1. How do you define and diagnose treatment-resistant depression?
Doctors can have very different ideas about what "treatment-resistant" means. For most, it means you didn’t feel better after trying at least two antidepressants from different classes, each for quite some time -- about eight weeks at an appropriate dose. Find out how your doctor views the condition and what that means for you and your treatment.
2. How much experience do you have in treating treatment-resistant depression?
If you have treatment-resistant depression, you need to see an expert -- such as a psychiatrist who has helped other people with chronic depression. You could also find a therapist, such as a psychologist or social worker, who has worked with people who have treatment-resistant depression.
3. Why is my depression hard to treat?
Ask your doctor if there could be a reason why treatments haven't helped you -- you took a previous medicine at too low a dose or for too short a time to see an effect; you have other medical conditions (such as hypothyroidism) or an additional psychiatric problem (such as alcoholism or drug abuse, or an anxiety disorder) that could interfere with treatment for depression. Remember that most antidepressants take six to eight weeks to have an effect. See if there is anything that you can do to help yourself during treatment.
4. Could different medications help with treatment-resistant depression?
Even though the drugs you've tried may not have worked for you, there are always other options. Other medications -- sometimes in different doses or combinations or those used to treat other conditions -- may help with treatment-resistant depression. Review the choices with your doctor, and make sure to ask about the potential side effects.
5. What are other treatment options for treatment-resistant depression?
Find out about the ways your doctor helps people with treatment-resistant depression. Could talk therapy such as cognitive behavioral therapy help? Could brain stimulation therapy help relieve the symptoms of depression? Brain stimulation therapy includes electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS), vagus nerve stimulation (VNS), and magnetic seizure therapy (MST). Get a good idea of what approaches your doctor might try.