Struggling with Treatment-Resistant Depression? Here Are Your Options

In this guide, we’ll explore why some depressions are resistant to treatment, the best alternative therapies, and how to find expert care near you with MDDCare.

Constantly battling with depression is difficult. When you aren’t responding to medication it makes it even worse. If you have not found relief from oral antidepressants, you are most likely suffering from treatment-resistant depression. TRD is a form of major depressive disorder (MDD) where depressive symptoms continue despite trying multiple treatments. However, If you suffer from TRD, there is some good news. There are innovative treatments available for those who have not found success with traditional medication. First, let’s discuss what TRD is, why it occurs, and then discuss the possible treatments that can help.

What is Treatment-Resistant Depression?

Treatment-resistant depression affects more than 30% of people with major depressive disorder. Patients are typically diagnosed with treatment-resistant depression when they have tried at least two different antidepressants without significant improvement in symptoms. Being diagnosed with TRD can feel discouraging, but understanding it is the first step toward finding a better solution.

Signs That Your Depression May Be Treatment-Resistant

• There is little to no improvement after at least two antidepressant medications
• Persistent or worsening symptoms despite treatment
• Continuing medication adjustments without long-term relief
• Experiencing thoughts of suicide
• You experience anxiety along with depression

Why Traditional Treatments Might Fail

There are many possibilities for why antidepressants may not work for everyone. Some of the most common factors include:

• Biological Differences: A person’s brain chemistry and genetic factors play a significant role in how they react to medication.
• Medication Tolerance: Patients can develop resistance to certain medications, causing them to lose their effectiveness.
• Underlying Conditions: Patients suffering from other mental health conditions, like anxiety or PTSD, can make it more difficult to treat depression.
• Incorrect Dosage or Diagnosis: Sometimes, the prescribed medication is not the best fit, or the dosage is not enough for the patient to experience symptom relief.

Alternative TRD Treatment Options

Medication Adjustments

For some, rather than switching treatments entirely, TRD can be managed by adjusting medications. For example, doctors may:

• Increase dosage or timing of medication intake
• Combine antidepressants for a more effective treatment
• Introduce mood stabilizers or atypical antipsychotics to enhance effectiveness 

Transcranial Magnetic Stimulation (TMS)

TMS is a non-invasive and drug-free treatment that uses magnetic pulses to stimulate areas of the brain associated with mood regulation. It is FDA-approved and has had promising results for those who have not responded to medication.

Benefits of TMS:

• No anesthesia or medication is needed
• Minimal side effects compared to oral antidepressants
• Long-term symptom relief for many patients

Spravato (esketamine)

Spravato is a fast-acting nasal spray, containing esketamine, and is FDA-approved to treat TRD. Unlike traditional medication that can take weeks to see changes, Spravato often provides relief within hours or days.

Considerations for Spravato:

• Must be given in a medical setting under supervision
• It can be effective for those who need rapid symptom relief
• Typically covered by insurance after failing two antidepressants

Therapy and Lifestyle Changes

Along with medical treatment, it’s important for those with TRD to embrace therapy and lifestyle changes to help manage their depression and create a strong foundation for healing.

• Cognitive Behavioral Therapy: Therapy will help patients feel supported, recognize and reframe negative thought patterns, and develop healthy coping strategies.
• Mindfulness and Stress Reduction: Patients who suffer from anxiety, along with their depression, find it harder to manage their depression. Techniques like meditation, or even just practicing deep breathing, can help reduce stress and regulate mood.
• Diet and Exercise: Exercise is important, as it helps release mood-boosting chemicals in the brain. Additionally, eating a well-balanced diet will help support brain function and overall well-being. Taking short walks or adding more whole foods to your meals, can start making a difference over time.

These changes alone may not be enough to overcome TRD, but combining these with medical treatments will help to improve a patient’s overall mental health and resilience.

Finding The Right Treatment For You

Many factors come into play when deciding the right treatment plan. Work closely with your healthcare provider to discuss your specific symptoms, medical history, and preferences. If you are unsure where to start, MDDCare can help you find clinics nearby offering treatments like TMS and Spravato. We know TRD can be frustrating, but know that effective treatments are available. Visit MDDCare to take the next step toward relief.