Over the past two years, the percentage of adults — particularly young adults — experiencing anxiety or depression has increased significantly. And each year, over 30% of people with major depressive disorder develop treatment resistance also known as treatment refractory depression or TRD.
What is Treatment-Refractory Depression and How is it Different from Depression?
Typically, medication and talk therapy are used as first line treatments for mood and anxiety disorders. Only approximately 50% of people, however, will achieve remission with after two medication trials, with each subsequent trial having a higher risk of intolerable side effects and a lower likelihood of achieving remission. Treatment resistant depression (TRD) is commonly defined as the failure to respond or achieve remission after two or more trials of antidepressant medication of adequate dose and duration.
Signs and Symptoms
Major depression is a common debilitating disorder affecting 10%–15% of the population per year. Despite advances in the understanding and treatment of major depression and the introduction of several new classes of antidepressants, only 60%–70% of patients with depression respond to antidepressant therapy. Of those who do not respond, 10%–30% exhibit treatment-resistant symptoms which usually include:
- Symptoms of depression including tearfulness, loss of interest in normal activities, sleep disturbances, trouble concentrating or unexplained weight loss/gain
- Lack of response to multiple medication trials or various prescribed medicines.
- Worsening symptoms of depression or side effects with each failed treatment attempt.
Causes of TRD
Treatment-resistant depression is likely caused by multiple risk factors. First, it’s important to confirm a correct diagnosis of depression. A failure to correctly and precisely identify the actual subtype of depression, such as atypical, psychotic, bipolar, or melancholic depression, can impact treatment outcomes. Misdiagnosis may also include failure to identify a comorbid medical condition, including hypothyroidism, anemia, substance abuse disorder or eating disorder, which can worsen depression or might be the main underlying cause of depression.
Then, for most patients correctly diagnosed with depression, it is likely a combination of different risk factors contribute to treatment resistance including personal characteristics, medication variables, and psychosocial stresses. Research suggests that these risk factors may specifically include older age, increased severity of the depressive episode, longer length of the depressive episode, not staying on prescribed antidepressants long enough or skipping doses, unpleasant antidepressant side effects, drug–drug interactions, the wrong medicine or the wrong dose for the individual in question and genetic disposition in terms of fast or slow metabolizers of antidepressants.
How Is Treatment-Refractory Depression Treated?
If antidepressants and talk therapy aren’t working for you, you’re not alone and it doesn’t mean you can’t feel better. But, it does mean you should try a different treatment. There are many alternative and non-drug treatments available that can help. Talk to your doctor or mental health professional about whether one of the following alternatives might work well for you:
TMS (Transcranial Magnetic Stimulation)
Transcranial magnetic stimulation is a drug-free, FDA-cleared treatment that uses gentle magnetic pulses to treat mood at its source. Unlike medications which can take 6-8 weeks to exert their full effects, most patients experience improvement in 2 weeks with TMS therapy. Plus, TMS therapy is covered by most insurance, including Aetna, Anthem, Blue Cross Blue Shield, Humana, United Healthcare, and others.
MeRT (Magnetic e-Resonance Therapy)
Magnetic Resonance Therapy, MeRT, is a revolutionary technology that combines the latest therapies of TMS (an FDA cleared therapy), EEG and EKG to deliver treatments tailored for each individual’s unique brain pattern. By measuring and analyzing your brainwave activity, MeRT assesses the communication quality between the neurons in your brain and custom designs treatment protocols to optimize brain function.
Spravato and IV Ketamine Therapy
Spravato and IV ketamine therapy are highly effective and rapid-acting treatments. Designated as a ‘breakthrough therapy’ by the FDA, ketamine can rapidly—often within an hour or two—lift the symptoms of treatment resistant depression, anxiety PTSD, OCD, and other conditions including chronic pain. After a short series of repeated doses, this effect typically extends out for weeks to months. Our thoughtfully designed treatment centers ensure a safe, comfortable and private experience while our therapeutic processing and integration enhance ketamine’s direct effects on the brain and psyche resulting in profound emotional insights and deep inner healing.
Treatment-Refractory Depression Help in Los Angeles, CA
There are many safe, efficacious treatments for treatment resistant depression which empower providers to treat each patient fully with the goal of remission.
To learn more about treatments for TRD, contact us or call 1-877-847-3984 today.