Treatment-resistant depression occurs when someone with depression does not respond adequately to traditional treatments like antidepressant medications or traditional psychotherapy routes. However, there isn’t a singular known cause. It’s a condition that can arise from a mix of factors.
For some people, their depression might be linked to complex changes in brain chemistry, such as imbalances in neurotransmitters like serotonin, dopamine, or norepinephrine. These imbalances can make standard treatments less effective. Genetics may also play a role for some people, which means they may be predisposed to forms of depression that are harder to treat.
The underlying causes of depression itself, such as unresolved trauma, chronic stress, or deeply ingrained negative thought patterns, might not be fully addressed by conventional therapies, making it difficult for recovery to take hold. Additionally, physical health issues, such as chronic pain or illnesses like diabetes, can contribute to the persistence of depressive symptoms.
In some cases, lifestyle factors such as poor sleep, substance misuse, alcoholism, or lack of social support can make it harder for treatments to work. It’s also possible that certain treatments may not have been tried for long enough, or the right combination of therapies hasn’t yet been found for that individual.
How Is TRD Diagnosed?
Treatment-resistant depression is typically diagnosed when:
- A person has tried at least two different antidepressant medications, each at an appropriate dose for an adequate period (usually 6-8 weeks), and
- They experience little to no improvement in their symptoms.
This doesn’t mean the condition is untreatable. It just means more advanced or alternative therapies may be required.
What Is the Best Treatment for Treatment-Resistant Depression?
When traditional therapies like antidepressants and CBT do not work, alternative approaches may help. Below are some of the most promising options available today.
Ketamine-Assisted Therapy for Treatment-Resistant Depression
Ketamine therapy has become one of the most talked-about breakthroughs for people struggling with treatment-resistant depression. Originally developed as an anaesthetic, ketamine was later found to have powerful antidepressant effects, especially for those who haven’t found relief with traditional medications.
Instead of focusing on serotonin (like most antidepressants), ketamine works on a completely different system in the brain, which is the glutamate system. This is important because it opens up new possibilities for healing where other treatments have failed.
One of the most exciting factors about ketamine therapy is how quickly it works. Traditional routes can take weeks to start making a difference, and it often gets worse before it gets better. Ketamine often reduces symptoms in just hours. And when combined with the right support, its effects can last far longer than you’d expect from a single treatment.
Ketamine isn’t just a standalone solution, it works best when it’s part of a therapeutic process. At EULAS, for example, the state of mind that ketamine creates allows patients to dig deeper into their emotions, face underlying trauma, and uncover more about their depression that might otherwise stay buried. The therapy helps make sense of the experience, turning the breakthroughs brought on by ketamine into lasting progress.
TRD Clinical Trials and Research
The NHS is considering the use of ketamine therapy as a new option for people suffering from severe or treatment-resistant depression (TRD), a condition where patients do not respond to traditional treatments like antidepressants or psychotherapy.
Professor Rupert McShane, a leading expert in this area, is advocating for the introduction of ketamine into clinical practice. His support is based on promising research, particularly a study from the United States, which found that ketamine can be as effective as electroconvulsive therapy (ECT), a commonly used treatment for severe depression. Importantly, the study also showed that ketamine causes fewer long-term side effects compared to ECT, making it a potentially safer option for many patients.
What makes this proposal especially practical is that ketamine could be administered in existing ECT clinics within the NHS. These clinics already have the necessary facilities and trained staff to deliver the treatment, which would make it easier to introduce ketamine therapy without requiring major changes or additional resources. If adopted on a larger scale, this approach could provide real hope for people who have not responded to other treatments, giving them access to a promising alternative that could significantly improve their quality of life.
Coping with TRD: Practical Advice
Living with treatment-resistant depression is undeniably challenging. It can feel overwhelming, but even small, consistent steps can help you through it and make life a little more manageable.
It’s, of course, always beneficial and important to have a strong support system in place. This doesn’t mean you need to share every detail of your feelings with everyone you know, but opening up to a trusted friend or family member can make a world of difference.
Sometimes, just having someone who listens without judgment can provide a sense of relief. If you don’t feel comfortable leaning on people you know personally, there are many support groups available. These can be local, in-person gatherings or online communities where you can connect with others who are experiencing similar struggles. Knowing you’re not alone can be incredibly powerful and healing.
When living with this condition, it’s also helpful to focus on the things you can control, even when so much feels out of your hands. Establishing some non-negotiable daily habits can provide a sense of stability and routine, which might help improve your overall mood. This includes paying attention to your sleep, aiming for consistent bedtimes and wake-up times, even on weekends.
Eating nutritious meals regularly can help fuel your body and mind, giving you the energy to face the day. Exercise (even in small doses) can also play a significant role. A short walk outside or some light stretching at home can do wonders for your mental and physical health. It doesn’t need to be anything intense or time-consuming, the goal is simply to keep moving in ways that feel good for you.
If you’re feeling overwhelmed or hopeless, it might be worth considering your options for professional support. There are always new options to explore.
Get In Touch With Us Today
Treatment-resistant depression doesn’t mean you’re out of options. It simply means your path to recovery may require different tools.
At Eulas, we’re proud to be part of this change, offering safe and effective treatments for those who need them most. If you or someone you know is struggling with TRD, don’t hesitate to reach out.
For more information about our services or to book a consultation, contact the team here today.
