Five Possible Solutions for Treatment-Resistant Depression

Male psychologist supporting client

Treatment-resistant depression (TRD) is a condition where a person does not experience significant improvement in their depressive symptoms despite receiving appropriate treatment, such as antidepressant medications or other therapeutic approaches.

TRD can be diagnosed when your first line of depression treatment, usually involving two courses of antidepressants, hasn’t made you feel better or has only made you feel partially better. (Treatment -Resistant Depression (TRD): Signs, Symptoms and Treatment, Priory Group.)

Someone with TRD may experience various symptoms, including persistent feelings of hopelessness, sadness, and low mood that can profoundly impact their everyday functioning and overall quality of life.

Treatment-resistant depression can be a frustrating and challenging condition for both patients and healthcare professionals.

This is because it can take a while to find an effective treatment plan that works, something that often requires trying multiple psychotherapies, medicines, and other interventions. 

If you have TRD, you must work closely with a mental health specialist who can help you explore the different treatment options available until you find the one that works best for you. 

This article explores five possible solutions for treatment-resistant depression. 

In the meantime, if you are struggling to cope with depressive symptoms or would like further information and support about our depression treatment program, our friendly team in Ontario can help.

We diagnose and treat various types of depressive disorders, providing comprehensive, individualised treatment to clients in Ontario and surrounding regions.

Our mental health treatment programs focus on the ‘whole’ person, not just mere symptom management, meaning that we help get to the root cause of your depression gently and compassionately.

Adopting a holistic approach to depression treatment, one that considers the whole picture, such as your history and unique life experiences, allows you to explore the various factors that may have caused or worsened your condition, which can lead to much more favourable treatment outcomes.

Our multidisciplinary team comprises counsellors, addiction specialists, therapists and nurses who provide a combination of holistic treatments for a wide range of mental health disorders, such as anxiety and various types of depression.

These treatments include:

To learn more about our depression treatment program, contact one of our friendly specialists today for further resources and support.

Five possible solutions for treatment-resistant depression

We know how challenging treatment-resistant depression can be to live with and manage.

You may have tried a range of different therapies and medications to help manage your symptoms and cope better with your condition, only to find they work for a short while or not at all.

Since depression is a complex mental health condition, it must be treated in a way that addresses the intricacies of this disorder, centralising your needs and preferences instead of adopting a ‘one-size-fits-all’ treatment approach, which often doesn’t work.

Although it may take a while to find the proper treatment solution for your condition, there are several strategies that you may find helpful.

Here are five possible solutions you may want to explore if you have treatment-resistant depression:

1. Psychotherapy

Many individuals with TRD often benefit from psychotherapeutic approaches, such as cognitive behavioural therapy (CBT) or interpersonal therapy (IPT).

These therapies can help you address any maladjusted thoughts or behaviour patterns that may cause or worsen your depression, allowing you to develop healthy coping strategies and improve your interpersonal relationships.

Cognitive behavioural therapy (CBT)

Various studies have shown CBT’s effectiveness in treating treatment-resistant depression.

Not only does CBT encourage you to challenge any negative or unhelpful thoughts or behaviours that may contribute to your depression, but it also helps you address any deep-rooted beliefs that may hold you back or prevent you from seeking treatment.

In addition, cognitive behavioural therapy armours you with lifelong coping mechanisms, lessening your chance of becoming depressed again in the future.

Interpersonal therapy (IPT)

Man having a therapeutic session with a psychologist

Interpersonal therapy is a short-term treatment for depression that is designed to manage acute mood symptoms and improve interpersonal relationship skills.

Researchers note that interpersonal therapy can help those seeking a short-term therapeutic approach to address their mood symptoms and relationship challenges. (All about Interpersonal Therapy (IPT) for Depression and Relationships, PsychCentral, Sandra Silva Casabianca and Traci Pedersen, 10 June 2021.)

To learn more about our cognitive behaviour therapy program, contact our team today for further information and support.

2. Ketamine therapy

Another possible solution for treatment-resistant depression is ketamine therapy, originally known as an anaesthetic.

Ketamine has proven to be a fast-acting antidepressant and has been found to provide relief for those with treatment-resistant depression.

How is ketamine therapy administered?

Ketamine is usually administered intravenously, orally or intranasally under medical guidance and supervision.

It is categorised as a dissociative psychedelic drug and is experiencing a re-emergence in popularity. 

Initially derived from PCP, ketamine has long been utilised in medical and veterinary settings as an anaesthetic. 

It has also gained notoriety as a recreational substance, often referred to as “special K.”

The consistent effects produced by ketamine include pain relief, amnesia, intoxication, dissociation, and euphoria, which reinforce both its medical and recreational uses. 

However, recently, ketamine has garnered attention for its approval in treating treatment-resistant depression (TRD), a severe form of depression that is unresponsive to conventional therapies.

Research has demonstrated ketamine’s effectiveness in reducing depression scores significantly compared to a placebo, with patients continuing their regular antidepressant regimen throughout the study. 

Additionally, nasal ketamine has shown longer-term efficacy when used alongside standard antidepressants, aiding individuals in achieving stable remission.

The relief from TRD provided by ketamine occurs rapidly, unlike the gradual onset associated with traditional antidepressants. 

Instead of waiting weeks for potential relief from medications such as SSRIs, individuals grappling with debilitating depression may experience the benefits of ketamine as quickly as forty minutes.

To learn more about the benefits of ketamine therapy for those with treatment-resistant depression, click here for further information and insights.

3. Transcranial magnetic stimulation (TMS)

African American female doctor communicating with senior woman at medical clinic.

Another possible solution you may want to explore if you have treatment-resistant depression is transcranial magnetic stimulation (TMS).

One study revealed that MRI-guided TMS significantly alleviated depression symptoms in participants for at least six months.

In addition, the study highlighted that a third of the participants showed a 50% improvement in their depressive symptoms, with a fifth achieving prolonged remission. (TMS Proves Long-Term Relief for Depression, Neuroscience News, 16 January 2024.)

This therapy is typically delivered as an outpatient treatment where an individual receives magnetic pulses which are delivered to the left side of the head near the temporal area of the scalp.

Individuals are awake during treatment and typically have around twenty sessions of TMS over four weeks.

TMS has been used since the 1980s as an effective treatment for individuals with severe depression, targeting specific brain regions where stimulation is known to be beneficial.

Researchers note that transcranial magnetic stimulation provides longer-lasting benefits for patients with severe treatment-resistant depression than other therapies and interventions.

4. Electroconvulsive therapy (ECT)

Electroconvulsive therapy (ECT) is typically delivered under general anaesthesia.

It involves small, electric currents passing through your brain, which intentionally bring on a seizure.

Researchers say that ECT can be beneficial for individuals with mental health conditions like treatment-resistant depression as it causes specific changes in brain chemistry that can quickly reverse depressive or other mental health symptoms.

This treatment is often recommended to individuals with TRD when other therapies and approaches have been unsuccessful; however, like other treatments, it may not always work or be suitable for everyone.

If we look back in history, there’s much stigma attached to electroconvulsive therapy, some of which is portrayed in the popular albeit controversial movie “One Flew Over the Cuckoo’s Nest”, starring Hollywood actor Jack Nicholson.

Because of the unrealistic portrayal of ECT in this movie, many people view this treatment as unethical and dangerous.

However, ECT is safe when delivered under medical guidance and supervision.

ECT is a highly effective treatment option for individuals with depression and can also help with other mental health symptoms, including mania and psychosis.

Electroconvulsive therapy is a somatic treatment, which includes stimulating electric activity in the brain. 

ECT works much faster than antidepressants, making it a practical option for individuals with treatment-resistant depression and other mental health disorders, including:

  • Severe depression
  • Severe mania
  • Catatonia

5. Medication changes or adjustments

Doctor discussing medicines to patient

Another possible solution for treatment-resistant depression is a potential change or adjustment to an individual’s medication.

For example, if someone isn’t responding to a specific type of antidepressant, their physician or treatment provider may try a different class of medicine to help alleviate their depressive symptoms.

Suppose you have depression and feel as though your medication isn’t working despite following prescribed instructions. In that case, it may be time to speak to your doctor or mental health specialist for further guidance and support.

They may recommend various other medications and approaches that can help reduce your depressive symptoms, allowing you to better cope with your condition.

Symptoms of treatment-resistant depression

Each person experiences depression symptoms differently.

However, if you notice the following symptoms, you must speak to a mental health professional, as they may be a sign that you have treatment-resistant depression. Symptoms of treatment-resistant depression include:

  • Experiencing depressive symptoms that persist even after your treatment should have started working.
  • A medication or treatment that used to work has lost effectiveness or stopped working even with ongoing treatment.
  • Frequent recurrences or relapses of depression, even if your treatment did initially help or result in partial or brief remission.
  • When your dosage increases, your depressive symptoms do not change or improve.
  • Treatment somewhat alleviates your symptoms, but not enough to significantly improve your quality of life.
  • Your symptoms do not improve despite following the treatment plan prescribed by your doctor or therapist.

Bottom line

Treatment-resistant depression can be a complicated condition to live with and treat.

However, recovery is possible with an accurate diagnosis, professional treatment, and support.

If you’ve been through various trials of medication and therapies without seeing any improvement in your symptoms or mood, this doesn’t mean your depression is untreatable.

Studies show that when individuals get an accurate diagnosis and switch to a more suitable treatment program, their depressive symptoms often improve in the process.

Depression treatment at Centres for Health and Healing

Centres for Health and Healing provide personalised, holistic treatment programs for all types of depression, shaped around your individual preferences and therapeutic needs.

Our highly-trained and passionate staff provides the highest care and support to guarantee deep transformational healing and lasting recovery.

In addition, our individualised treatment approach considers all the parts that must be unpacked and worked through to ensure you get the most out of your recovery, including comprehensive depression treatment, trauma-informed therapy and other approaches.

We also ensure a complete aftercare plan is in place following your treatment to provide the necessary tools to support your long-term recovery, with comprehensive follow-up treatments and support available to each client.

Our team is here to advise, guide, and support you every step of the way through your recovery from depression and beyond.

If you or a loved one are struggling with depression, please get in touch with our friendly treatment centre in Ontario for further information and support about our depression treatment program.

We are here and ready to help.

Additional resources

All about Interpersonal Therapy (IPT) for Depression and Relationships, PsychCentral,  Sandra Silva Casabianca and Traci Pedersen, 10 June 2021

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