (ECT) has been around for over seventy-five years. It has gotten acknowledged as the most important treatment for severe mood and psychotic disorders and treatment-resistant depression.
ECT has gotten labelled controversial by many within clinical psychiatry due to the misconceptions around how the therapy gets conducted and the lack of familiarity among mental health professionals about ECT techniques.
Electroconvulsive therapy ECT
The treatment of ECT mainly gets used when antidepressant medications fail to treat severe depression successfully.
Research states that in the US, most ECT treatments get used to treating unipolar depression, mainly as a secondary treatment, after one or more antidepressant trials have failed.
Repetitive transcranial magnetic stimulation
Sometimes referred to as rTMS, repetitive transcranial magnetic stimulation seeks to stimulate nerve cells in the brain using magnetic fields to improve symptoms of depression.
Brain stimulation therapies
An electromagnet gets placed against the scalp near the forehead, thus creating electric currents that seek to stimulate nerve cells in the part of the brain that is responsible for depression and mood control. Broadly, treatment sessions get delivered in thirty-minute sessions in quick bursts.
Vagus nerve stimulation
Typically, vagus nerve stimulation (VNS) gets explored after other treatments such as rTMS and ECT have failed to improve symptoms of depression.
VNS works by stimulating the vagus nerve through electric impulses. The treatment of VNS uses a device that gets fitted into a person’s chest and connects to a wire through a nerve in the neck (vagus nerve).
Electrical signals originate from the implant travel along the vagus nerve to the mood control centres of the brain, all of which seek to improve symptoms of depression.
Fortunately, plenty of treatment approaches are available for treatment-resistant depression, many of which are incredibly effective.
If you have been experiencing symptoms of depression and tried every treatment prescribed to you, you may benefit from getting in touch with one of our specialists, who will be able to point you in the right direction.
Symptoms of depression and major depressive disorder don’t have to be a way of life, there are treatments out there, it’s just about exploring the right treatment plan for you.
We’re here to help.
Contact us today if you’d like a confidential and free chat with one of our highly-trained mental health and addiction care professionals at White River Manor in South Africa.