Treatment Resistant Depression

As I’ve mentioned in 389,432 of my other blogs, I have treatment resistant depression (TRD). It may sound like its not curable, but by definition it means one is non responsive to at least two antidepressants for a period of time. It also is characterized by extreme sadness, sleep disturbances, low energy, suicidal ideation and suicidal attempts.

TRD is experienced by 45 percent of patients with a major depressive disorder. That’s just crazy to me. It contributes to nearly one-third of patients attempting suicide in their lifetime, a rate more than double that of their treatment responsive peers, according to this article by Psychiatry Advisors.

While psychiatrists cannot pinpoint why some are treatment resistant, researchers have seen correlations in certain populations who are more vulnerable than others. For instance, women and senior citizens. Individuals who have had severe or recurring bouts of depression also appear to be more susceptible, according to Johnson and Johnson’s website on health.

What I found most interesting is other medical illnesses can play a part in TRD. The article states that thyroid disease and chronic pain (I have both thyroid disease and chronic migraines) makes you a greater risk for treatment resistant depression. Mind blown.

Other factors include substance abuse and eating and sleep disorders. I also suffer from compulsive eating and insomnia. I should donate my body to science when I die.

So, what happens with you’re treatment resistance and your meds don’t work? We do have options. We can go on the highest dosages of our meds – IF YOU’RE DOCTOR THINKS THAT IS RIGHT FOR YOU – or there are non-drug therapies which I’ve mentioned in the past, such as transcranial magnetic stimulation, ketamine infusions and ECT, which helps reverse symptoms of TRD.

I think the only non-drug therapy I haven’t mentioned in detail is ECT (electro-convulsant therapy), which is effective to 70-80 percent of patients. This is not to be confused of electroshock therapy, poorly portrayed in movies and TV. ECT uses general anesthesia intentionally triggering a quick seizure. It’s meant to reverse symptoms of mental health problems and as of now is the best treatment for depression.

So, as of now I’ve definitely more than two antidepressants/antipychotics: Doxepin, Zoloft, Prozac, Lexapro, Wellbutrin, Abilify, Rexulti, Saphris and Seroquel. For me, that’s a lot. I’m also tried Lamictal as a mood stabilizer.

I’ve also tried TMS (transcranial magnetic stimulation), ketamine infusions and I’m about to try the Spravato nasal spray which is based on ketamine.

Here’s to my people who are treatment resistant. You’re not alone and hopefully there will be better alternatives in the future.

One thing I forgot, there’s also a genetic test you can take that can tell you which antidepressants will work better for you. It’s called the cytochrome P450 (CYP450) test. Ask your doctor if this is an option for you.

Stay well. Stay in the light.

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