Treatment-resistant depression (TRD) is diagnosed when at least two medications in two classes have been unsuccessful in improving your symptoms. It is a form of major depressive disorder where the usual treatments fail to provide you with adequate response.
Usually, most people coping with any type of major depressive disorder (MDD) find relief with psychotherapy and medication. However, with TRD, standard pharmacological approaches may provide little to no benefit at all.
However, that does not mean you should lose hope and give up! While the term treatment-resistant might sound discouraging, effective treatment options are still available for TRD.
At Agentic Mental Health, we utilize various treatment approaches to relieve your symptoms and treat TRD.
TRD is a specific form of depression in which the patient does not respond adequately to two medications in two classes. Up to one-third of adults with MDD also have treatment-resistant depression.
Having TRD does not mean that there is no treatment for your depression. It just takes extra time and exploration to figure out the right treatment. At Agentic Mental Health, we use innovative approaches like pharmacogenetic testing to identify the medications that are more likely to be effective for you.
The lack of improvement after trying multiple medications is the most obvious symptom of TRD. Other notable symptoms of TRD include:
Another way to recognize TRD is by paying attention to specific aspects of your treatment and overall experience with depression.
Diagnosing TRD involves a detailed and careful process to ensure accurate identification and effective treatment.
TRD is diagnosed in people who have already been diagnosed with another form of depression. It is diagnosed when you have not seen improvement after trying at least two medications in two classes for six to eight weeks.
It is very easy for major depression to be misdiagnosed as TRD if patients do not follow dosage guidelines as instructed by their doctors. That is why it is crucial to stay on course with your medication. Do not make changes to your medication schedule without consulting your doctor.
At Agentic Mental Health, our experienced team conducts an in-depth intake process to understand your unique experiences with depression.
Some patients experiencing TRD may not respond to treatments due to misdiagnosis. Other psychiatric illnesses, such as bipolar disorder and complex post-traumatic stress disorder (PTSD) can often appear very similar to major depressive disorder
To ensure an accurate diagnosis, we employ a rigorous diagnostic process that includes structured clinical interviews and an in-depth exploration of your developmental and interpersonal history.
For those who have experienced resistance to treatment, we may also use pharmacogenomic testing to rule out individual metabolic differences that might be affecting response to medications.
Our team meticulously reviews your mental health history, including a thorough analysis of past illnesses and current symptoms.
We identify factors and conditions that could contribute to the symptoms or interfere with treatment. These include:
Our team also examines your treatment history, including past medications and psychotherapy trials, to provide an accurate diagnosis. We assess the dosages, duration, and types of medications used.
This also includes assessing your medication intake patterns and looking for signs of misuse, non-compliance, or potential drug interactions that could worsen your symptoms or make your condition resistant to treatment.
We may also evaluate the effectiveness of previous psychotherapy interventions to identify any barriers to success.
Pharmacogenomic testing analyzes how your genetic makeup affects your response to medications and influences outcomes such as symptom improvement, side effects, and rare hypersensitivity reactions.
At Agentic Mental Health, we use pharmacogenomic tests to examine your unique genetic profile and identify medications that are most likely to be effective and well-tolerated by you. This allows us to find the right medication and dosage without the trial-and-error phase typically associated with TRD treatment.
Pharmacogenomic testing increases the chances of finding the right treatment and provides valuable information for developing an optimal treatment plan. The results can reveal how medications interact with your genes and how well you metabolize certain medications.
This testing is especially useful for TRD patients, as finding an effective medication can be challenging.
When the first line of treatment with medications does not show the desired results, it is time to explore other options. An unsuccessful prior treatment simply indicates it was not the right fit for your specific needs. You need not lose hope!
At Agentic Mental Health, we work with you to develop and refine a treatment plan that meets your needs and brings you the relief you deserve. Your treatment plan may include any one or a combination of the following options.
Most people do not respond well to the first set of antidepressants. With TRD, it is important to consider all options. The key is to find the right dosage, medication, and combination of medications that works for each person.
We may employ a few strategies to find the right medication for you. These include:
Ketamine has emerged as a promising option for treating TRD. It can provide relief within hours or days, making it valuable for those who have not responded to other treatments.
There are two forms of ketamine used for TRD:
If our team determines that it would be useful, we can recommend ketamine-assisted therapy alongside other treatments to alleviate your symptoms. We can provide referrals to experts who specialize in Ketamine therapy.
If the initial therapy session does not seem helpful, we may try different approaches or combinations of various types of psychotherapy.
We work together with you to gain a deeper and thorough understanding of your specific condition. Our aim is to uncover the root causes of your current challenges and empower you to take charge of your thoughts and actions.
Repetitive transcranial magnetic stimulation (rTMS) has shown effectiveness in improving the symptoms of TRD. It is a non-invasive treatment that uses magnetic fields to stimulate nerve cells in the brain, helping to alleviate depression symptoms.
If we determine that TMS could be beneficial for you, our team can refer you to specialists who provide TMS treatments. While we do not offer TMS in-house, our doctors have the experience and expertise to guide you and connect you with trusted experts.
Treatment-Resistant Depression (TRD) can be a challenging journey that impacts your daily functioning and often diminishes your sense of hope.
At Agentic Mental Health, our skilled team is dedicated to supporting your mental health and helping you regain control of your life and happiness. We work with you to find effective treatment options for achieving long-term relief from TRD.
To book a consultation, call us at 434-284-5980 or schedule an appointment online.
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