Treatment-resistant depression (sometimes known as TRD) refers to pervasive depression symptoms that don't respond well to typical depressive treatments. For example, someone might take antidepressant medications or participate in therapy, but they still don't feel much relief. In some cases, treatment may actually worsen depression. Some clients end up experiencing more numbness, apathy, or even suicidal ideation after getting help.
Managing treatment-resistant depression sometimes requires specialized care. In this article, we'll unpack the main risk factors to be aware of, and we'll also discuss alternative treatment options to consider when conventional treatment hasn't worked.
What Do We Know About Patients with Treatment-Resistant Depressive Symptoms?
Major depressive disorder exists on a large continuum with many different subtypes and symptoms. Some people only experience one or a few depressive episodes during their lives. Others have ongoing symptoms that affect every part of their functioning.
Although it may sound rare, research shows that approximately 30% of people with depression show signs of treatment-resistant depression. Many have tried several different medication strategies or therapy approaches with limited relief.
What Causes TRD?
Depression is a complex condition without a single cause. However, it's important to be aware of the potential risk factors associated with TRD. These can include:
Underlying trauma: Depression symptoms may actually emerge in response to trauma flashbacks or unresolved traumatic experiences. Some people find that, once they relieve depressive symptoms, they struggle with trauma symptoms, thus reinforcing a vicious cycle.
Other mental health conditions: Depression can be a misdiagnosis, as symptoms sometimes overlap with symptoms of other conditions like bipolar disorder, schizophrenia, or personality disorders. It's important to receive a comprehensive assessment with ongoing monitoring to assess whether other conditions may be exacerbating depression.
Substance use: Current or past substance abuse can affect neurochemistry. Treatment-resistant depression may also be a part of post-acute withdrawal syndrome (PAWS), which can take several months or years to fully subside.
What Typically Best Treats Major Depressive Disorder?
Treating mental illness often entails some form of a trial-and-error process. However, in about 70% of cases, people generally respond to some combination therapy that includes:
Antidepressant medications: An oral antidepressant works to improve depression symptoms by acting on the serotonin receptors in the brain. This often helps stabilize mood and support overall emotional regulation.
Talk therapy: Talk therapy sessions may be multifaceted and can include interventions from cognitive-behavioral therapy (CBT), interpersonal psychotherapy (IPT), dialectical behavioral therapy (DBT), and somatic therapies.
Psychoeducation: Learning about depression, including its associated triggers, behavioral patterns, and how it emerges in the body can help people feel more empowered about their mental health.
Healthy lifestyle changes: Holistic approaches also have a place in depression treatment, and comprehensive care may include examining the role nutrition, physical activity, sleep, relationships, and self-esteem play in overall mental health.
If you have tried one or more of these approaches and haven't experienced any relief (or your relief was short-lived), you may be experiencing treatment-resistant major depression. This isn't your fault, but you may benefit from other treatment approaches.
What Helps Treat Resistant Depression Symptoms?
In addition to the conventional approaches, many psychiatric disorders benefit from other treatment modalities. Some of these alternative treatment methods include:
Electroconvulsive therapy (ECT): ECT induces deliberate seizures, and research shows these procedures can reduce depression symptoms. This treatment is non-invasive and is also used to treat other mood disorders.
Repetitive transcranial magnetic stimulation (TMS): TMS uses magnetic seizure fields to deliberately stimulate nerve cells in the part of the brain associated with mood disorders. This may change how your brain cells communicate with one another.
Vagus nerve stimulation (VNS): VNS works by stimulating nerve cells in the vagus nerve with electric impulses. This temporarily alters brain chemistry, and it is also shown to reduce depressive issues.
Microdosing: Emerging research shows that microdosing psychedelics may reduce symptoms of depression and anxiety. However, microdosing may not be appropriate for clients with psychotic symptoms or those in recovery from substance use disorders.
If you are not sure which approach to try, start. by talking to your primary care physician or doctor. Alternatively, our team can explore the best options for you based on your current symptoms, needs, and past treatment experiences. Regardless of what you're currently experiencing, we are equipped to provide you with competent, evidence-based care.
Depression Treatment at Resurface Group
At Resurface Group, we specialize in treating mood disorders via our multifaceted, customized care. We support clients at all stages of recovery, and we work with individuals and their families to give them the tools needed to improve their symptoms and live a more meaningful life.
If you're struggling with severe depression, there is hope. You're not alone. The right treatment can ease depression symptoms and restore a sense of vibrance and vitality.
We offer a variety of services, including our fully-virtual IOP program, Resurface Connect. Contact us today to learn more about how we can best support you.
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