What Is Treatment Resistant Depression: 7 Ways To Help Cope


what is treatment resistant depression

Are you wondering why your symptoms don’t get better even with treatment? For most people, depression is usually treated with antidepressants or therapy or a combination of both. But still, some people remain unresponsive to antidepressants and they are believed to be suffering from treatment resistant depression.

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.

Having Anxiety And Depression

Their symptoms have not yet been reduced by treatment with medications, although they’re both working with competent psychiatrists to make this happen.

Related: Anxiety In Children: 15 Calming Things You Can Say As A Parent

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.

What Is Treatment Resistant Depression?

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.

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.

Related: Psychologists Think That ADHD And ADD Sufferers Might Actually Be “Indigo Children”

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.

Related: How I Used CBT to Mend a Broken Heart

As we progress, we’ll see first-hand how their daily life patterns and lifestyle changes impact their mood regulation, helping or hurting in their wellness equations.

Those two clients in my waiting room are ready for change. Their struggles with their mood issues are working overtime. You or someone you know may be in a similar situation.

Here’s more to know about each of these two particular individuals:

Client A is a long-term client who decided to work with a holistic therapist because his husband was threatening to leave him if he didn’t.

For six years, he’d met with his primary care physician for the first course of anti-depressants, which didn’t work. He then went on to other psychiatrists — four, in fact — hoping to find just the right pharmaceutical cocktail with which to toast a new happy chapter.

Deep in his gut, he told me he’d wondered if he had a real chance of whipping his depression, as his parents and grandparents had suffered from the same throughout their adult lives.

Client B arrived in my waiting room a day early.

Embarrassed, she apologizes, saying, “I just feel so down and anxious and overwhelmed that I don’t even know what day it is.”

She’s a relatively new mom, 14 months into it, whose history of anxiety-based depression is pretty minimal. She was what she describes as “blue” and anxious as a teen, but played competitive tennis to handle it, so she felt no need to see a psychiatrist for her condition back then.

When her first child was born after twenty-two hours of labor managed by an angelic and skilled midwife, she felt increasingly moody. The psychiatrist she began seeing is known for successfully matching meds with patients, but it’s been a year now, and after four tweaks trying to find her the right medication, she’s found no full relief yet.

What’s the next step for managing treatment resistant depression in such cases?

One of the first questions I ask clients with TRD is whether their psychiatrist has mentioned repetitive transcranial magnetic stimulation — also known as rTMS or simply TMS — and if so, if they’ve determined whether they are good candidates. Usually, their psychiatrist and I will also touch base on this, as only a physician is able to prescribe this form of treatment (which may be covered by health insurance).

I raise this because, while some people with treatment resistant depression will want to start by making holistic changes, they can’t because their brain chemistry won’t cooperate.

Repetitive transcranial magnetic stimulation is an evidence-based neuromodulation technique that gets added to a patient’s current medication regimen, and which modifies neurotransmitters in the limbic region of the brain. It is noninvasive, meaning it does not involve any type of surgery or surgical process, and therefore also does not involve either sedation or hospitalization.

The technique works by generating magnetic pulses that penetrate brain tissue and induce electrical currents that can correct imbalances in neuron activity, often leading to improvements in symptoms that have otherwise been hanging on.

TMS therapy has been proven to be safe and effective in many worldwide clinical studies and is currently being tested for treating several other mental health and medical conditions. It’s exciting science for sure!

After a period of 4-10 weeks of receiving treatments, many people’s brain chemistry will reach some range of normalization. This means they can now proceed with other types of therapy mentioned above, as well as with other strategies and holistic life changes.

Here Are Seven Holistic Strategies That Help Sustain Wellness And Brain Chemical Balance If You Suffer From Treatment Resistant Depression.

1. Exercise on a regular basis

Regular exercise increases the production of endorphins. It’s the feel-good brain chemical that can lift mood, plus improve sleep quality, energy level, and concentration.

Related: 15 Art Therapy Exercises to Control Your Mind and Channel Your Emotions

2. Practice yoga

Yoga for treatment resistant depression

Yoga is an Eastern-influenced practice that’s thousands of years old. It involves the mind, body, and spirit, using slow, purposeful positions and movements while also focusing attention on the rhythm of your breathing.

Related: Meditation and Yoga Can Reverse DNA Reactions Which Cause Stress

3. Make good food choices

Nutrition has a direct biochemical reaction to our system. Harvard Health confirms that a rich, plant-based diet influences mood stability; and decreases the risk of depression happening or worsening. Ever had a blood sugar drop because you waited too long for lunch? Drowned your date disappointment in too many bobas with cookies? Notice your mood then.

4. Try mindfulness exercises and techniques

Mindfulness is an ancient tradition like yoga. It trains you to remain focused on the present moment; instead of ruminating about the past, anticipating future events, and, thereby keeping emotional angst enlivened.

Related: How Mindfulness Can Help You Let Go Of Past Hurts and Heal Yourself

5. Get regular massages

Massage therapy helps to release serotonin and dopamine while reducing cortisol levels. This improves mood and reduces depression and anxiety symptoms.

6. Participate in your favorite hobbies

Participating in hobbies or interests that inspire you or excite your passions raises your mood, while also boosting self-confidence and self-esteem.

Related: Brain Power: 5 Good Hobbies That Nourish the Mind

7. Listen to — and make — music

Music for treatment resistant depression

Music is an imperative tool to use. It feeds the right side of the brain, which is where our emotions live. It can also offset the negative impact of too much screen time on this part of the brain.

Using music regularly activates your brain in positive ways, both when you listen, and even more so, when you make it. You don’t need to riff like Brittany Howard or sing with perfect pitch. Pick pieces that you happily, passionately enjoy.

Related: 8 Surprising Ways Music Benefits Your Brain

Ready to do some work and take the next step in relieving the symptoms of treatment resistant depression?

Hopefully, you’ve just reviewed your checklist here and have an idea of where to start. Reach out for help. Remember, depression and anxiety has no familial or geographical boundaries. Wherever you are, we can talk.

What’s your view on depression? Share with us by commenting below!

Written By Christy Whitman
Originally Appeared On Your Tango
What It Means To Have Treatment Resistant Depression?
what is treatment resistant depression pin

— Share —

— About the Author —

Leave a Reply

Up Next

How Work Depression Can Impact Your Life And What To Do

What is Work Depression and How To Deal with It

Does being at work feel like a prison sentence? Is it becoming increasingly difficult to perform your tasks and meet deadlines? Does your job feel like a heavy cloud hanging over you? If so, you may be experiencing the unspoken reality of work depression.

While most of us become burnt out from time to time due to the daily grind, work depression can be much severe and can seriously affect your career and life. Let us explore what is work depression, its signs, causes, and the profound impact it can have on mental health. 

But most importantly, we will also learn about some valuable strategies to cope with depression in the workplace, enabling you to find a sense of balance and well-being in your professional life.

What is W

Up Next

8 Deep Depression Poems That Can Help You Stay Strong During Tough Times

Deep Depression Poems: Discovering Strength In The Shadows

Amid life’s stormy seas, when your despair threatens to overwhelm you, finding solace in the power of words can feel like a lifesaver. For centuries, poetry has been able to capture our raw emotions and illuminate our inner struggles. Today we are going to do a deep dive into some of the best and deep depression poems that will tug at your heartstrings and help guide you towards the light.

These depression poems has the ability to help you understand just how resilient you are, and all you need to do is get in touch with your resilient side. These poems tell stories of pain, hope, and the unwavering strength that emerges from even the darkest corners of our hearts.

Let’s explore some of the most impactful and deep depression poems that can help you get in touch with your vulnerable and strong side.

Up Next

Understanding The Sylvia Plath Effect: How Mental Turmoil Fuels Artistic Brilliance

The Sylvia Plath Effect: How Mental Turmoil Fuels Artistic Brilliance

Poets have long been seen as depressed souls. But why? Is there a deep connection between creativity and mental illnesses? Why do writers and poets who can create such  greatest works of art, literature, and poetry struggle with depression? Let’s delve into the world of writers grappling with the Sylvia Plath Effect.

Creativity is a blessing that each and every writer is always grateful for. But it can also be a curse for some. Why? Writers and poets think deeply. They feel everything from the core of their heart. 

They are sensitive souls who often repress their own emotions and pour it out on the page, expressing their deepest thoughts and feelings, and joys and sorrows through their work.

While this can help them to create literary masterpieces, it can also

Up Next

Depressed Overeating: 7 Tricks That Can Help You Stop Overeating When Depressed

Depressed Overeating: Ways You Can Stop Overeating

Struggling with the dark cloud of depression is tough enough on its own, but when it comes hand in hand with overeating, it can feel like an endless cycle of despair. I am talking about depressed overeating.

We’ve all been there, finding solace in that extra slice of red velvet cake or the bottom of a bag of deep fried cheese balls, only to be left with a mix of guilt, shame and physical discomfort.

However, the good news is that there are certain things you can do to break free from the clutches of depressed overeating. There is light at the end of the tunnel, and all you have to do is have faith in yourself.

Before we delve into the strategies that can help you put a stop to depressed overeating, let’s find out the link between depression and overeating.

Up Next

Feeling Blue? 9 Signs of Mild Depression You Shouldn’t Ignore For A Brighter Tomorrow

Feeling Blue? Signs of Mild Depression

Have you ever found yourself feeling down, lacking motivation, or losing interest in activities you once enjoyed? If so, you may be experiencing mild depression. It’s essential to recognize the signs of mild depression and understand its causes and treatment options. 

What is Mild Depression?

Mild depression, also known as dysthymia or persistent depressive disorder, is a form of depression that lies on the milder end of the depressive spectrum

Up Next

Masculinity And Mental Health: 12 Warning Signs of Depression In Men And What To Do

Signs of Depression in Men You Shouldn't Ignore

Do you often feel frustrated, irritable, and withdrawn? If you are a man and if you are frequently in a bad mood, then it’s likely that you have male depression. The shadows of masculinity can often hide the signs of depression in men.

Male mental health is a topic we rarely talk about as a society that is supposed to be fair and equal. Yet, societal expectations often silence the cries for help from men who suffer from depression. 

But let’s change that today! Depression affects millions of people worldwide, regardless of gender. However, men often face unique challenges when it comes to recognizing and addressing

Up Next

Battling Post Graduation Depression: 7 Powerful Strategies To Crush Post-Grad Blues After College

Coping with Post Graduation Depression: Powerful Tips

Did you experience a mix of excitement and uncertainty after completing your graduation? The transition from the structured world of academia to the uncharted territory of post-graduation life can be overwhelming. This can lead to a rollercoaster of emotions, including post-graduation depression.

Let us explore what is post grad depression, its symptoms, and most importantly, effective strategies on how to overcome post graduation depression. So, if you’re a recent graduate struggling to find your footing, keep reading – there is hope on the other side!

What is Post Grad Depression?

Post graduation depression, also known as post grad