Treatment-Resistant Depression

Treatment-resistant depression (TRD) is often diagnosed when you have depression that hasn’t responded to medications or other therapy. Virtua’s caring team is here for you, offering innovative treatments to help improve your mood and quality of life.

What are the symptoms of treatment-resistant depression?

The most common TRD symptoms include:

• Persistent feelings of sadness, hopelessness, or despair
• A loss of interest or pleasure in activities you once loved
• Significant changes in appetite
• Sleep disturbances, such as insomnia or sleeping too much
• Chronic fatigue or low energy
• Difficulty focusing or making decisions, even for simple tasks
• Overwhelming feelings of worthlessness, guilt, or self-blame
• Recurrent thoughts of suicide or death or attempts at self-harm

If you're struggling with any of these symptoms, Virtua experts provide compassionate, judgment-free care and treatment options that can put you on the path to healing.

What are the risk factors for treatment-resistant depression?

TRD occurs in 30% of people who have been diagnosed with clinical depression. Understanding the risk factors can help you recognize potential challenges on your path to recovery. Factors that may contribute to your risk include:

• A personal or family history of depression or other mood disorders
• Previous unsuccessful attempts at managing depression through standard treatments
• Currently experiencing other mental health conditions, such as anxiety or substance use disorder
• Chronic medical conditions that impact overall well-being and mood
• Environmental factors, such as stress, trauma, or significant life changes

How is treatment-resistant depression diagnosed?

Diagnosing treatment-resistant depression (TRD) involves a thoughtful and comprehensive evaluation of your mental and physical health with your primary care provider or psychiatrist.

Your health care provider will assess your symptoms, medical history, and past treatment responses to determine the most effective care plan. Your evaluation and diagnosis may include the following:

Comprehensive evaluation: Your provider will conduct a thorough physical examination, mental health assessment, and in-depth medical history review. This step is crucial in identifying any underlying conditions or other disorders that could cause depression symptoms.

Assessing response to past treatments: Your provider will explore how you’ve responded to previous interventions, including antidepressants and talk therapy.

Ruling out other medical conditions: Your provider may order lab work or other tests to exclude conditions such as thyroid disorders, chronic pain, or hormonal imbalances that may mimic or worsen depression symptoms.

Based on your results, your health care provider may refer you to a Virtua interventional psychiatrist to discuss the benefits of brain stimulation therapy.

Treatment-Resistant Depression Care at Virtua

Living with treatment-resistant depression can feel overwhelming, but it’s important to know that you’re not alone on this journey. Virtua’s caring team of mental health experts meets you where you are, providing support and treatments to help relieve your symptoms.

These treatments include:

Electroconvulsive therapy (ECT): ECT is a brain stimulation therapy that uses electrical pulses to stimulate changes in the brain that can improve your mood and relieve symptoms of TRD. ECT is the most effective treatment for people who have severe depression that hasn’t improved with medication or psychotherapy.

Transcranial magnetic stimulation (TMS): TMS is a noninvasive treatment that uses an electromagnetic field to stimulate specific areas of the brain. This option offers hope for those who may not have found success with medications or traditional therapy.

Lifestyle changes: Lifestyle changes alone aren’t a cure for TRD. However, they can help ease symptoms and contribute to your overall wellness. Here are some positive changes to consider:

• Regular exercise: Even in small amounts, exercise can positively impact your mood and overall well-being. Finding an activity you enjoy can make incorporating exercise into your routine more manageable.
• Healthy diet: A balanced, nutrient-rich diet supports your physical and mental health, helping you feel your best.
• Stress management: Self-care techniques such as meditation, yoga, or mindfulness can help you reduce stress.
• Adequate sleep: Consistently getting 7-9 hours of sleep each night is crucial for managing your mood and emotions.
• Social support: Connecting with loved ones or joining a support group can make a significant difference in overcoming the isolation that often accompanies depression.

Finding an effective TRD treatment approach often involves a combination of therapies and lifestyle changes. Your health care provider will work closely with you to help navigate these options and develop a plan tailored to your needs. Together, we can help you find a path toward healing and hope.