If you’ve been depressed — sad, angry, irritable, had months’ long trouble sleeping – and nothing seems to help, you may be suffering from treatment-resistant depression. Depression is a leading source of disability worldwide, and sometimes routine treatment like psychotherapy or medicine doesn’t help. It’s time for a new solution.
What Is Treatment-Resistant Depression?
Treatment-resistant depression is exactly what it sounds like. “If you’ve been treated for depression but your symptoms haven’t improved, you may have treatment-resistant depression.” Psychotherapy or particular medicine may reduce depression symptoms for most people. Still, when standard treatment fails, warning signs return, and your quality of life is affected, you may be suffering from a more severe form of depression. Ketamine and transcranial magnetic stimulation (TMS) may help ease symptoms.
What Are The Symptoms?
Symptoms of treatment-resistant depression are the same as other kinds of depression, except they come back day after day, never responding to standard treatment like psychotherapy or antidepressant medications. Symptoms may include:
- You feel sad, tearful, empty, or hopeless
- You’re easily angered, irritated, or frustrated, even over trivial matters
- You’re not interested in something you used to enjoy doing
- You have trouble sleeping
- You’re fatigued and have low energy
- Significant changes in appetite and weight
What To Know About Treatment-Resistant Depression?
According to the U.S. National Institutes of Health, up to 30 percent of people diagnosed with major depression show little to no improvement following standard treatment. What else to know?
- A person’s age, gender, and health may boost the risk for treatment-resistant depression.
- The exact cause of depression isn’t fully understood, which may explain my certain antidepressants aren’t effective for everyone.
- There are recognized strategies for managing treatment-resistant depression.
- Research into treatment-resistant depression is ongoing.
What Causes Treatment-Resistant Depression?
- Studies show that people with depression appear to have physical changes in their brains, which could help find the source of the illness.
- Faulty neurotransmitters or chemical messengers in the brain affect mood stability and significantly affect depression and its treatment.
- Changes in hormone levels may cause or trigger depression, including during and after pregnancy. It may also be caused by thyroid problems, menopause, or several other conditions.
- Inherited traits.
TMS For Treatment-Resistant Depression
“Transcranial magnetic stimulation (TMS) is a noninvasive procedure that uses magnetic fields to stimulate nerve cells in the brain to improve symptoms of depression. TMS is typically used when other depression treatments haven’t been effective.
“This treatment for depression involves delivering repetitive magnetic pulses, so it’s called repetitive TMS or rTMS.” It’s a kind of procedure that may be recommended if medicine or psychotherapy hasn’t lowered depression symptoms in some people.
Are there side effects?
TMS is considered safe, but there are potential side effects:
- Scalp irritation where the stimulation takes place
- Tingling, tremors, or jerking of facial muscles
- Mania, especially in someone with bipolar disorder
- Loss of hearing if there is insufficient ear protection while being treated
TMS involves placing an electromagnetic coil against your head and repeatedly turning it off and on to create stimulating pulses. This generates a tapping or clicking noise that usually persists for several seconds and is followed by a pause. You may also perceive a tapping sensation on the forehead. This part of the procedure is known as mapping.
“Existing evidence to date suggests that less treatment-resistant patients respond better to rTMS than those who are highly treatment-resistant. However, there is much yet to be learned about particular variables that may impact response to rTMS. Researchers are presently conducting clinical studies to evaluate who will benefit most from rTMS therapy.” Research into whether rTMS with antidepressant medications is more effective than rTMS alone is ongoing.
Diagnosis & Treatment
Diagnosing treatment-resistant depression normally involves:
- A physical examination by your doctor. You’ll be expected to talk about personal and family medical history and may undergo tests to find a medical problem for your depression symptoms. If there isn’t a medical reason, you may be referred for a psychiatric assessment by a mental health professional.
- At a psychiatric assessment, you’ll talk about thoughts, feelings, and behaviors as possible triggers, as well as whether you have a personal or family history of mental illness.
- Comparing your depression symptoms to the Diagnostic and Statistical Manual of Mental Disorders criteria.
TMS or ketamine may be recommended for treatment.
Treatment-resistant depression, like other mental illnesses, can have devastating consequences if left untreated. If you experience any of its symptoms and haven’t gotten better, ask your doctor or mental healthcare specialist for information on other treatment options. You may be an ideal candidate for ketamine therapy or transcranial magnetic stimulation.