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Treatment-Resistant Depression

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Treatment-Resistant Depression: Getting Help continued...

Treatment-resistant depression can be hard to diagnose. Sometimes, other conditions or problems can cause similar symptoms. So when you meet with your doctor, he or she will want to:

  • Confirm the diagnosis. Some people who apparently have treatment-resistant depression were misdiagnosed. They never had only depression in the first place. Instead, they have conditions like bipolar disorder (where antidepressants may be less effective than in unipolar depression), or problems with drugs or alcohol that can cause or worsen depression, or a medical condition (such as hypothyroidism) that can cause symptoms of depression, and may have been getting the wrong treatment. When major depressive disorder is accompanied by other medical or psychiatric disorders (such as anxiety disorders, eating disorders, or personality disorders), the depression often is harder to treat, particularly if the additional disorders that are present don't receive their own independent treatment.
  • Make sure you've been using your medicine correctly. Up to half of all people who get prescribed drugs for depression don't take them as recommended. They miss doses or stop taking them because of side effects. Some give up too soon – it can take 4-12 weeks for a medicine to take effect.  Sometimes taking a medicine at too low a dose also explains an inadequate response.
  • Check for other causes. Other issues – ranging from thyroid problems to substance abuse – can worsen or cause depression. So can many medicines used to treat common medical problems. Sometimes, switching medicines or treating an underlying condition can resolve a hard-to-treat depression.

You may wonder why some people do so well with the first medication they try, while you continue to suffer. Experts don't  know for sure, but we do know that not all depressions are the same across every sufferer. Evidence also suggests that people who have especially severe depression or long-term depression may be harder to treat. 

Medications for Treatment-Resistant Depression

Different antidepressants work in different ways to affect specific chemicals (neurotransmitters) that transmit information along brain circuits that regulate mood. If your current medicine isn't helping – or isn't helping enough – other drugs might. There are two basic approaches:

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