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What is Treatment-Resistant Depression?

What is Treatment-Resistant Depression? cover

In recent years, the quantity of adults and even adolescents who suffer from depression, anxiety, and other mental health disorders has increased dramatically. Many of them refuse to get help or are reluctant to do so, either because they believe they will recover naturally or because of the stigma surrounding mental illness. Among those who do seek help, though, there are some individuals who do not respond to conventional treatments. Current research estimates that the percentage of people with this condition, known as treatment-resistant depression, is as high as 30%. Fortunately, there are plenty of options out there for people with this type of depression.

How is Treatment-Resistant Depression Different from Depression?

When an individual is diagnosed with depression, the most common first line treatments are antidepressant medication and talk therapy. Talk therapy can be a powerful tool for addressing the underlying emotional issues, thinking patterns, and coping skills that are driving depression symptoms. Antidepressants can help patients cope with the most debilitating symptoms of depression, which in turn makes it far easier for them to make changes in their lives. While it may take some trial and error to find the ideal medication, in most cases remission can be achieved with an SSRI medication like Prozac or another common antidepressant.

However, a significant percentage of clients respond negatively to antidepressants – or simply do not benefit from them. For those responding negatively, side effects of their drugs may actually lead to worsened mood problems. Weight gain and issues with libido, for instance, are common side effects of SSRIs. Some antidepressants, such as Wellbutrin, can sometimes increase anxiety or even in some cases lead to increased suicidal ideation. The extent to which a patient experiences these side effects depends very much on their unique body chemistry and how they respond to particular medications. While side effects can worsen depression, there are those who simply do not get any results for the – neither positive nor negative.

When a person does not get relief from conventional medications or talk therapy, they are said to suffer from treatment-resistant depression. This does not mean that their depression cannot be treated. It just means that their mood disorder is a little more difficult to deal with than most cases of depression. Achieving remission for treatment-resistant depression is simply a matter of finding the right approach – which may take a little creative out of the box thinking.

What Are the Signs of Treatment-Resistant Depression?

Treatment-resistant depression occurs in approximately 30% of individuals seeking help for their mood disorder. This debilitating condition is poorly understood. While psychiatrists know that SSRIs and other antidepressants work for many people, the reasons why they work for some and not for others are still unclear. What experts do know, though, is that individuals with treatment-resistant depression can be identified by a number of qualities that they have in common. These symptoms of treatment-resistant depression include:

  • Typical symptoms of depression, such as sleep disturbances, loss of interest in everyday activities, tearfulness, weight loss or weight gain, and difficulty concentrating
  • A failure to respond to multiple medications
  • Gradually worsening depression symptoms or side effects after each attempt to treat the condition
  • A failure to respond to talk therapy

What Causes Treatment-Resistant Depression?

While the exact causes of treatment-resistant depression are still being researched, psychologists do know that certain risk factors play important roles. One of the most common reasons why patients do not get results from their treatment is that they have been incorrectly diagnosed. There are multiple types of depression, such as atypical depression, psychotic depression, melancholic depression, and bipolar depression. When a person receives treatment for the wrong kind of depression, they may experience worsened symptoms or simply remain unaffected. This can make people lose hope in recovery, which in turn drives them deeper into despair.

However, some people simply have cases of depression that inherently resist treatment. Risk factors that contribute to this situation include old age, the severity of a person’s depression symptoms, having a longer length of depressive episodes, and a failure to take medications exactly as prescribed. Drug interactions, personality characteristics, psychosocial stressors, and lifestyle factors can also all contribute as well. For some, it simply boils down to metabolism: certain individuals process antidepressants in their bodies more slowly or quickly than others, which can affect functionality.

How Do You Treat Treatment-Resistant Depression?

When antidepressants and talk therapy don’t work, it is important to recognize that this is happening through no fault of your own. Blaming yourself will not help. You are also not alone. A large percentage of people treating their depression get no results through conventional means. Fortunately, there are a wide variety of non-drug interventions and alternative treatments for depression and other mood disorders. It is a good idea to talk to your doctor or your mental health counselor to determine your options. Some of the most effective alternative treatments for treatment-resistant depression include TMS (transcranial magnetic stimulation) and ketamine therapy.

TMS (Transcranial Magnetic Stimulation) for Treatment-Resistant Depression

TMS is a type of treatment that is approved by the FDA for cases of depression that resist treatment. TMS is not a drug. However, it is sometimes far more effective than even the most powerful antidepressants. This treatment involves providing gentle magnetic pulses to the brain. This procedure effectively and safely treats mood problems at the source. A full course of transcranial magnetic stimulation generally takes 6 to 8 weeks to complete, and clients need to go in regularly for sessions. However, improvements can be noticed after as short a time as 2 weeks. The procedure is safe, with little to no side effects. Best of all, it is generally covered by a wide range of health insurance plans, including Anthem, Aetna, United Healthcare, and Blue Cross Blue Shield.

IV Ketamine Therapy and Spravato for Treatment-Resistant Depression

Ketamine and esketamine are two very similar drugs that can both be effectively utilized to treat cases of severe depression. Ketamine is administered intravenously through an IV, while esketamine, which is available under the brand name Spravato, is administered via an easy-to-use nasal spray. The FDA considers these drugs to be “breakthrough therapies” for depression. Not only are they extremely effective at reducing the symptoms of severe depression, they are also very rapid-acting. In fact, patients are likely to experience a dramatic reduction in symptoms within an hour or two of receiving their first dose. A full course of ketamine therapy involves regular doses spaced out over several weeks. Beyond treating depression, ketamine and Spravato therapy can be used to handle OCD, PTSD, chronic pain, and other conditions.

Alternative Treatments for Depression in Los Angeles

Lucid Wellness Center, located in West Los Angeles, specializes in alternative and evidence-based approaches for depression treatment. Our staff are trained in providing both ketamine therapy and TMS therapy. We ensure that our patients are comfortable and safe during the entire process. Our clinicians evaluate each patient as an individual to determine their case history and their unique needs. Most people come to us after having tried many other approaches, from SSRis to talk therapy, and they are ready for something new. Ketamine therapy and TMS therapy can provide life changing results after other treatments fail. Best of all, they are safe and have very few side effects. If you are ready to make a change, give us a call today for a free and confidential consultation.

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