Depression

An estimated 5% of the world’s population suffers from depression, making it one of the most prevalent mental disorders. Additionally, it is one of the main causes of disability worldwide. Therapy, medicine, and maybe electroconvulsive therapy or transcranial magnetic stimulation are all forms of treatment for depression.

However, for some people, these remedies are insufficient to reduce depression symptoms. Depression that is resistant to treatment is what happens in this situation. Treatment-resistant depression is defined differently by different sources, however it often manifests itself when at least two treatments fail to significantly reduce symptoms.

Treatment-resistant depression has many underlying reasons, but recent research has identified some risk factors. These include genetics, family history, and lifestyle variables as well as risk factors for the body and the brain.

Other Related Health Problems

Certain medical problems and depression can coexist. These include hypertension, digestive issues, and heart disease. Chronic non-cancer pain disorders have also been closely linked to treatment-resistant depression.

It can be difficult to determine how much one aspect of chronic illness and treatment-resistant depression influences the other, which can create a chicken-and-egg situation.

Depression can coexist with other mental health issues such eating disorders, substance abuse, post-traumatic stress disorder, and personality disorders.

Metabolic Disorders

Clinical studies have also revealed that nutritional deficits and metabolic issues might contribute to depression that is resistant to treatment. One study looked at 33 people with treatment-resistant depression’s blood, urine, and cerebrospinal fluid. It was discovered that 21 of the subjects had metabolic anomalies, the most typical of which was a folate (vitamin B9) deficiency.

Studies have also shown a connection between a vitamin D deficit and serious depressive disorder. Vitamin D insufficiency and treatment-resistant depression have not been directly linked, though.

Genealogy and genetics

Over the course of their lives, those who have a family history of depression are more likely to experience clinical depression themselves. Studies have found a link between clinical depression and family history, but they have not particularly looked at the risk factors for treatment-resistant depression.

Research on the relationship between a genetic propensity for depression and treatment resistance is still in its early stages. Findings, however, have revealed some biomarkers that place people at a higher risk of depression that is resistant to treatment. To decide whether treatments are suitable for people with these biomarkers, further empirical data are needed.

Misdiagnosis

Unfortunately, misdiagnosis of mental health disorders happens frequently. This may be because mental diseases frequently share the same symptoms that are common for  numerous different diagnoses.

Furthermore, depression is frequently misdiagnosed in people with bipolar disorder. In a study of 466 patients in psychiatric units with severe depressive illness, 57% of those who were evaluated had hypomanic symptoms, suggesting a possible misdiagnosis.

Issues With Medications

The action of antidepressants can take up to six weeks. People frequently stop taking medications too soon, before the drug has a chance to fully take action. Due to unpleasant side effects, some people may sometimes skip doses or stop taking their drugs early.

Additionally, an antidepressant’s effects can vary from person to person. It’s vital to experiment with various drugs and doses until you find the one that works best because what significantly relieves pain for one person may not be enough for another.

Diagnosis

The Diagnostic and Statistical Manual of Mental Disorders does not list treatment-resistant depression as a mental disorder (DSM-5). However, after there have been at least two unsuccessful treatment attempts, the majority of mental health specialists consider a diagnosis.

If your present treatments aren’t helping, it’s crucial to talk to your doctor or psychiatrist. To rule out any physical or mental health issues, your doctor can do a more thorough evaluation and reassess your treatment plan.

Treatment

Antidepressants do not show a clinical improvement in 20% to 40% of people with serious depression.

What Your Doctor Looks For When Treatment Fails

Before declaring a medication-based treatment technique ineffective, your doctor will take into account a number of aspects. These factors include: your level of adherence to your existing treatment plan; the length of time you took the drug; and the dosage.

Your physician might suggest a different medication.

Your doctor can suggest a different antidepressant or add another to your present prescription if the medicine is a problem. These have the potential to alter your brain’s chemistry in order to produce the desired alleviation.

Behavioral Cognitive Therapy for Depression

If you aren’t currently doing psychotherapy, your doctor might also suggest that you seek the help of a mental health expert. Treatment-resistant depression has been demonstrated to benefit particularly from cognitive-behavioral therapy. This kind of therapy can aid in reframing mental processes and addressing sleep problems.

How to Manage Depression That Is Resistant to Treatment

It might be difficult to manage depression that is resistant to treatment. Here are some coping strategies for people who have depression that is resistant to treatment:

• Put self-care first. Make an effort to consume a balanced diet, get enough rest, and exercise frequently. You can lessen some of your depression symptoms by taking each of these steps.
• Control your tension. There will always be demands in life, but it’s important to practice stress management skills to lessen your worries. Yoga, meditation, and journaling are a few examples.
• Abandon alcohol and drug use. These chemicals might interfere with the drugs you are already taking and make your symptoms worse.
• Follow your treatment schedule. Before you see changes, treatment and drugs can both take some time. In order for these components of your treatment plan to have the best chance of working, you must adhere to them.

Here are a some of our certified therapists who you can get in touch and book a therapy session with:

• Hal M.
• Ioanna Matte
• Dr Simona Cassar