What is Treatment Resistant Depression?

First you need to be diagnosed with depression and have the symptoms of any kind of depression. If you tried treatment for your depression but symptoms never improved, you may have treatment-resistant depression. Taking an antidepressant or going to psychological counseling helps reduce symptoms for mamy people. But with treatment-resistant depression, standard treatments aren't enough. They may not help much at all, or may improve your symptoms, only for them to keep coming back. This shouldn't be confused with persistent depression, which requires you have had depression for at least two years [in a single span of time]. While many people with treatment resistant depression do have chronic or persistent depression, it typically isn't their main diagnosis.

My personal experience is that medication does not help, from anxiety to depression to insomnia meds, and I've been in therapy for 6 years but it certainly hasnt relieved my symptoms to the point I'm functional. Even after two inpatient programs [partial hospitalizations] which did help a lot, my depression always came back full force within a year. The best thing I ever did for my mental health was TMS, and I still had my depression come back, which confirmed to everyone I have TRD.

My one tip would be to consider pharmacogenetic testing. These tests check for specific genes that indicate how well your body can process (metabolize) a medication or how your depression might respond to a particular medication based on additional factors. Currently, pharmacogenetics tests are not a sure way to show if a medication will work for you, but these tests can provide important clues for treatment, particularly in people who have many side effects or have had poor results with certain medications. They are not always covered by insurance.

There are limited treatment options for TRD, and they all have pros & cons, but the efficacy rates of each are fairly good. There is TMS, what I am currently doing, as well as Ketamine Infusions, ECT [electrconvulsive therapy] and vagus nerve stimulation. Ketamine and TMS are usually the first options, sometimes used together. ECT is often only reccomended if TMS doesn't work or only gets a response [relief] but not remission [no symptoms]. Vagus nerve stimulation is typically a last resort if ECT, TMS, and ketamine doesn't work at all.

Mayo Clinic TRD

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Comparing the Two Main Treatment Options for Treatment Resistant Depression [TMS & Ketamine]

Time Commitment Ketamine infusions work very quickly — often within hours — to ease depressive symptoms. The relief from Ketamine, in 99% of cases, will be felt more quickly than TMS. TMS fast and safe for adolescents For the average patient, ketamine infusion therapy consists of a series of six infusions spaced out over the course of two or three weeks, so the time frame is could be 2 weeks or almost the same This initial treatment is followed by a long-term maintenance phase that includes occasional booster infusions as needed. While TMS also has a maintenance phase it is not standard to do a maintenance dose for every TMS patient. Once a patient reaches the maintenance phase, it is quite varied how often they will need these “booster” infusions. Some patients prefer to get 1 or 2 infusions per month in order to proactively prevent the resurgence of their depression. Others come back for their booster infusions 3 or 4 months after the completion of their initial 6-12 infu...

A Year of Remission

For my first full round of TMS therapy, I was approved for 32 days of TMS for anxiety [which also helps depression] and I noticed small mood changes my the end of the 7th treatment. Things like having less anxiety and racing thoughts, laughing more, slightly better sleep, less fatigue, and more motivation. By the end of the 14th day I noticed some moderate mood changes, like reaching less to hypotheticals I would normally have anxiety about, and things happening in my real life making me happy. It was also easier to cope with mood swings and difficult days. By my 21st day, I noticed a much bigger difference in my quality of sleep as well as in my mood. I had a clarity of mind I had never experienced, and everything felt light and calm, for once. Every day after that- my mood got significantly better once I finished each treatment. I would notice that it was like watching storm clouds clear away and seeing a sunny blue sky after a long storm. I had more plans for my future, everybody ar...

Depression Relapse and TMS Again

Trigger warning: self harm, suicidal thoughts [not graphic] In 2022 my depression came back quick, and in full force. I didn't just have a full depressive episode, I had it with all my old self harming and suicidal thoughts. I'm already in therapy, and the meds don't work. It took months just to get a sleep med that helped my insomnia so I didn't plan to treat this with medication. I knew that for some people TMS only lasts around a year [could be more as well] so I decided to see if I could get TMS again. I contacted a TMS provider, filled out the forms, and we had a telehealth call to discuss them. After that they called to let me know I was approved on their end for TMS so they would send everything to insurance. Soon after that I was told insurance approved me and was fully covering it. We set a date, and I came in for my first treatment last Friday after waiting two weeks. I decided to document this journey with TMS to show people what it is, since its relatively ...

TMS Trials

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