In this article
- Understanding Treatment-Resistant Depression
- Treatment-Resistant Depression: Getting Help
- Medications for Treatment-Resistant Depression
- Other Treatments for Treatment-Resistant Depression
- Living With Treatment-Resistant Depression
Other Treatments for Treatment-Resistant Depression
Drugs aren't the only approach used in treatment-resistant depression. Some other methods included in the treatment of TRD are:
- Talk therapy. Approaches like cognitive behavioral therapy - which focuses on concrete goals and how your own thoughts and behaviors contribute to your depression -- can really help people with depression. There’s some evidence it works especially well with treatment-resistant depression.
If you've tried therapy in the past and it hasn't helped, you could try again. Think about seeing a new therapist. Or look into a different therapeutic approach. For instance, if one-on-one therapy didn't do much for you, ask your doctor if group therapy or a different approach might be more worth a try. - ECT (electroconvulsive therapy.) ECT is typically used in people with serious or life-threatening depression that can’t be resolved by other treatments, or in significant depressive episodes that have not gotten better after several medication trials. It uses electric impulses to trigger controlled seizures in the brain. A series of ECT treatments (usually 6-12 over a few weeks) can often rapidly relieve depression, although some form of continued therapy (either a medicine or else periodic ECT "booster" treatments are usually necessary to prevent relapse.
- VNS (vagus nerve stimulation.) This approach is also used in people with serious depression that just hasn't responded to other treatments. Like ECT, it uses electrical stimulation to relieve the symptoms of depression. The difference is that the device is surgically implanted in your body. VNS is FDA-approved for the long-term (not acute) depression of chronic depression that does not respond to at least two antidepressant trials. Its effects may take up to 9 months to appear and studies have shown that a meaningful response seems to occur only in about 1 in 3 people.
- TMS (transcranial magnetic stimulation.) This is a non-invasive approach that's been approved for treatment-resistant depression. Like VNS and ECT, it uses electrical stimulation to treat depression. Unlike those procedures, TMS poses few side effects. It may be best for seriously depressed people who are mildly resistant to drug therapy. Treatment is done on an outpatient basis four to five days a week for four or more weeks. It is considered safe, but appears to be not as effective as ECT.
- Experimental techniques. Experts are researching new techniques to tackle treatment-resistant depression, like deep brain stimulation and MST (magnetic seizure therapy.) Although some studies have been promising, more research needs to be done. But if you're interested in trying them, talk to your doctor about joining a clinical trial.
Sometimes, a doctor might recommend hospitalization for treatment-resistant depression. It could be the best option if your depression is severe and you're at risk of hurting yourself. A stay in the hospital also offers a way for you to recover from your depression in a safe and stable environment. You’ll get a break from some of the daily stresses that might contribute to your condition. Your doctors will also get a chance to collaborate and come up with a good treatment plan.