What to Do If Antidepressants Aren’t Working – Achieve TMS East

What to Do If Antidepressants Aren’t Working

It’s common knowledge that when you’re depressed, you get prescribed antidepressants. Some lament that too many psychiatrists get trigger-happy with the prescription pad, describing them when they might not work or be necessary. Regardless of where you stand on that topic, the data shows that despite a scare regarding suicidality and SSRIs, today’s antidepressants are some of the most effective currently available, while offering a reduced chance of any side effects compared to other similar antidepressants.

But these pills aren’t always the right solution. It’s difficult to ascertain exactly how or why they work, and it’s hard to tell if they would work for the majority of depressed individuals, as only a fraction of people possibly diagnosed with depression actually seek adequate and effective treatment.

Many drop out or quit their treatment before it can fully take effect, while many others just don’t seek help at all. Some do seek and get treatment, but only after their suicidality has already reached a high level, skewing the statistics a little as its difficult to gauge how effective antidepressants alone might be for a patient struggling with a depression too severe to fix without a total change of environment and extensive, intensive daily therapy.

Still, while the numbers suggest that many don’t use antidepressants enough, there are many others who do, and still don’t experience a remission of depressive symptoms. There are several routes to go after this.

 

Try Different Ones

The reality is that antidepressants are not a perfect science, and they’re far from an effective “cure” for depression. They work often, more often than other antidepressants, but they don’t work every time. Furthermore, while SSRIs generally function in much the same way, different drug companies use different chemicals and formulation, thus achieving a different effect in patients. A drug that might work well for patient A might cause patient B to feel nauseous, or sexually impotent, or perhaps even not help at all.

How a psychiatrist or doctor deals with this issue depends largely on their overall professional experience, as well as their medical opinion, as informed by their experience with a specific patient, but generally speaking it’s advisable to ask a patient to try several different drugs before coming to the conclusion that antidepressants don’t work at all for said patient. For example, a patient might try two brands of antidepressants, one for a month-long period, followed by a month-long tapering off the drug to prevent antidepressant withdrawal, followed by another month with a different drug. If both SSRIs don’t work, there are different classes of drugs to use. These include:

A doctor may prescribe a total of four or more different medications to a patient before suggesting non-antidepressant alternatives. This can take a long while, and a doctor should take care to prescribe medication in such a way that limits the patient’s risk of worsening their depression throughout the course of finding the right treatment.

 

Other Prescription Medication

Meanwhile, the FDA recently approved the use of a low dosage prescription of atypical antipsychotic drugs to help treat depression. These function differently from antidepressants, and are usually used at a higher dosage, albeit for thought disorders ranging from a psychotic break to schizophrenia.

These drugs have a history of potential misuse and dependence, which is why a low dosage is the most that can be recommended for the treatment of depression.

 

Work with Your Therapist

Antidepressants should ideally not be your only line of treatment. While they may be the “first line” of treatment when dealing with major depressive disorder, it’s important to pair them up with two other effective antidepressants: talk therapy and lifestyle changes. A therapist can help teens and adults alike navigate their thoughts and emotions and better identify the difference between a normal, rational thought, and a negative, irrational thought.

By recognizing depression when it rears its head, they can learn to override these thoughts over time, either through affirmations or mental homework or stress management tools, or any number of healthy coping mechanisms, from going for a run to playing a musical instrument or working on an essay of self-expression.

 

Transcranial Magnetic Stimulation

Drugs and therapy are the typical ways to treat depression, but they definitely aren’t the only ways. If antidepressants don’t work, a person’s depression is generally categorized as “treatment-resistant”, but there are treatments that work especially well on patients who don’t respond to antidepressants.

Transcranial magnetic stimulation, for example, has been approved by the FDA to help with depression and OCD, through the use of a magnetic coil held over the scalp of a patient, with magnetic fields penetrating just a few centimeters under the scalp, targeting an area of the brain specifically responsible for mood regulation. The treatment is completely painless, with no lasting side effects or any significant recovery time.

It takes several sessions for a full treatment, but more than half of patients with treatment-resistant depression who underwent TMS experienced significant or full remission of depressive symptoms – in other words, it helped them tremendously.

 

Maintain Healthy Lifestyle Changes

Lifestyle matters significantly. While it’s definitely a chicken-and-egg situation where one affects the other, leading an unhealthy or chaotic lifestyle correlates with depression, especially when metabolic illnesses like diabetes and hypertension are involved.

While it might sound strange to have to start eating your veggies for a happier life, it’s generally true that a healthier body is going to leave you feeling better both physically and emotionally. Sometimes, being physically fitter can help you better cope with your depression, if only due to the regular emotional boost provided by the endorphin release during exercise. At other times, avoiding the stress associated with leading a lifestyle prone to inflammation, chronic pain, and constant worrying can also help you deal with any mental health issues that you may have been struggling with, including depression and anxiety.

Often enough, an unhealthy lifestyle is the result of struggling with mental illness without the right treatment. You “let yourself go”, either because food becomes an effective short-term coping mechanism, or because it’s impossible to find the motivation to lead a healthier life. But if you get the help you need and the start you deserve, you might find that being healthier can also help you be a little happier.

There’s no wonder treatment, though. It takes a multimodal approach – a plan with several prongs, utilizing different effective treatments to help someone cope with their depression and lead a fulfilling life despite their diagnosis.

 

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