Guidelines on Treatment Resistant Depression

Depression is much deeper than feeling "a little down." Affecting the neurotransmitters within the brain, depression is an often debilitating mental disorder. Sufferers are plagued with recurring thoughts and feelings of sadness and low self-worth. There are several treatments for depression, and sometimes it takes trial and error to find the right treatment for a resistant case.

Medications

• Antidepressant medications manipulate chemicals in the brain to ease the symptoms of depression. Norepinephrine, or noradrenaline, is a neurotransmitter that has a stimulating affect. The correct levels of norepinephrine promote a general sense of well-being. Serotonin is a hormone that, like norepinephrine, fosters a sense of well-being when the chemical exists in the right proportion.
  There are three types of antidepressant medications on the market today. Norepinephrine and dopamine reuptake inhibitors (NDRIs) are designed to increase the amount of norepinephrine and dopamine in the brain. Buproprion is the only approved drug in the NDRI category.
  Selective serotonin reuptake inhibitors (SSRIs) increase the amount of serotonin remaining in the brain. Some medications in this category are Celexa, Zoloft, Paxil, Lexapro, Luvox and Prozac.
  Serotonin and norepinephrine reuptake inhibitors (SNRIs) increase the amount of both serotonin and norepinephrine remaining in the brain. Medications in this category include Effexor, Cymbalta and Serzone.

Psychotherapy

• There are four types of psychotherapy (or talk therapy) commonly used to treat depression.
  Cognitive behavioral therapy is directed at identifying and changing the negative thought and behavior patterns typical of a depressed person. This is a short-term therapy that has been successful in many depression cases.
  Interpersonal therapy focuses on the resolution of relationship causes of depression. The goal is to resolve interpersonal conflicts that cause or contribute to a depressive state of being.
  Psychodynamic therapy is typically a longer process than cognitive behavioral therapy. It explores the connection between trauma in the patient's past and his current depression.
  Group therapy may employ any of the aforementioned forms of therapy but in a group setting. This gives patients the benefit of a sense of community and the realization that others suffer from depression as well.

Emergency Care

• The amount of time and the type of treatment needed to recover from depression varies from person to person. For those with depression that is resistant to treatment, the important thing is to not give up. Depression brings with it thoughts and feelings of hopelessness. This disorder distorts reality to make it seem unbearable. There are people waiting to help in times of crisis. One number available to those with depressive thoughts of self-harm is 1-800-273-8255. This is the number for the Crisis Connection. There are counselors available 24 hours a day, seven days a week.