Antidepressants are one of the most common and effective forms of depression treatment: about one in eight Americans over the age of twelve report recent antidepressant use. Unfortunately, up to 60% of those using antidepressants will find that their depression does not completely respond to the medication they try.
Often, these people are referred to as having “treatment-resistant” depression. Think this might be you? Let’s take a closer look at what treatment-resistant depression is and how, if you think you might have it, you can seek the care you deserve.
What is Treatment-Resistant Depression?
Treatment-resistant depression is defined by the Mayo Clinic as a form of depression for which medication does not seem to provide symptom relief (or, if it does, the relief does not last long). For many with treatment-resistant depression, finding an effective antidepressant often involves a long and tenuous trial-and-error process. Here are some ways that can help you find a plan that works for you:
One way to avoid subjecting yourself to the “guess and check” method of multiple antidepressant trials by getting a closer look at how your body responds to medication on a molecular level. By better understanding your genetic makeup, you can better understand how your body responds to medication as genetics comprises a large part of why people develop depression.
Think about it this way: if you knew someone had a bad food allergy, you wouldn’t force them to eat a three-course meal of different foods and hope they won’t have an allergic reaction. Instead, you might do an allergy test to see how their cells react and respond to different food groups. Then, they could better understand which foods nurture and fuel their body.
By offering the option of genetic (also called pharmacogenomic) testing for mental health care, we at Prairie Health are doing something similar. Your genes can drive up to 50% of your response to medication, so when your medication doesn’t seem to be working, your genes are a good place to start. By having a doctor analyze your genetic makeup, you can receive treatment that’s specifically tailored to you — not treatment based on an educated guess.
If you want to know whether genetic testing can help you, you can take our free assessment on it here.
Consult Your Psychiatrist
If, of course, you don’t like the idea of genetic/pharmacogenomic testing, but are still seeking help for your treatment-resistant depression, there are other options. For starters, you can talk to your psychiatrist about some of the following:
- What life circumstances might be contributing to your depression
- What other physical conditions you might have that could be worsening your depression (e.g. thyroid disorders, chronic pain, or heart problems)
- If you might have another mental health condition (like bipolar disorder, which can cause or worsen depression and may require different treatment)
- Whether or not you’re taking your medications as prescribed.
If you are looking specifically for a new medication strategy, you can try discussing with your doctor some of the following options:
- Giving your current medications more time
Antidepressants can take up to eight weeks to become fully effective. For some people, it can take even longer.
- Increasing your dose or decreasing your dose (if indicated by your doctor)
Your genetic makeup is a huge driving factor in what your starting dosage of an antidepressant should be. Without a tool like genetic testing, it can sometimes be hard to gauge what dosage that is. If your medication doesn’t seem to be working, speak with your doctor about adjusting your dose.
- Changing antidepressants
You may need to try multiple medications before finding the right one for you.
- Adding another type of antidepressant
By prescribing multiple antidepressants at once, your doctor might be able to help you affect a wider range of brain chemicals linked to your depression.
- Adding a medication generally used for another condition
Doctors sometimes prescribe a treatment that is typically used for a different condition than the one you have. This approach is known as augmentation and sometimes helps people with treatment-resistant depression. It can include, but is not limited to, antipsychotics, mood stabilizers, anti-anxiety medications, thyroid hormone, or other drugs.
Whether you choose to speak to your doctor about external factors impacting your treatment, get prescribed a different medication strategy, or opt to take a closer look at how your genes might be impacting your mental health, keep in mind that this is your journey. We are all unique, and so each of our paths to treatment will look different. No matter where your journey to addressing your mental health takes you, remember that you are not alone, and you will eventually find the help that makes all the difference.