What do you do when therapy and medication don’t work?

Depression affects more than 300 million people worldwide. Despite the high volume of reported cases, there is no surefire depression cure. It’s a universal concern.

There are, however, plenty of treatment options. Talk therapy and antidepressant medications are by far the most commonly prescribed methods for treating depression, and many individuals find success with these traditional treatment plans.

But what happens when they don’t work? What if your depression is resistant to therapy and medication?

Explore a different type of depression treatment.

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Common Depression Treatments

Depression Talk Therapy

The American Psychiatric Association defines psychotherapy as “talk therapy” or, more generally, “a way to help people with a broad variety of mental illnesses and emotional difficulties”.

Simply put, psychotherapy involves regular meetings with a mental health professional in which a patient’s concerns and problems are discussed. The care provider  — who may be a therapist, counselor, psychologist, or psychiatrist — guides each discussion and leads the patient to better understand the root of their issues with the goal of developing healthy ways to cope.

Antidepressant Medications

When talk therapy is not enough, or if symptoms become unbearable, a healthcare provider may prescribe an antidepressant medication to treat severe depression.

Depression is thought to be caused by an imbalance of chemicals  — neurotransmitters — that facilitate communication between nerve cells in the brain. Antidepressants work by affecting the behavior of certain neurotransmitters, like serotonin or noradrenaline, that are linked to feelings and emotion. The goal is to restore balance and allow the patient to better regulate mood. The most commonly prescribed antidepressants include:

  • Fluxetime (Prozac)
  • Citalopram (Celexa)
  • Escitalopram (Lexapro)
  • Sertraline (Zoloft)
  • Duloxetine (Cymbalta)

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Why Do Talk Therapy and Medication Fail?

Both talk therapy and antidepressant medications have proven to improve a large number of depression cases. But they aren’t always successful.

When it comes to talk therapy, it can be difficult for patients to find a mental healthcare professional with whom they can foster a good working relationship. Not all therapists are created equal, and one may be better equipped to help a certain individual than the next, due to a unique combination of personalty traits or skill sets. It can also be difficult sticking to a treatment plan, as talk therapy is often slow progressing, and it can take months or even years of consistent treatment to make a breakthrough.

Antidepressant medications also frequently fail. They may simply not work with a patient’s particular body chemistry.

Some medications also may cause severe side effects — such as nausea, lack of sexual desire or decrease in sexual performance, insomnia, weight gain, constipation, and agitation — that greatly outweigh the benefits of taking the medication in the first place. There is also the danger of developing a dependency on antidepressants. While antidepressants lack the addictive properties of substances like opiates or alcohol, patients can still experience withdrawal symptoms when they stop taking their depression medications, and are more likely to abuse other drugs when on them.

“Both talk therapy and antidepressant medications have proven to improve a large number of depression cases. But they aren’t always successful.”

Alternative Treatments for Depression

Transcranial Magnetic Stimulation (TMS) 

Transcranial magnetic stimulation, or TMS for short, is an experimental, noninvasive, non-drug therapy technique that applies magnetic energy to specific parts of the brain associated with depression.

During treatment, a trained technician uses a TMS machine to produce very small electrical currents in the patient’s brain. These electrical currents activate cells within the brain which are thought to release neurotransmitters like serotonin, norepinephrine, and dopamine. Typically, this therapy is reserved for those people who have tried other forms of traditional treatment without success. In most cases, people who utilize this form of therapy do see noted improvements with very minimal negative side effects.

TMS Center of the Lehigh Valley is the Allentown area’s premiere provider of TMS therapy for depression.

Lifestyle Changes

Lifestyle changes are often recommended alongside talk therapy or medication as a part of a  larger depression treatment plan. When appropriate, mental healthcare professionals encourage patients to adopt healthier diets, reduce drugs and alcohol intake, pursue more social interaction, and take other steps that are thought to naturally treat the symptoms of depression.

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