Sad Depression TMS

Depression | Chronic Treatment Resistant Depression – What if treatment doesn’t work?

Depression and how is this impacting me?

Treating Depression is an ongoing concern for many Australians across the country, where almost half (45%) of all Australians have experienced a mental health condition at some point in their lifetime. Depression, often is misdiagnosed or left undiagnosed for several years, with many struggling to find treatment suitable to them.

Depression does not discriminate, where all people from differing backgrounds and experiences can be diagnosed with the condition. Depression is often diagnosed after two weeks of consistent pervasive low mood that significantly impacts different areas of their life (such as work, school and relationships).

Depression is often complex and impacts many key areas in a person’s life, such as sleep, appetite, sex drive, interactions with people, motivation, energy and feelings of hopelessness and self-worth. Depression can often be linked with other mental health conditions such as Anxiety, Obsessive Compulsive Disorder, Post-Traumatic Stress Disorder and Addictions.

How can we treat depression?

There are several nationally recommended treatment modalities to combat mood disorders, with medication being the mainstream. It is recommended that you seek GP or psychiatry assistance, and discuss a treatment plan using medication to manage symptoms. Often these Antidepressants elevate three key neurotransmitters in the brain: serotonin, norepinephrine and dopamine, aiming to reduce depression symptoms.

What if first line of medication does not work?

Despite medication being a key treatment modality, many people do not respond to the medication and have minimal or adverse responses. Secondly, many people find the side-effects (i.e., sexual dysfunction, weight gain, poor concentration and lethargy) overall, outweigh the perceived benefits of medication. Many people are now looking for alternative treatments to assist with their depression.

A large-scale study, known as the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) effectiveness study, showed that approximately half of patients will respond to an initial trial of an antidepressant, with only a third reaching clinical remission with that first trial. Where, a third of patients may not reach remission despite multiple drug trials. It is considered that people who have not responded to 2 or more medications are considered to have Treatment Resistant Depression. These statistics have led to more and more research and introduction of non-medication treatment modalities alternative modes, such as Vagus Nerve Stimulation, Repetitive Transcranial Magnetic Stimulation or Electric Convulsive Therapy.

Other key treatment modality, other than pharmacology is treatment using Cognitive Behavioural Therapy (CBT). CBT is a treatment modality often facilitated by a psychologist who will assist you with looking at key thought and behaviour patterns that may be perpetuating depressive symptoms. Research suggests that CBT is just as effective as pharmacological treatment.

What can I do?

Firstly, it is important that you as the patient have all of the information available to you. You need to be able to make an informed decision on your health, including your mental health. You are the expert in your life, and you should find a care team that can support your recovery.

Please visit your GP or psychiatrist to discuss your current treatment plan, and if you are suitable candidate for other depression treatment modalities.

Please call our friendly TMS Care Team if you would like more information on alternative treatment options on 1300 867 888 or email info@tmsclinics.com.au

If you are feeling suicidal or need immediate assistance, please contact 000 for emergency services or Lifeline13 11 14

 

  1. Philip NS, Carpenter LL, Tyrka AR, Price LH. Pharmacologic approaches to treatment resistant depression: A re-examination for the modern era. Expert opinion on pharmacotherapy. 2010;11(5):709-722.
  2. Gaynes BN, Warden D, Trivedi MH, et al. What did STAR*D teach us? Results from a large-scale, practical, clinical trial for patients with depression. Psychiatr Serv.2009 Nov; 60(11):1439-45.
  3. Manicavasagar V. A review of depression diagnosis and management. Australian Psychological Society. Retrieved from http://www.psychology.org.au/publications/inpsych/2012/february/manicavasagar/u.  Accessed 12 April 2017
  4. Demitrack M, Dunner D, Carpenter L, et al. A multisite, longitudinal, naturalistic observational study of transcranial magnetic stimulation for major depression in clinical practice. Poster presented at: 166th Annual Meeting of the American Psychiatric Association; May 18-22, 2013; San Francisco, CA. NR12-5.
  5. Photo credit to:https://unsplash.com/collections/199874/sad

 

 

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