How well is your depression treatment working? Does it help a bit, but you still don't feel as if the darkness has lifted? Perhaps you feel the treatment isn't working at all. If so, you could have treatment-resistant depression, also called refractory depression.
Unfortunately, depression treatments don't always work. As many as two-thirds of people with depression aren't helped by the first antidepressant they try. Up to a third don't respond to several attempts at treatment.
Antidepressants, especially when combined with talk therapy, generally help people recover from depression. Symptoms begin to improve within weeks for the majority of people taking antidepressants. And people who take antidepressants long-term -- up to 36 months -- have a relapse rate of only 18% compared to 40% for those who do not.
But if they work so well, why do so many people stop taking antidepressants within a few weeks of starting them? Or skip doses when they start to feel better?
Treatment-resistant depression can leave you feeling hopeless and discouraged. Months or even years can go by without any relief. And after the effort it took to get help, it can be demoralizing when you're just not getting better.
But if your depression treatment isn't working, don't give up. Many people can get their treatment-resistant depression under control. You and your doctor just need to find the right approach. This might include different drugs, therapy, and other treatments. If you're still struggling with depression despite treatment, here's what you need to know.
Understanding Treatment-Resistant Depression
What is treatment-resistant depression? Surprisingly, that can be hard to answer. Experts still disagree on what exactly the term means.
Many say that it's a case of depression that doesn't respond to two different antidepressants from different classes. Other experts say that a person needs to try at least four different treatments before depression can be truly considered treatment-resistant.
Of course for you, the exact definition doesn't matter. You just need to ask yourself some basic questions.
Has your treatment failed to make you feel better?
Has your treatment helped a bit, but you still don’t feel like your old self?
Have the side effects of your medication been hard to handle?
If the answer is yes to any of these, you need to see your doctor. Whether or not you actually have treatment-resistant depression, you need expert help.
Treatment-Resistant Depression: Getting Help
Although a primary care doctor can treat depression (research suggests that 60%-65% of antidepressants are prescribed by primary care physicians), it may be best to see a specialist, like a psychiatrist, if you think you may have treatment-resistant depression. It's a good idea to also work with a therapist, like a psychologist or social worker, because the best treatment is often a combination of medicine and therapy.