Treatment Resistant Depression in Parys: Exploring Your Options
You’ve taken the brave step of seeking help for your depression, diligently following your medication regimen, and doing everything you can to feel better.
Yet, despite your efforts, you’re still not feeling like yourself. It’s important to know that you’re not alone in this journey.
If you’ve tried two or more different antidepressants without finding relief, it’s time to consider an evaluation to discuss further treatment options.
Here’s what the research tells us:
- 33% of patients with depression remain depressed after trying two different types of antidepressants.
- Among patients with unipolar major depression who receive initial treatment, the estimated incidence of treatment resistance ranges from 45 to 65 percent.
- Risk factors include general medical and psychiatric comorbidity, a severe degree of depressive symptoms, and adverse life events.
Understanding these statistics can help you realize that what you’re experiencing is more common than you might think, and it doesn’t mean there’s no hope.
Why It’s Important
Depression can take a significant toll on your emotional, mental, and physical well-being. When it doesn’t improve after trying multiple treatments, the burden can feel even heavier. It’s crucial to keep seeking solutions because your well-being matters deeply.
Degrees of Depression
Depression varies in severity. For those suffering from a severe degree of depression, specialized treatment by a psychiatrist is often necessary. These professionals are equipped to provide the comprehensive care required to manage treatment-resistant depression effectively.
Next Steps
After a thorough evaluation, your psychiatrist in Parys will discuss various treatment options with you, which might include:
- Admission: Sometimes a more intensive, structured environment can be beneficial.
- Psychotherapy: Engaging in therapy with a trained professional can provide valuable support and strategies.
- Combination of Medications: Finding the right mix of medications can make a significant difference.
Remember, seeking help and exploring new treatment options is a sign of your strength and dedication to your health. It’s perfectly okay to need additional support, and taking these steps can lead to better days ahead.
Stay hopeful and know that you’re not alone on this journey. With the right support and treatment, you can find relief and rediscover your true self. You’ve got this.
Transcranial Magnetic Stimulation (TMS)
TMS is a relative new treatment is South Africa. It is an effective treatment for TRD with relative mild side-effects.
TMS has the following benefits:
- The patient is awake during the process and can drive home afterward
- There is no need for a theatre or anesthetist
- The patients do not report memory loss
- The series of treatments can be squeezed into one week
- The treatment is individualized to treat other conditions than depression
Electroconvulsive Treatment (ECT)
ECT remains the gold standard treatment for severe depression, and it can be life-saving in the following scenarios:
- Catatonic depression
- Depression in pregnancy
- Depression or mania with psychosis
Ketamine
We are offering all the most effective treatments for TRD in Benoni. We believe in ethical, evidence-based practice guidelines and consult with all our patients to co-plan each patient’s treatment.
We actively engage with medical aids to ensure funding for evidence-based treatments.
Unipolar major depression (major depressive disorder) is diagnosed in patients who have suffered at least one major depressive episode and have no history of mania or hypomania
Treatment-resistant depression typically refers to a major depressive episode that does not respond satisfactorily after two trials of antidepressant monotherapy; however, the definition has not been standardized.
– Treatment-refractory depression typically refers to unipolar major depressive episodes that do not respond satisfactorily to many sequential standard regimens, including multiple antidepressants and adjunctive drugs, as well as at least one trial each of adjunctive psychotherapy, repetitive transcranial magnetic stimulation, and electroconvulsive therapy. However, the definition has not been standardized, and no clear demarcation exists between treatment-resistant and treatment-refractory depression.
- Suicidal or homicidal ideation or behaviour, or ideation that pose an imminent risk. Ideation that pose an imminent risk includes the wish or hope that death will overtake oneself (e.g., “Life is not worth living” or “I would be better off dead”); or fleeting thoughts of killing oneself, with plans to commit suicide and intent.
- Psychotic features (e.g., delusions or hallucinations).
- Moderate to severe aggressiveness.
- Impaired judgment such that the patient or others are at eminent risk of being harmed
- Impaired functioning is obvious.
- In addition, severe major depression is indicated by a score of >20 points on the Patient Health Questionnaire – Nine Item (PHQ-9).
- Comorbid general medical disorders (e.g., coronary heart disease and hypothyroidism
- Chronic pain
- Medications (e.g., glucocorticoids and interferons)
- Comorbid psychiatric disorders (e.g., anxiety, personality, and substance use disorders)
- Severe intensity of depressive symptoms
- Suicidal thoughts and behaviour
- Adverse life events (e.g., childhood trauma or marital discord)
- Personality traits (e.g., low reward-dependence, low extraversion, and high neuroticism)
- Early age of onset of major depression (e.g., age <18 years)
- Recurrent depressive episodes
- Loss of employment and low socioeconomic statu
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