Additional Strategies for Treatment Resistant Depression

There are many other strategies used to help someone who has treatment resistant depression. These should be considered when traditional treatments — such as trying multiple different types of antidepressants and more than one psychotherapist — have failed. Although no formal definition exists, typically a person is not considered to have treatment resistant depression (TRD) unless they’ve tried at least four different medications and at least one or two courses of psychotherapy.

Vagus nerve stimulation (VNS) is FDA-approved as an adjunctive long-term treatment of chronic or recurrent depression for patients 18 years of age or older who are experiencing a major depressive episode and have not had an adequate response to four or more adequate antidepressant treatments. It has shown to be effective in long-term clinical trials. In VNS, a device is put into the chest and sends an electrical current to the brain, which help reduce a person’s depressive feelings.

Electroconvulsive therapy (ECT) is another treatment option for treatment resistant depression. Despite its long history and negative reputation, ECT can be helpful for people whose depression is severe or life-threatening and for people who cannot take antidepressant medicine. In ECT, electrodes are placed on the head to deliver electrical impulses. A person typically undergoes a course of 8 to 12 sessions; most people need to continue such courses year after year, as the treatment usually wears off over time. The largest side effect of ECT is memory loss, the extent and degree of which cannot be accurately predicted by professionals.

Researchers are also looking at other neurostimulation treatments, such as transcranial magnetic stimulation (TMS), magnetic stimulation therapy (MST), and deep brain stimulation (DBS). Deep brain stimulation has been shown in clinical trials to help people with treatment resistant depression, but is not yet an FDA approved treatment for TRD.

Treatment resistant depression is often just another way of saying that a dedicated mental health professional hasn’t found an answer to a particular person’s depression. Even treatment resistant depression can be successfully treated, as long as both the person suffering from depression and his or her professional don’t give up hope.