Seeking Treatment: How Can I Find Resources For Refractory Depression?
- For those experiencing suicidal thoughts, please contact the 988 Suicide & Crisis Lifeline at 988
- For those experiencing abuse, please contact the Domestic Violence Hotline at 1-800-799-SAFE (7233)
- For those experiencing substance use, please contact SAMHSA National Helpline at 1-800-662-HELP (4357)
Understanding major depressive disorder
Major depressive disorder (MDD)—also called major depression—is a serious mental health condition that can significantly impact an individual’s life.
If you’ve experienced major depression that doesn’t respond to conventional forms of care, you may have a condition known as treatment-resistant depression (TRD), also called refractory depression. Below, we’re going to provide an overview of treatment-resistant depression and discuss how you can find resources for addressing its symptoms
What is treatment-resistant depression?
Depending on the symptoms that an individual with major depression experiences, a healthcare professional may develop a treatment plan that includes psychotherapy, medication, or a combination of both. And while these standard modalities for managing depression are effective in reducing symptoms for most, some individuals do not respond as favorably, or at all, to them.
According to research published in the journal BMC Psychiatry, when consecutive treatments with two products from different pharmacological classes are used at the optimal dose for a sufficient length of time without an improvement in symptoms, the individual is considered to have treatment-resistant depression. It can be frustrating to experience this form of major depressive disorder, but if you believe you may have treatment-resistant depression, you’re not alone. It’s estimated that one-third of adults with depression experience symptoms that do not respond to treatment.
Finding resources for refractory depression or treatment-resistant depression
For patients with treatment-resistant depression, experiencing symptoms that do not respond to common forms of care can further complicate an already complex disorder. Often, though, TRD can be managed by developing a unique approach based on the individual’s symptoms, past treatments, and various other factors. If you’re looking to address treatment-resistant depression symptoms, the following are ways you can find resources geared toward managing TRD.
Working with a specialist for treatment-resistant depression
Because TRD can vary in intensity and may manifest differently between individuals, it can be challenging to diagnose. If you’re experiencing TRD, seeking the help of a psychiatrist or other mental health professional who focuses on depression can be a helpful first step toward managing your symptoms. There are multiple strategies specialists can use to determine whether TRD is the reason that treatment isn’t working for you.
Treatment plan to address major depressive disorder
A depression specialist can work with you to gather more in-depth information about your symptoms, medical history, lifestyle, etc. This can provide them with a more thorough understanding of the factors that may influence their symptoms and inform the development of a new treatment plan.
Your doctor will likely want to know what medications, if any, you’re taking for depression and other health conditions. Try to be as accurate as you can when discussing whether you’ve been taking your medications as prescribed so that the specialist can better evaluate their efficacy.
Your provider may want clarification on how you’ve responded to other types of treatment, including psychotherapy. They will likely also ask about other health conditions that may have exacerbated depressive symptoms or impacted the effectiveness of medication. Be sure to discuss any specific health conditions, like thyroid disorders, chronic pain, or heart problems, with your doctor.
Exploring medication strategies as treatment for TRD
If nothing seems to effectively treat your depression, a licensed clinical professional will consider the entire scope of your treatment plan, including medications, psychotherapy, and alternative treatments for refractory depression.
Medication as primary care for treatment-resistant depression
Medications for refractory depression may work differently for different people. A psychiatrist may work with you to find the right medication or the right combination of medications, as well as the right dosage for each medication. Some medicines take longer than others to become effective, so your doctor may ask that you try a particular medication schedule for an extended time. If you experience side effects, you might mention these so that your doctor can prescribe something that works better for you.
Specialists may also use a cytochrome P450 (CYP450) test to measure how effectively your medications are working. The cytochrome CYP450 is a genotyping test that identifies certain genetic indicators for how well your body may be able to metabolize a particular medication. Certain genetic traits cause variations in some cytochrome P450 enzymes, and that can cause people to respond to medications differently. While a CYP450 test can be a useful tool in helping to treat refractory depression, it doesn’t always guarantee clear answers. Patients might also want to contact your insurance company to confirm that your plan covers CYP450.
BetterHelp currently accepts HSA/FSA cards and is recognized as an eligible expense by most HSA/FSA providers. Get started today.
Exploring psychological counseling or therapy as primary care for TRD
Psychological counseling, which is also referred to as psychotherapy, is a type of treatment administered by a psychiatrist, psychologist, or other mental health professional. It can be a beneficial form of treatment for many people, either alone or in combination with medications. Your therapist will help identify underlying issues that may be contributing to your depression and set some goals for your treatment plan.
How therapy can be one of the resources for refractory depression
- Find ways that work for you to help you cope with your challenges.
- Identify and address any issues with past trauma.
- Find effective ways to manage the effects of stressors in your life.
- Help you manage and improve essential relationships in your life.
- Help you to address any issues with substance use.
It’s important to communicate with your therapist about how well your psychotherapy is working. If the current treatment isn’t working, your therapist may decide to use a different form of psychotherapy. If your therapist changes your treatment plan yet you still seem to be lacking progress, try seeing a different therapist. A different therapist with a fresh outlook may be able to work better with your condition.
There are many types of psychotherapy used to treat symptoms of major depression. Your therapist will likely choose the modality they think will be most effective for you based on initial sessions with you and any information they received from your other healthcare professionals.
Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) addresses the thoughts, feelings, and behaviors that may contribute to depression. It is designed to help you identify and change any distorted or unhelpful thought patterns that may be underlying symptoms of depression. For example, your therapist may help you recognize that a negative attitude toward treatment causes you to feel less motivated and contributes to your low mood. CBT is considered one of the most effective forms of psychotherapy for depression, and many patients benefit from its structured, goal-oriented approach.
Acceptance and commitment therapy
A derivative of CBT and traditional behavioral therapy, acceptance and commitment therapy encourages the individual to accept their thought patterns and feelings with the goal of understanding why they exist and how the mind uses them to cope with difficulty. With this understanding, they can then work on developing healthier, more productive behavioral patterns.
Interpersonal therapy
Interpersonal therapy focuses on resolving challenges surrounding your relationships that may contribute to refractory depression. For example, a therapist could help you realize that communication struggles between you and your partner cause you to internalize feelings of sadness and experience feelings of loneliness.
Group therapy
Group therapy is a form of counseling in which several people attend sessions at the same time, typically for the same concerns. When addressing treatment-resistant depression, it may help to participate in therapy with people who are experiencing similar challenges.
Brain stimulation therapies
In addition to the above options, treatments known as brain stimulation therapies have proven effective for many people with treatment-resistant depression. These modalities are typically only suggested for people with persistent, severe depression symptoms. If your healthcare provider is considering one of these treatments, they will likely spend a lot of time educating you on the risks, potential benefits, and processes involved. The following are the most common forms of brain stimulation therapy.
- Electroconvulsive therapy (ECT) – Electroconvulsive therapy is a form of brain stimulation in which a carefully measured amount of electricity is conducted through the brain to trigger a small, brief seizure. The seizure creates changes in brain chemistry that may relieve the symptoms of major depression.
- Repetitive transcranial magnetic stimulation (rTMS) – Transcranial magnetic stimulation is a process in which a magnetic field is used to stimulate areas in the brain that control mood to target depression symptoms.
- Vagus nerve stimulation (VNS) – VNS is a process in which a device sends signals through the vagus nerve, which is partially responsible for facilitating functions that can alleviate depression. Clinicians usually reserve this type of therapy when ECT and rTMS aren’t effective.
According to the National Institute of Mental Health, researchers are looking into other forms of treatment, such as deep brain stimulation and magnetic seizure therapy. You can ask a doctor about these and other forms of treatment for depression.
Lifestyle changes
As with many kinds of mental health care, treatment for refractory depression is often more effective when the individual is mindful of their physical health and practices self-care. There are many ways you can reduce the stress in your life and improve your chances of experiencing desirable long-term treatment outcomes. Try to get as much rest as possible, maintain a balanced diet, and get regular exercise. Self-care practices such as yoga, mindfulness, and deep breathing can also be beneficial.
Navigating refractory depression with online therapy
The results from a growing number of studies suggest that online therapy is an efficacious form of treatment for people with depression. In a meta-analysis of 14 studies examining the benefits of online cognitive behavioral therapy for depression, researchers concluded that treatment produces an “immediate and sustained reduction in depressive symptoms”. They also noted the ability of online therapy to bridge the treatment gap that often exists in mental health care due to barriers such as cost, geographical limitations, and time constraints.
If you’d like a new perspective on your depression symptoms, consider getting matched with a qualified mental health professional through BetterHelp. BetterHelp works with thousands of licensed therapists—who each have three years and 1,000 hours of hands-on experiences—so you’ll have a good chance of connecting with someone who can help you address your specific concerns regarding treatment-resistant depression. With online therapy, you can participate in sessions remotely, which can be helpful if refractory depression makes leaving home difficult.
Takeaway
What resources are available for those with depression?
There are several resources available for individuals with depression, depending on the severity of their mental health condition. Some common treatment options for patients include psychotherapy, antidepressants, and acceptance and commitment therapy, which is focused on helping patients behave more consistently and develop psychological flexibility. Healthcare professionals may recommend a treatment-resistant depression program for more complex cases. Other advanced methods like transcranial magnetic stimulation, vagus nerve stimulation, or other brain stimulation therapies can also help improve depression symptoms, especially when standard treatments haven't worked. Patients should consult their doctor to find the best approach or treatment based on their diagnosis, overall mood, and any underlying physical health conditions.
How do you help someone with severe depression?
To help someone with severe depression, you can start by encouraging them to see a mental health professional. A healthcare professional or provider may recommend depression treatment, such as therapy, oral antidepressant medications, and other methods to cope with depression. A treatment-resistant depression program and other treatment modalities may also be recommended by mental health professionals in case standard treatments don’t work for patients. There are some therapies as well that have shown high efficacy in some patients, such as ECT and therapies that can help stimulate nerve cells in the brain. It is important to check for possible underlying issues that can affect someone’s mood. Consider telling someone to consult with a psychiatry specialist to find the right prescribed care.
Which of the following is the most effective treatment available for refractory major depression?
ECT or electroconvulsive therapy is one of the most effective treatments available for refractory major depression. It is an FDA-approved option used when standard treatments, like antidepressants or certain medications, have not worked. Research in the field of psychiatry shows strong efficacy for ECT in helping patients with chronic and severe depression by directly affecting nerve cells in the brain. It is typically considered when other treatment modalities fail to treat the condition effectively.
What resources can you use to help someone with a mental illness?
To help someone with a mental illness, you may start by encouraging them to talk or seek support from a doctor of psychiatry or another mental health professional. Various resources are available, including therapy, support groups, and antidepressants, which may help many patients manage symptoms. It’s also often important to reduce stress and give emotional support, especially when they begin to lose hope or feel overwhelmed. Early help can prevent the condition from getting worse and affecting the brain over time.
Which would be the best resource for someone who is mildly depressed?
The best resource for someone who is mildly depressed is often early support and guidance through psychiatry or counseling. This may help patients manage their emotions and feelings and reduce stress before symptoms worsen depression over time.
What is the most efficient treatment for depression?
The most efficient treatment for depression often involves a combination of therapy and support from psychiatry professionals. This type of approach can help patients manage their emotions, reduce stress, and avoid actions or habits that can worsen depression.
What defines refractory depression?
Refractory depression is defined as a form of depression that does not improve after trying multiple standard treatments. Patients with this condition often need specialized care from psychiatry professionals, as untreated symptoms can worsen depression over time.
What is treatment-resistant persistent depressive disorder?
Treatment-resistant persistent depressive disorder is a long-lasting form of depression that does not adequately respond to typical treatments like medication or therapy. Patients with this condition often need ongoing support and may benefit from specialized care in psychiatry to explore alternative treatment options.
- Previous Article
- Next Article