Depression is a common mental health condition, affecting millions worldwide. For many, symptoms improve with antidepressants, therapy, or a combination of both. But for some, even after trying multiple treatments, the dark cloud doesn’t lift.
When your depression symptoms persist after trying different medications and therapies, you may have treatment-resistant depression (TRD). Despite the name, TRD is treatable, and you can feel better.
At Reviv Functional Psychiatry & TMS Wellness Center in Fullerton, California, our psychiatrist, Dr. Hina Sidhu, understands the frustration, exhaustion, and doubt that can come with TRD. However, thanks to advances in treatment, lasting relief is possible.
About 30% of folks diagnosed with major depressive disorder (MDD) experience TRD. It’s a type of depression that doesn’t improve after trying at least two first-line antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin or norepinephrine reuptake inhibitors (SNRIs) given at adequate doses and for a sufficient time.
Symptoms of TRD are similar to MDD and include:
However, TRD symptoms are usually more severe, and the depressive episodes last longer. People with TRD may also have a challenging time experiencing pleasure and struggle with anxiety.
Unfortunately, there’s no universally accepted definition for TRD. The Food and Drug Administration (FDA) and European Medicines Agency (EMA) define TRD as failure to respond to two or more antidepressants despite adequate dosing and duration.
However, this definition is limited and fails to distinguish partial improvements in symptoms with medication or therapeutic treatments. It also doesn’t include outside factors that may contribute to the low mood, such as a chronic health condition or substance use disorder.
Ongoing depression may also occur with other undiagnosed mental health conditions, such as bipolar disorder.
In addition to the guidelines, we must rule out other causes when considering depression as treatment resistance.
We have developed effective treatments for TRD. We may start by trying other antidepressants and psychotherapies.
We also offer transcranial magnetic stimulation (TMS) therapy for TRD — a nondrug treatment that uses magnetic pulses to stimulate the area of the brain that manages your mood.
Studies show that TMS is an effective treatment for TRD, typically requiring five sessions a week for up to six weeks. As a functional medicine psychiatrist, we also help with lifestyle changes that support overall health, including good nutrition, regular exercise, and stress management.
If you’re struggling to get relief from your depression symptoms and have concerns about treatment resistance, we can help. Call us today to schedule an appointment with our specialist.
