Finding Help for Treatment-Resistant Depression

Treatment-resistant depression (TRD) has the same symptoms as depression, but with a more complex recovery process. Because of its effect on energy levels, depression can interfere with your capacity to seek help. This makes TRD especially daunting for many people. It takes a great deal of determination to try new treatments, with the knowledge that just finding the right modality may take some time. As difficult as this is, it’s important to stay focused on the goal of getting well. 

Whatever treatment you’re currently trying, you can always continue to learn about this condition. Knowledge is power. The more you know about treatment-resistant depression, the better equipped you’ll be to manage your symptoms and get the depression help you need. 

Lifestyle Changes and Behavioral Health Treatments for TRD

Treatment-resistant depression¹ is defined as depression with symptoms that are not alleviated after trying two or more treatment options (medications) for at least six weeks each. Despite the myriad medical and behavioral options for treating depression, many people still struggle to find an effective treatment. One-third of people with major depression have TRD.² 

If you think you may have treatment-resistant depression, you’re likely already familiar with the symptoms of major depression.³ While these criteria are well understood, research is beginning to explore some of their underlying causes. 

Most people understand depression to be related to chemical factors in the brain. There are a number of environmental factors that may contribute to depression⁴—and it’s not just physical health. Depression has recently been associated with more frequent use of screens (cell phones, computers, etc.), and a lack of access to green space. High levels of air and noise pollution may also exacerbate symptoms. On the other hand, activities that guard against depression include confiding in other people, being part of a sports club or gym, and strangely enough, eating cereal. 

These protective factors paint a clear picture: eating cereal with friends at the gym might be a valid treatment for treatment-resistant depression. In all seriousness, though, most of the activities that diminish the chances of depression include social support. That support doesn’t have to come from friends; it can also come from a one-on-one therapist, a psychiatrist, or a support group. The simple act of reaching out for help can have an immensely positive impact on TRD.

Alternative Therapies for Treatment-Resistant Depression

Holistic and alternative modalities are an increasingly popular way to treat mental health conditions. People with treatment-resistant depression might be particularly interested in these types of therapy. If traditional interventions—like SSRIs, talk therapy, and exercise—haven’t worked, you may be ready to try a radically different strategy. 

Many of these depression treatments , like psychedelic-assisted therapies,⁵ are just starting to gain traction. However, they are not new. This class of medications was studied extensively from 1943-1970. The political shift of the 1970’s pushed researchers away from the subject, but now, public perception of psychedelics is starting to change. More effective treatments for TRD are very likely on the horizon. 

In this new era, the stigma once associated with alternative therapy is dissipating. It’s an exciting time for anyone who wants to find new ways of treating mental health. That’s true for both clinicians and people dealing with their own diagnoses. Living with treatment-resistant depression might not be straightforward, but the number of safe and readily available treatments is steadily growing.

Ketamine Therapy for Depression

Ketamine is a psychedelic dissociative that can be helpful in treating depression,⁶ including TRD, and PTSD. It is administered in a supervised setting, rather than being prescribed for daily use. Ketamine IV treatments may be conducted individually or with small groups, and are always closely monitored by a medical team. 

Ketamine therapy is intended to give you space to step back from your emotional experience, and to process your feelings from a more objective point of view. This perspective can be especially helpful in treating depression; simply taking space from your feelings can result in the immediate relief of some symptoms. Clients enter a trance state, during which they gain greater insight into their lives, often returning to full consciousness with renewed energy and a clear sense of how to move forward. The pharmaceutical aspect of ketamine therapy is often, but not always, combined with talk therapy either before or after the treatment itself. This invites clients to process the experience and set intentions for the future. 

Ibogaine Treatment for Depression and Addiction

Ibogaine is a psychedelic that can be used to treat depression and addiction. According to MAPS, it is “a psychoactive alkaloid naturally occurring in the West African shrub iboga. While ibogaine is a mild stimulant in small doses, in larger doses it induces a profound psychedelic state. Historically, it has been used in healing ceremonies and initiations by members of the Bwiti religion in various parts of West Africa.” Modern-day clinicians are finding that clients with treatment-resistant depression also benefit from ibogaine therapy.⁷

Like ketamine, ibogaine is administered in a protected, controlled environment. Although more research is needed into this form of therapy, ibogaine shows promising results in observational studies.⁸ Thanks to these positive outcomes, this treatment is becoming more readily available in a number of settings, including rehab facilities. 

For many clients, ibogaine therapy is a transcendent, even spiritual experience. By revisiting past experiences, they are able to reconnect with their higher selves. Álvaro de Ferranti, Founder of Tabula Rasa, explains that this treatment “heals the pain by helping the user deal with deep-seated traumas and emotional baggage. It helps them open themselves up to new possibilities, to let self-love back in, and to simply allow them to get back to self again.”