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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TMS Trials

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