Depression is a condition that affects millions of people nationwide each year. From seasonal depression to postpartum depression, there are many different ways that this condition can manifest in a person’s life. Most people can successfully treat their symptoms with therapy, medication, or a combination of both. But what happens if the usual treatment approach doesn’t work? Then you may have treatment-resistant depression, a condition that requires specialized care in order to get relief. At WAVE Treatment Centers, our treatment-resistant depression options in Philadelphia can help individuals recover and get back to a full life.
What Is Treatment-Resistant Depression?
While there isn’t one cut-and-dry definition for this condition, most often a person is considered to have treatment resistant depression if they have tried at least two different appropriate depression treatments and haven’t experienced relief from their symptoms. This condition can be very complex as it often affects multiple areas of a person’s life. This can include sleep changes, weight changes, poor work or school performance, issues within personal relationships, and more. Treatment-resistant depression may be more common than you think. An estimated 30 to 40 percent of all people who take antidepressants only experience partial relief of their symptoms, while 10 to 15 percent don’t experience any relief at all.
Depression is complex and treating the neurobiology can be an ongoing process. This means that the dosages for your medications may need to be adjusted over time. By having the oversight of a medical provider and treatment resistant depression options during a medication management program, you can have your medications adjusted as needed to ensure they are working properly to treat your symptoms.
The symptoms of this condition are usually considered to be either no or little relief from depression symptoms with standard treatment programs, or brief periods of relief followed by a return of symptoms. Doctors believe that there is not just one situation that causes this condition. Instead, they believe it can be tied to one of three different causes:
- Misdiagnosis – The issue of misdiagnosis is one that has plagued people with mental health conditions for decades. While it may appear that someone has one condition upon an initial medical evaluation, they may in fact be suffering from something else. One of the most commonly misdiagnosed conditions is bipolar disorder, which can be misdiagnosed as depression if all symptoms aren’t considered and discussed. Each mental health condition must be treated in a way that is appropriate; a misdiagnosis can lead to a person being prescribed treatments that simply aren’t going to work.
- Genetics – Some research has shown that our genetics can affect how well our bodies respond to certain medications, including antidepressants. Some genes have been found to have a connection to treatment-resistant depression, but more research is necessary to solidify the findings. Wave Treatment Centers can conduct pharmacogenetic testing (collect saliva and cheek cell samples which are sent to specialized labs) to identify the degree to which you are able to metabolize psychotropic medications. This is one of the latest steps towards Personalized Medicine.
- Metabolic Issues – Other research has found a potential connection between depression and nutrient deficiencies. Numerous studies have identified links between vitamin deficiencies and mental health symptoms. Some of the more commonly identified deficiencies are folate and cyanocobalamin (B12). We are able to provide B12 injections when indicated as well as prescriptions for critical vitamins when they are not being adequately incorporated into your diet.
Treatment-Resistant Depression Options
Before your doctor will begin treatment for this condition, they will likely first ask you a series of questions to be sure that the failed treatment was administered properly. This may include ensuring you were taking it correctly, how long you used it, and that the dose was appropriate for you. If everything appears to have been done properly, additional options will be presented to you. Many times, doctors will suggest that you go to a therapist or counselor to discuss your symptoms. People often find additional, more lasting relief from depression symptoms when medical treatment is combined with psychotherapy or counseling. Many insurance companies consider adequate trials of psychotherapy (particularly CBT) in determining treatment resistance and approval of more intensive treatment such as transcranial magnetic stimulation (TMS) and Spravato (esketamine).
Once your therapist has discussed your past depression treatments with you and determined that they were administered properly, they will likely suggest a change to your medication. There are different classes, or types, of antidepressants available, each of which affect your brain chemistry in different ways. Your therapist may decide to treat you in one of the following ways:
- Prescribing a different antidepressant in the same class – For some people, one antidepressant within a certain class just doesn’t work for them. But many times, another may work to give you relief from your symptoms. This is often the first choice of treatment, as it is the simplest way to try and get you relief as quickly as possible.
- Changing to another class of antidepressant – For others, one class of antidepressants may just not work for them. Many doctors begin patients on selective serotonin reuptake inhibitors, or SSRIs. If this class does not work, you may be prescribed a serotonin and norepinephrine reuptake inhibitor (SNRIs), tricyclic antidepressants (TCAs), or a monoamine oxidase inhibitor (MAOI) instead. Each class of antidepressant affects your brain differently, so changing can be helpful to find what works for you.
- Adding a different type of medication – Augmenting antidepressants with a secondary medication can help to increase their effectiveness for some people. Certain anti-anxiety drugs, for example, have been shown to help boost the effectiveness of antidepressants. Some anticonvulsants have been found to have the same effect as well.
While finding relief from your depression symptoms can feel like an uphill battle, it is important to do what you can to try and help yourself. At WAVE Treatment Centers, we can help you get a handle on your treatment-resistant depression with a plethora of different options while sticking to your treatment plan even if it does not seem to be working. Most antidepressants take an average of 4-6 weeks to start showing results. Avoid alcohol or recreational drugs, which can interfere with the effectiveness of antidepressants. You should also try and maintain a normal sleep schedule, get enough exercise, and eat a well-balanced diet.
Without treatment, treatment-resistant depression symptoms are only likely to get worse, leaving you at a higher risk of further health complications. Learn more about WAVE Treatment Centers today and give us a call at 215-242-0420.