Treatment Resistant Depression

You are taking treatment for depression; however your symptoms do not improve. In such cases, you may have treatment-resistant depression.

With treatment-resistant depression, standard treatments like antidepressant medications or psychotherapy do not improve the symptoms of depression. In some cases symptoms improve only to return after some time.

Treatment-resistant depression requires different approaches of treatment. You should consult your psychiatrist for considering your situation.

Consultation with doctor for Treatment-resistant depression

  • Your psychiatrist may perform the detail evaluation of your case and review your medical history.
  • You may be asked questions about your lifestyle and various factors that trigger your depression.
  • Your response to various standard treatments is evaluated including medications or psychotherapy tried by you.
  • The timings and dosage of various medications including antidepressants and other herbal supplements are evaluated.
  • Your psychiatrist may perform the diagnosis for presence of any mental health disorder that can worsen depression.
  • You may be asked to conduct blood tests or other tests for ruling out the presence of other diseases such as thyroid disorders, anaemia and other medical problems.

Adjusting your medications  

One of the reasons your medications might not have worked for you is the incorrect dosage or ineffective combination of medications.

You may follow the below mentioned medication strategies

  • Take your medications for some more time as antidepressants may take up to eight weeks to show their effect. In some cases, it takes even longer.
  • Your psychiatrist may make adjustments in dosage of your medications. Usually, the increase in dosage provides improvement in symptoms.
  • Your psychiatrist may switch your antidepressant medications if the prescribed antidepressant isn’t effective.
  • If one antidepressant is not effective, your doctor may add another antidepressant to the treatment. The combination of antidepressants may yield more effective results as they affect a wide range of brain chemicals.
  • You may be prescribed medications used for another health disorder such as mood stabilizers, beta blockers, antipsychotics and stimulants, anti-anxiety medications, anti-seizure medications, etc.


Psychotherapy is very effective in individuals who do not respond to antidepressants alone. With psychotherapy, patients can learn to find better ways for coping with life’s challenges and managing healthier relationships.

  • Cognitive behavioural therapy includes the counselling session with patients. During the session, the feelings and behaviours of patient responsible for affecting mood are addressed.

It assists in identifying patterns of negative thinking. Patients learn to cope the stresses of life in better way.

  • Interpersonal psychotherapy deals with resolving relationship issues responsible for causing depression.
  • Family therapy involves counselling session with family members or spouse for resolving the issues responsible for stress in your relationships.
  • Group psychotherapy involves counselling session with group of people who share their feelings and symptoms with others.

Procedures for Treatment-resistant depression

The treatment resistant depression can be treated by following the below mentioned procedures.

Electroconvulsive therapy (ECT)

Electroconvulsive therapy is widely practised in treating severe cases of depression as it can immediately reverse symptoms of depression. It is usually administered in those depressed patients who do not respond to other treatments.

Changes in the brain chemistry can be achieved by passing electricity through brain. This phenomenon is known as Electroconvulsive therapy. When electric currents are passed through the patient’s brain, it triggers a brief seizure resulting in changes in brain chemistry.

Vagus nerve stimulation

A Vagus Nerve Stimulation is newly designed brain stimulation procedure where electrical impulses are sent into the patient’s brain for treating depression symptoms.

Transcranial magnetic stimulation

Transcranial magnetic stimulation involves using magnetic fields for stimulating the nerve cells in brain for improving the symptoms of depression.

It is a relatively new procedure that is recommended in patients who do not respond to other standard treatments such as medications and psychotherapy.