Are you wondering why your symptoms don’t get better even with treatment? Have you heard about treatment resistant depression?
Successful treatment does exist. Stay persistent!
The two clients in my waiting room have something tough in common, though they don’t know it.
They are both depressed. Their symptoms may look like depression, depression and anxiety combined, or sometimes even like the up-and-down mood swings associated with bipolar disorder.
Their symptoms have not yet been reduced by treatment with medications, although they’re both working with competent psychiatrists to make this happen.
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The toughest part of the equation for both is that they have Treatment Resistant Depression (TRD)
This means that they’ve had an inadequate response to at least two antidepressants despite adequate dosing and duration. In other words, they feel still lousy after a long time, even though they’ve tried to get help and get better — and it sucks.
Treatment-Resistant Depression (TRD) is a relatively common occurrence.
Here are some basic facts about TRD:
- 50% to 60% of patients with a history of bipolar, anxiety-based or major depression have not achieved an adequate response following antidepressant treatment.
- Approximately 50% of patients diagnosed with major depressive disorder will experience a recurrent or chronic course of illness for which long-term treatment is recommended.
- At least 20% of patients diagnosed with depression do not respond satisfactorily to several traditional antidepressant medication treatment trials.
Watch the video to know more about depression from a neurologist point of view
Treatment resistant depression may be the result of the following issues:
1. The patient resists taking medication as prescribed:
This represents 40% of patients and may be due to a lack of understanding or education about the process, low self-esteem, or other mental health issues.
2. The medication dosing has been too low:
Also known as sub-therapeutic depression, this is the cause for 20% of patients.
3. The patient experienced intolerable adverse effects:
This means the patient can not/will not tolerate negative side effects of antidepressant medications, and is the cause for 20-30% of patients.
4. The patient received the wrong diagnosis:
The symptoms may be arising for another reason entirely, such as thyroid disease, nutritional deficiencies, sleep apnea, latent bipolarity, co-occurring mental illnesses like ADHD or addiction. This is the case for 10-15% of patients.
This morning the foggy weather outside is emulating the mood of the two clients inside.
Local meteorologists say the fog will lift by noon, but, when you have treatment-resistant depression, the bleakness of your fog doesn’t break at noon with the hope of newly blue skies.
You get discouraged about that.
These two are discouraged as well; yet, they’re encouraged to learn that there are holistic behavioral health and wellness treatments available for them to try.
Both have said that it’s hard to avoid the negative belief cycle causing them to fear this may not work because, as bioscience shows us, negative thoughts have a tendency to perpetuate themselves.
The longer you’re in the negative, the harder it is to bring in the positive. With all this biochemical instability, it’s hard to add the next essential pieces to ensure a positive impact on quality-of-life.
That’s the holistic therapeutic journey we go on together.
Clients come in for this proactive, psycho-educational, expressive, strategy-building part of a successful wellness plan. They’ve already learned that, with or without treatment-resistant depression, medication isn’t their sole assurance for long-term relief. Their plans must expand to include a whole system of change in how they think, emote and act.
We’ll add some additional types of therapies, such as problem-solving, solution-focused therapy, cognitive-behavioral therapy (CBT), dialectical behavioral therapy (DBT), EFT, and more.
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