Typical treatment approaches for depression include psychotherapy, medication, or a combination of the two. Psychotherapy (also known as talk therapy) is a broad term which includes specific types of therapy designed to help patients gain control and awareness of their feelings and behaviors. A commonly used form is cognitive-behavioral therapy (CBT), which works to help patients redirect negative, self-defeating thoughts and replace them with more productive ones. Common medications for depression include selective serotonin reuptake inhibitors (SSRIs), which help treat depression by increasing available levels of naturally occurring “feel good” chemicals in the brain.
For most people, psychotherapy and medications improve symptoms. But finding the right combination of these treatments can be a trial-and-error challenge. Treatment-resistant depression—that which doesn’t respond sufficiently to medication or psychotherapy—may be caused by a variety of factors, from other medical disorders to skipped doses of your medication. So when should you consider taking a new approach to your treatment plan?
Questions to Consider
Dr. Rob Dobrenski, clinical psychologist, points out the periodic frustration in diagnosing and treating depression. “You don’t measure depression with a dipstick inside the head,” he says. “The reality is, some patients will plateau.” If it seems like you’ve reached a wall, try to identify possible factors contributing to your treatment-resistant depression. Locating factors will help determine how you and your doctor can proceed.
Is your medication working?
The answer to this question requires complete honesty. Are you taking your medication on a regular basis? A skipped dosage here and there may not seem like a big deal, but skipping or lowering a dosage can have a major impact on your depression. If you have been faithful to your medication schedule, then it may be time to speak with your doctor about increasing the dosage or considering a switch to a different drug.
Is it time for a new or a combined form of treatment?
Rather than dropping your medication altogether—which can have negative effects—you may want to consider introducing complementary approaches to your treatment plan. Some people benefit from a combined form of therapy, incorporating mind-body techniques such as Yoga and meditation, along with their medication and/or psychotherapy.
Is your therapist a good match?
Before you consider a new form of psychotherapy, take a good look at the relationship between you and your therapist. You deserve someone who listens and displays warmth, confidence, and compassion. However, your therapist could be the nicest, most compassionate person on Earth, but if you do not connect or respond well to your therapist, it might be time to reconsider.
Could it be a misdiagnosis?
Depression is sometimes misdiagnosed. Other factors include mental health conditions or other disorders, such as anxiety or thyroid disorders, that can affect or worsen depression.
Examining Your Treatment Plan
If medication dosage has been increased and therapy sessions ramped up without further improvement, it may be time for a candid talk. As Dr. Dobrenski says, patient and doctor may need to ask, “Are we at the best spot we can be?”
It could be that you have reached the best possible place for you. While it’s important to continue taking prescribed medications, you may want to consider other options in addition to your medication. Joining a support group, lifestyle modifications (such as regular exercise and a balanced diet) and complementary treatments (including Yoga and meditation) are additional options to discuss with your doctor.
