It’s okay for you to feel a little sad, down, or even occasionally lose interest in things. But, if those feelings persist or interfere with your ability to function and act normally, it may be time to see a doctor about clinical depression.
Clinical depression is a widespread mental health disorder that affects children and adults. Not everyone is aware they have it. Others are aware of their symptoms, yet they delay formal diagnosis and treatment due to stigmas and misconceptions associated with common mental health disorders. Also, many of those affected cannot rely on conventional treatments for relief. Their depression is often treatment-resistant.
Many people are unaware that there is a darker side to depression that is much more severe, debilitating, and difficult to manage. Individuals suffering from treatment-resistant depression (TRD) often encounter significant difficulties in many aspects of their lives, from sleeping and eating to maintaining relationships and gainful employment.
Usually, depression responds favorably to positive lifestyle changes, antidepressants, and therapy/counseling. However, many of those diagnosed with clinical depression experience tendencies that indicate the presence of severe major depressive disorder (MDD) or bipolar disorder.
The Difference Between Depression and Treatment-Resistant Depression
According to the U.S. Centers for Medicare & Medicaid Services, traditional antidepressants, medications, and therapeutics have little to no effect on up to 30 percent of those living with depression. For many, periodic feelings of sadness come and go and are often temporary. They may even be accompanied by anxiety and stress. Individuals with depression often feel better as their symptoms resolve, the triggering event or situation is over, after using antidepressants or seeing a therapist.
On the other hand, the impact of living with refractory depression or treatment-resistant depression is not the same. The symptoms never really seem to go away and can become worse. Many TRD sufferers feel life is not enjoyable or worth living. Medications are typically viewed as a waste of time and are often a primary factor in why many stop seeking help for their condition.
It’s very common for those with a formal depression diagnosis to try several antidepressants and prescription medications to improve their symptoms and outlook on life, only to end up disappointed or, in some cases, more depressed.
Treatment-Resistant Depression Risk Factors
There is no definitive cause for depression, nor is it possible to determine who will develop the type that is unresponsive to conventional treatment. However, the following risk factors are common in individuals with TRD.
Severity – Depression is a spectrum-like disorder that has multiple degrees of severity. Treatment effectiveness is typically much lower in individuals with mild and severe types of depression.
Episode duration – Studies show that the duration of depression symptoms tends to alter the brain’s response to medications the longer they persist. Episode length is usually determined by the type of depression and symptom triggers.
Comorbidities – Certain anxiety, avoidant and borderline symptoms, and the presence of other mental health conditions, such as generalized anxiety disorder (GAD), tend to counteract the positive effects of medications and treatments.
Tolerance – Some individuals have what is known as low efficacy treatment-resistant depression. This is typically diagnosed after two to three unsuccessful treatment attempts with different medications. Tolerance is highly dependent on the patient. In many cases, depression medications produce positive results. However, many people eventually build up a tolerance or resistance to them.
Intolerability – Another cause of low efficacy TRD is adverse reactions. Medications often come with side effects. Usually, taking them for treatment is more advantageous than forgoing them. However, many prescriptions for depression cause side effects that can exacerbate the symptoms or cause significant distress and anxiety, causing patients to terminate treatment prematurely. Signs of intolerability include diarrhea, headaches, nausea, and insomnia.
Symptoms of Treatment-Resistant Depression
Depression can cause symptoms similar to other medical and mental health conditions. Many mental disorders cause long-term depressive episodes, leading to misdiagnosis, delayed diagnosis, and treatment avoidance. The following signs are common in individuals suffering from treatment-resistant depression.
- Trouble concentrating
- Abnormal weight fluctuations
- Frequent and prolonged episodes of sadness
- Poor self-confidence
- Feelings of guilt
- Low energy
- Problems sleeping
- suicidal thoughts
- Persistent feelings of doom and gloom (hopelessness)
- Frustration
- Anger
These symptoms are also common in many other types of depression. Refractory depression can make the ability to process emotions normally quite challenging. A formal diagnosis is necessary to determine the most effective treatment considerations to diminish the adverse effects and improve mood, overall outlook, and quality of life.
How Can NeoPsych Help With Treatment-Resistant Depression?
There is hope for those living with treatment-resistant depression. The first step is to get a proper diagnosis. Even those who’ve been diagnosed in the past with the condition can benefit from an additional professional evaluation. It is not uncommon for some to learn of more suitable treatment options than they’ve tried in the past.
It’s important not to overlook the impact of living with clinical depression and how proper treatment and counseling can help. NeoPsych specializes in evidence-based cognitive behavioral therapy to treat psychological disorders, including treatment-resistant depression.
If you suspect that you or a loved one may be suffering from depression, contact NeoPsych at (213) 433-2823 to schedule an appointment to talk with one of our therapists about your feelings and situation.
