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Treatment-Resistant Depression: Hope in the Absence of Relief

Treatment-Resistant Depression: Hope in the Absence of Relief

As those who suffer from it know all too well, treatment-resistant depression is more than just depression that’s a little harder to treat. It’s often years of poor mood and lack of interest that persist despite multiple, concerted efforts to treat the disorder with a combination of psychotherapy, meds, and other treatment protocols.

There is no single story or experience that fits everybody with treatment-resistant depression, but there are some touchstones that are familiar to many of those who struggle with the disorder. In those rare times when individuals do find themselves caring about something, it might be some vague combination of anger and envy that’s felt toward the nearest person, or maybe it’s a resentment of those who have similar symptoms but who quickly and permanently respond to treatment, so-called “wannabe” depressives. But these feelings never last and what most often takes their place is a deeply ingrained sense that one’s life is not worth living.

 

Good and Bad Kinds of Psychoeducation

One of the first and most common ways in which depression is treated is with psychotherapy that includes a heavy dose of psychoeducation and mindfulness. By meeting with an experienced therapist, a client learns more about how depression acts on the thoughts and feelings of the individual. Obsessively thinking about depression, also known as rumination, can be one of the signs of the disorder. Recognizing the way in which depressed thoughts become obsessive and exploring ways to disrupt this cognitive pattern, also known as mindfulness, is an essential therapy method for a lot of depressed people.

Yet, this particular symptom of the depressed mind also helps explain why psychoeducation may, in some cases, actually deepen the depressed mood in someone with treatment-resistant depression. Once you’ve read about how neurotransmitters no longer seem to be the key to beating depression, once you’ve read about the lack of new neurons being created in the hippocampus, once you’ve read about depression as an insidious, slow-moving neurological infection, and determined that none of the theories of depression have helped, the last reservoirs of hope may be threatened.

 

Let’s Talk about a Revolution — and the Hype that Comes with it

Lithium for people with bipolar disorder, antipsychotics for schizophrenics, antidepressants and better ECT protocols. Perhaps in part because mental disorders have some many different potential causes, there is rarely such a thing as a universal cure for everybody who suffers from them. However, the success stories do tend to be dramatic with rapidly-occurring changes.

Today, the frontier of the next revolution seems to look toward neuroscience. PET scans and new MRI technologies are allowing mental health professionals to observe the functioning brain in much greater detail. The study of this brain-imaging data and the resulting research is commonly referred to as neuroscience. But here’s the thing: Neuroscience as it exists today has been severely over-hyped by its own marketing, in large part by a mental health industry that wants to be taken more seriously by the scientific and medical communities. Now that we mental health professionals have neuroscience, we can tell you that your problems are a real thing.

 

A Better Approach for Treatment-Resistant Depression

There are several problems with this attitude. For one thing, this marketing seemingly tries to persuade people to seek treatment at all costs, but doesn’t seem to be aware of the ways it may diminish the empowerment that comes with seeking therapy. Put another way, this messaging leads the average person to more readily adopt the view that they don’t need to talk to anyone about their problems, they just need to get their brain fixed. The situation is almost always more complicated than that.

Also, neuroscience marketing also dramatically overstates our current understanding of the brain, its underlying mechanisms, and what they might mean for mental health therapy in general. For another thing, it makes it sound like neuroscience has “arrived.” There’s no doubt that brain-imaging technology and the study of neuroscience holds immense promise. But more than likely, we’ve only begun to scratch the surface. For most people with treatment-resistant depression, it’s not today’s treatment that offers hope, but tomorrow’s.

And there’s no telling what the future may hold. The day may come when people suffering from a chronic biological depression have access to an easy, effective treatment, while the people who suffer from situational depression must continue to go through a prolonged course of psychotherapy. Or maybe there’s a breakthrough that doesn’t make the news but which delivers life-changing results to you personally. There are clinical trials that produce dramatic results for a few, while creating comparatively little promise for large-scale implementation.

 

Hope and Bargaining with Your Life’s Value

Even individuals who struggle to believe their life has value may find a way to avoid suicide by bargaining with themselves about their situation. One of the most common examples is the presence of loved ones in their life. I could never do that to my mom. I could never leave my husband on his own like that. But not everybody has these loved ones in their life. And sometimes it’s hard not to think that ending their own long-standing agony shouldn’t be the bigger concern.

Recognizing that a personal mental health revolution may still be in stars is another way to protect that last threads of hope to which one may cling. Even when it feels like there’s nothing left for the individual to try on their own, there are hundreds of thousands of people across the world who are actively studying and experimenting with different mental health therapies.

 

The Importance of Documenting Treatment-Resistant Depression

The importance is so that you can be first in line for clinical trials and so that mental health professionals can match you with the most promising new treatments. Even as they have deepened your depression over the years, the repeated failure of depression treatments may still lay the groundwork for eventual success. Even if the chances aren’t as big as you would like, endless agony or suicide may turn out to be a false choice if you can keep finding a way to make it through another day.

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