Options for Treatment-Resistant Depression
Have you been through numerous drug trials without getting relief from your depression? Do antidepressants only work for a short while before "pooping out"? Treatment-resistant depression (TRD) can be very discouraging for those who have it, but there are options that may be able to help you.
One option is electroconvulsive therapy (ECT). While ECT doesn't come without side-effects, it does bring rapid relief for about 80 percent of patients and it can work where other treatments have failed.
A newer option is vagus nerve stimulation (VNS), which involves the implantation of a pacemaker-like device to periodically send a pulse to the vagus nerve, which communicates with brain cells involved in mood control.
If medications have failed you, please don't give up hope. Speak with your doctor about other treatment options available to you, such as ECT and VNS.
Thank you for finally stating the fact that treatment resistant depression exists. I have had major depression for the last 25 years. For a while medication worked, but then it “pooped out” as you say. I went for years where all I did was try every possible combination of drugs without any luck. I am puzzled why your column never lists psychoanalysis as an option. True, it is very expensive, but it is the only thing that has brought me relief. I feel that it is purposely not talked about because professionals would then have to deal with clients that see an option, but is out of their reach causing more problems. The fact is that many analysts will work with the patient on finances and analysts-in-training will often do it for next to nothing. I believe that this is often the reason that nobody talks about “TRD” again, professionals are concerned that patients will give up hope if medication does not work. Thank you very much for bringing to light two more options that few doctors will every recommend.
Sincerely,
Jim
I had ECT when I was 18 and it worked excellent. I also had it when I was 35 and it made things worse. It affected my memory so much it affected my job; I could not function. I could not remember simple things like relatives names’, simple recipes, my phone number, forgetting what I was saying mid-sentence, getting lost in a town where I grew up and lived my whole life, spelling words (which I never had a problem with), vocabulary and just plain English. To this day, I still struggle. It is a little better but I still have memory issues. It has left me feeling as though my IQ is back to elementary level.
If you do decide this route, go to a good place like a University, that is where I went when I was 18.
Hi,
I was 22 and gave my Dr an ultimatum. Have a series of blood studies and if they showed depression, then I wanted ECT. No more “we can try this” without effect. Well the Dexamethasone Suppression test and Thyroid tests were way off. I was a slug with no motivation or want to go thru another day. I was lucky the tests pointed my Dr to an Endocrinologist who sent me to a surgeon for a tumor on my adrenal gland. I had no problems with depression after surgery until recently. That was 26 yrs ago. It saved my life as I had started muscle wasting.
I found then how many people who are depressed have medical problems that either are the culprit or aggravate the illness. It is very important for anyone with any form of depression to get a thorough medical evaluation which includes the Dexamethasone Suppression test and other labwork. There are medical problems that can be fixed and it will take the depression with it.
No more assuming that it is emotional. Most Dr’s have to be reminded to look further. Not just medicate.
Thank you,
Sheri
ECT does pose a risk of side effects and complications, such as memory loss and confusion.
But now the procedure has become refined, with precisely calculated electrical currents administered in a controlled medical setting to achieve the most benefits with the fewest risks.
I have had Treatment Resistant Depression for about 10-15 years. I have been on multiple anti-depressants which work for awhile but then stop working. Right now I am on a MAOI wich was my doctor’s last resort. I have opted not to have ECT because I am a single parent and I have to work to support my family. With no support system to help ECT was not a viable option for me. I have fought for 2 years with my insurance company through appeals to have VNS to no avail. They continue to refuse to allow it even though I fit the FDA requirements for VNS therapy. My doctor doesn’t know what to do when the medication I am on runs it course and no longer works. I have run out of options for treatment and I am very disgusted that insurance companies get to decide what treatment patient’s will get.
my mom has taken 5 different medicines + homeopathy for past year.we have reached a status quo after that.how many more drugs should we try till we choose ECT.
mine was an emergency case as it was acute and meds haven’t started working; then years later i had a relapse which needed ECT agn… memory sure’s affected as Chris mentioned- both long term and short term ones; scary
Do NOT EVER have ECT. It erases your short term memory and the good effects of the treatment are very short lived but you are stuck with the memory loss forever! I have told my shrink that if he ever mentions it to me again I will pick up my pocketbook and leave never to return & I’ve been seeing him for 15 years.
I’ve had treatment resistant depression since I was 15 years old. I am now 29 turning 30. In June 09, I received the VNS implant surgery and the implant has been turned up very high after not working in the lower settings. It’s now November 09 and it is still not working. Because of a recent tragedy I lost my insurance, girlfriend, job, and place to live. I know they say that it can take up to a year for the VNS impant to work, but I don’t have a year, so I am considering having ECT, and hopefully that will help my VNS implant start to work.