Chronic, Severe, Treatment Resistant Depression, What You Need to Know!

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Dr. Maupin and Brett Discuss Different Treatment Options for Severe Depression.

Talk therapy is a standard treatment for depression. Often depression is treated with a type of drug called an SSRI (a serotonin reuptake inhibitor). There are many of these types of drugs and most doctors will prescribe one of them for you if you suffer from depression. There are more severe types of depression that do not respond well to these two treatments and other things need to be done to treat them. This week we are going to talk about the various types of treatments that you can check into if you or someone you care for has severe chronic treatment resistant depression.

Regular or mild depression is what most of us get. There are treatments for this, and we often improve, although it usually takes a couple of weeks of taking the antidepressant before it begins to work, and we feel better. If that drug does not work, then you have to let it all get out of your system and try another, then wait a couple of weeks to see if it is the one that will work for you.

If you have a more chronic and severe type of depression, these traditional treatments will not meet your needs. This is particularly difficulty because your loved ones and your support system will exhaust themselves and deplete their energy for helping you. They will get frustrated and angry because you don’t get better. Even when they understand that you have no control over the depression, they will feel this way, in part because there are no visible signs except your inability to move and work and be better. They will often blame you for that and be frustrated with you as if you were doing it on purpose. The more severe your depression, the more intense their reaction to it.

In this week’s podcast, we are going to talk about some of the new treatments that are being studied for the treatment of this type of severe resistant depression.

To begin with, we will speak about ECT or EST. Better known as electroshock therapy or electroconvulsive therapy. This is a treatment that has been around for a long time and was once a horrible treatment because it was so severe on its impact on the body and brain. Today, it is not such a horror story, but many are still frightened of it because of its history. Today most people who receive this treatment get it as outpatients at their doctor’s office or an outpatient clinic. They get a muscle relaxer and the shock is administered to only one hemisphere of the brain. The most common side effect is temporary short -term memory loss.

Another treatment is repetitive transcranial stimulation which is the use of high-powered magnets. These magnetic currents will stimulate your brain cells to fire. It is not precise in its ability to cause stimulation of specific bunches of cells in your brain. But what they have noticed is that after a series of these treatments people often seem not to be as depressed as they were for a while. So, if you are at the end of your rope with traditional treatments, you may want to speak with your doctor about this type of treatment.

Another treatment that is showing some success is the stimulation of the Vagus nerve. They place a battery under your collar bone which will send a surge of electric current every five minutes day and night for about ten years before it needs to be replaced. We do not know precisely why this impacts severe depression but there is data available to suggest that for some chronic severe depressions there is a ten year or more relief from the depressive symptoms.

Ketamine, a drug that has been around awhile is also now being used by some doctors to treat chronic severe depression. It is usually given as an infusion at the doctor’s office and has some severe side effects.

Another new drug brexanalone was just approved by the FDA as a drug for postpartum depression. But they are studying it to see if it can help other forms of chronic depression.

Finally, there are innovations that are being offered in addition to traditional types of treatment for depression. Teletherapy is one, new phone apps tailored to help with mindfulness and digital reminders and trackers are being used in some cases where there are positive results being found.

If you are suffering from chronic severe depression, please do not give up. If you are living with someone who suffers from this terrible affliction, insist that they look into some of these treatments. There is hope.

This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author, with Brett Newcomb, MA., LPC., Family Counselor, Presenter and Author.



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