Antidepressants can be incredibly helpful in relieving symptoms for many people with severe depressive disorder, which encompasses various types of depression that last for at least two weeks. This allows them to get back to the life they once loved. Standard drugs, however, frequently offer little to no comfort for people with the kind of depression known as treatment resistant depression (TRD).
The condition is not uncommon in up to one-third of adults with significant depression who struggle with symptoms that don’t go away with therapy, like persistent melancholy, sleep problems, low energy, and suicidal thoughts.
Even though there is still plenty to discover, a number of recent and encouraging developments are providing fresh insight into how to comprehend and handle TRD. We recently highlighted some of the most significant findings—and why there may be new hope for people who have lived with the condition for far too long—during Mental Health Month.
Your risk of depression that is resistant to therapy may increase based on your age, gender, and state of health.
Nobody’s response to therapy will always be positive when they have depression. But researchers have found that some populations are more susceptible than others. TRD appears to affect women and older people more frequently, for reasons that are likely biological and psychological. Additionally, it appears that those who have severe or recurrent depression are more vulnerable.
The general health of a depressed person may also be important.
Antidepressants might not be effective for everyone but may have causes that we haven’t yet fully comprehended.
Although the biochemistry of sadness is still largely unknown. Low levels of neurotransmitters in the brain are a major contributor, according to the most widely accepted theory. These are linked to happiness and wellbeing, such as norepinephrine and serotonin. Antidepressants, which attempt to raise serotonin or norepinephrine levels, may not be a one-size-fits-all treatment. According to a current study, which reveals that these neurotransmitters may not be the only reason.
One of the more recent views is that sadness causes brain inflammation or that inflammation causes depression. Some patients may not respond to traditional antidepressants since they primarily affect neurotransmitters, according to the author.
Whether or not this turns out to be accurate, one thing is certain. There is still no sure way to solve the issue, which can be upsetting for both patients and the people.
In esketamine clinic practice, many patients with treatment-resistant depression who revealed to that loved ones thought they enjoyed being depressed or weren’t trying hard enough to get better because their antidepressants weren’t working. This has nothing to do with a lack of drive. Never have I encountered a patient who didn’t want to improve.
Treatment-resistant depression can be managed using well-established techniques.
Though the phrase “treatment-resistant” may connote “no hope,” there are resources available to assist those who have TRD. Optimization, switching, combination, augmentation, and somatic therapy. These are the five basic treatment strategies that psychiatrists might utilize to develop a customized treatment plan for patients. According to a 2012 study published in the journal Patient Preference and Adherence.
For instance, optimization entails “some people with TRD may benefit simply from allowing their antidepressants more time to act or by taking a greater dose.
Others may experience remission by changing to a different type of antidepressant. Adding one to their current regimen for a combination strategy.
Electroconvulsive therapy (ECT), which causes changes in brain chemistry to help reverse symptoms of TRD, are other somatic (non-drug) therapies.