Treatment Resistant Depression (TRD) is the lack of response to one or more antidepressant trials that contain adequate doses and duration. TRD is common and occurs with 50% to 60% of patients in a clinical practice. Symptoms of TRD include: an increase in the severity and length of depressive episodes, no response to the antidepressants and psychotherapy treatments or a response to the proper treatment followed by regression to a depressive mood, and an anxiety disorder. Taking antidepressants and attending psychotherapy treatments may not assist with improving TRD as standardize treatments are not helpful in treating TRD. 

Patients must take their antidepressants as prescribed and attend psychotherapy treatments as suggested to determine if it is helping with their depression. If the patient is misdiagnosed or is not treated correctly then treatment is the issue, and it cannot be determined that a patient has TRD. Approximately 25-30% of patients experience tachyphylaxis, which is a lack of response to a drug. There is no known cause for TRD. However, many individuals are susceptible to TRD including those with a previous depression diagnosis, women, senior citizens, individuals with underlying conditions, and those that have bipolar disorder. Although standard treatments do not treat TRD, there are treatments that can assist individuals with TRD. Treatments for TRD are ketamine, Botox, Electroconvulsive Therapy (ECT), and micro dosing. Individuals should avoid self-medicating, include self-care in their daily life, and do not give up on finding a treatment. You can make it through this! 

By Chantay Stanley, MSW, LCSWA