Treatment-resistant depression (TRD), or treatment-refractory depression, is depression that has failed to respond to multiple evidence-based treatments. While there is no universally accepted criteria for diagnosing TRD, it is most commonly defined as failure to respond to at least two different medications. Approximately 30% of patients with depression do not respond to the first or second treatment tried. While many people struggling with treatment-resistant depression feel like they are alone in their struggles, the reality is, if you are struggling with treatment-resistant depression, you are not alone, and there is hope. A significant majority of patients with TRD do respond with the right treatment.

What Causes Treatment-Resistant Depression?

There are many reasons why some patients do not initially respond to treatment. Depression is a multifactorial disease. This means it is caused by many different things. Because of this, the treatments which work for some patients may not work for others. This doesn’t necessarily mean that their depression is “worse” than others’ depression. Rather, it simply that it has a different cause, and thus requires a different treatment. An example of this is bipolar disorder, as patients with bipolar disorder often struggle with depression but do not respond as well to treatment with traditional antidepressants.

Additionally, many patients with depression also struggle with another mental illness, or “comorbidity.” If not properly treated, these comorbidities may contribute to depression and

make it much harder to treat. For example, if a patient struggles with depression and PTSD, but treatment is not addressing the underlying trauma, the depression will be much more difficult to treat.

There are also genetic factors which may contribute to treatment resistance. Some people make more or less of the enzymes that clear out certain medications. This may mean that they are much more sensitive to side effects from that medication. It may also mean they get rid of it so fast that it can’t work properly. Others have variances in the proteins that the medications target. This may prevent a particular medication from working properly or may make them more sensitive to side effects from certain medications.

What Can Be Done About It?

There are many options for treating patients with treatment-resistant depression. While it can be frustrating to keep trying different medications, depending on what medications you have tried, this may be the right approach. Sometimes it is just a matter of needing a higher dose of a medication you have already tried. Additionally, certain combinations of medications can also be effective when a single medication has not worked.

When a patient is struggling with treatment-resistant depression, it is always critical that we confirm the diagnosis.. This ensures we are treating the right thing and are not ignoring any comorbidities such as PTSD or ADHD.

Genetic testing is available and can sometimes be helpful in identifying certain genetic factors which may be contributing to your poor response to or inability to tolerate medications.

Psychotherapy in combination with medications is also more effective than medication or psychotherapy alone.

Finally, there are several newer treatment options which are very effective in treatment-resistant depression. These options should be considered for patients who have demonstrated a poor response to, or an inability to tolerate, more traditional treatments for their depression. In particular, repetitive Transcranial Magnetic Stimulation (rTMS) is a safe, effective, FDA-approved treatment for depression that is covered by insurance for patients with treatment-resistant depression.

Our Approach to Treatment-Resistant Depression Treatment

At Chrysalis Psychiatry, our priority is offering a safe, welcoming space for all patients. If you are struggling with treatment-resistant depression, you may feel frustrated and tired of seeking new ways to relieve your symptoms. We are committed to working with you to develop a treatment plan that meets your specific needs and goals, and we believe in leaving no stone unturned.

The fight against treatment-resistant depression is a long and difficult road, but you do not need to fight alone. Allow us to come along side you and be your partner in the fight.

Contact Us for Albuquerque Depression Treatment

If you are interested in learning more about the treatment options for treatment-resistant depression in Albuquerque, you can contact us through our website. You can also call (505) 503-6300 to schedule an appointment today.