Treatment-Resistant Depression: Definition and More

by cadabamshospital

06 June,2019 | Reading Time: 7 minutes

If you thought that just regular depression was difficult to deal with, there are sometimes cases worse than that- such as Treatment-Resistant Depression (TRD). Feelings of sadness and hopelessness are something that is very normal, but with people with depression, things like this can really affect their personal and professional lives.  If you’ve mustered up the courage to seek help for your depression but conditions still don’t improve even after several weeks/months of medication and therapy, then there is a chance that you could have this disorder. Your symptoms could reduce marginally, but they seem to be coming back, or it could be the case that your medications aren’t working for you for some reason. In cases like this, it could be necessary to get in touch with your doctor and let them know that something isn’t working for you, since there is no rapid relief in cases like these. However, what exactly is TDD, and what causes it?

What is Treatment-Resistant Depression?

As the name suggests, a subset of depression (or major depressive disorder) wherein the body doesn’t respond to the treatment provided for depression, despite doing things properly, for a few weeks/months. The treatment for depression varies in nature compared to TRD. 

How do I know if I have Treatment-Resistant Depression?

At the end of the day, your medical professional should diagnose you, and self-diagnosis isn’t ever valid- however, you can really think about getting your depression re-evaluated if you’ve not responded to two separate antidepressant treatments. If you also see that you happen to have longer and/or more severe bouts of depression, as well a return of the symptoms despite being on medication, it is best to contact your doctor about it. 

How is Treatment-Resistant Depression diagnosed?

In most cases, it can be said that if your antidepressant medication isn't working as it should, one should consider seeing a doctor about it anyway. There are things that you should consider, and respond in affirmative for some of the following statements:

-I have been diagnosed correctly (could be a case of misdiagnosis and you may not have the major depressive disorder at all, which is why the medications don’t work)

-I have been prescribed the right amount of medication (and not less or more)

-I have been taking my medication at the right time in the right time interval (and not missing doses)

-I have been taking my medication for a decent amount of time (6-8 weeks at least)

What really causes Treatment-Resistant Depression?

There are many possible causes of Treatment-Resistant Depression. Even though we don’t know the reason why people don’t respond to antidepressants, some reasons could be as follows:

  1. Wrongfully diagnosed- Sometimes it isn't a major depressive disorder that the patient has, but only symptoms similar to depression (such as bipolar disorder). If this is the case, then it is natural that just antidepressants might not work. 
  2. Family genes- Genetically the patient could have genes that make them resistant to a certain kind of antidepressant. In cases like this, a genetic test can be undertaken to find out the genetic composition, to see what alternatives can be arranged that can be treated despite the genes. 
  3. Persistent depression- If one has had major depression for a long period of time, they are more likely to have TRD (since something clearly isn’t working)
  4. Lack of neurochemicals- Chemicals such as serotonin and norepinephrine are associated with creating/signaling happiness in the brain. If there is a low level of them then it is likely that depressive symptoms will persist for a long time. 

Who is more likely to be affected?

Not surprisingly, it affects the same pattern as major depressive disorder. It affects people who are diagnosed with depression, women, older people, people with other mental health disorders such as PTSD or Bipolar disorder, and people with a history of medical conditions such as substance abuse, sleep disorders, and chronic pain. 

What is the actual treatment like?

Not surprisingly, it affects the same pattern as major depressive disorder. It affects people who are diagnosed with depression, women, older people, people with other mental health disorders such as PTSD or Bipolar disorder, and people with a history of medical conditions such as substance abuse, sleep disorders, and chronic pain. 

What is the actual treatment like?

It is very possible to treat this, despite the complicated method to diagnose it. Systematic reviews are done to take care of other complications. In most cases, your doctor will prescribe a different kind of treatment option, such as a specific treatment resistant depression medication. Maybe your doctor will even prescribe more than one antidepressant depending on the case. In certain cases, one might get prescribed other medication which isn’t an antidepressant at all, but antipsychotics, hormonal pills, dopamine drugs, or even nutritional supplements- again depending on your case. 

Therapies such as cognitive behavioral therapy are usually also prescribed. Procedures such as vagus nerve stimulation and repetitive transcranial magnetic stimulation can also help. Rehab is also usually very important in some cases. 

Some Do’s and Don’ts

There are certain things you can do to elevate your mood, other than the entire medication and therapy situation. These are smaller things that you can do in your day-to-day life to make your day a little more bearable, but at the end of the day, the former is what is more important when it comes to treating treatment-resistant depression. 

Do find your happy place- Find an activity, or two, or ten that makes you truly happy, and make sure you take time out for it! If you are someone who enjoys talking to friends, make sure you meet them in some capacity. If you enjoy binge-watching shows, make sure you do that. If you enjoy petting a dog on the street, make sure you actively go out of your way to do it. 

Don’t self-medicate- This is a very, very big mistake. Don’t act on the temptation to take your friend’s antidepressants to try for yourself if you think you’re having a depressive episode. Contact a specialist, and confide in them first, and only after they prescribe you medicine do you consume it. Just because you could have easy access to it or because it worked for a family member, doesn’t mean it’ll work for you. It could further complicate an already complicated history with mental health. 

Do acknowledge your vices- It is extremely tough to come to the point wherein one acknowledges that there actually is something that isn’t right with oneself, but we have to be honest with ourselves. Sometimes drinking can lead to depression and sometimes drug abuse too can affect your mood. Whatever be the case, it is important to know when you have a problem, especially if it starts affecting people around you.

Don’t forget to reach out- There is nothing wrong or shameful in admitting that you need help, or that these medications aren’t working out for you. Everybody and brain is different and has different needs, so why should yours be any different? Doctors and professionals are there to help you, so don’t feel any sort of reservation about reaching out to them. 

Do self-care- If you don’t have a self-care routine, make sure that you make one for yourself. Whether it is extensive or not doesn’t matter, it should be something that you do to rewind at the end of the day. This can help you regain your zen and calmness and also keep your mind eased into the night’s sleep. Self-care also involves eating well, sleeping enough, and exercising, so all things considered, do what is good for your body and mind. Treat it kindly. 

Don’t settle for anything- No matter how long it takes, don’t lose hope. It is often a difficult path for many, and it usually takes a while to get better. This is why one needs to have faith in the treatment even more, and also faith in the process. Things will get better. Always talk to your doctor about how you’re doing, physically as well as mentally and emotionally. 

In Conclusion

Despite its daunting and complicated nature, it is not impossible to be treated and managed. It is a tough time for the individual suffering from depression as well as their families, and it is essential that they have a good support system in place (if not, this might be a good time to actively make some connections of some kind because support can make the process so much easier). Connecting with support groups could also be helpful. Despite the long-term co-existence with this disorder, it is essential to have faith in oneself and the process.  

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  • If you thought that just regular depression was difficult to deal with, there are sometimes cases worse than that- such as Treatment-Resistant Depression (TRD). 
  • Feelings of sadness and hopelessness are something that is very normal, but with people with depression, things like this can really affect their personal and professional lives. 
  • Despite its daunting and complicated nature, it is not impossible to be treated and managed. It is a tough time for the individual suffering from depression as well as their families. 
  • It is essential that they have a good support system in place (if not, this might be a good time to actively make some connections of some kind because support can make the process so much easier).

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No matter how long it takes, don’t lose hope. It is often a difficult path for many, and it usually takes a while to get better. This is why one needs to have faith in the treatment even more, and also faith in the process. 

Extract

If you’ve mustered up the courage to seek help for your depression but conditions still don’t improve even after several weeks/months of medication and therapy, then there is a chance that you could have this disorder. Your symptoms could reduce marginally, but they seem to be coming back, or it could be the case that your medications aren’t working for you for some reason. In cases like this, it could be necessary to get in touch with your doctor and let them know that something isn’t working for you, since there is no rapid relief in cases like these. 

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  • If you thought that just regular depression was difficult to deal with, there are sometimes cases worse than that- such as Treatment-Resistant Depression (TRD). 
  • Feelings of sadness and hopelessness are something that is very normal, but with people with depression, things like this can really affect their personal and professional lives. 
  • Despite its daunting and complicated nature, it is not impossible to be treated and managed. It is a tough time for the individual suffering from depression as well as their families. 
  • No matter how long it takes, don’t lose hope. It is often a difficult path for many, and it usually takes a while to get better. This is why one needs to have faith in the treatment even more, and also faith in the process. 

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