Treatment Resistant & Alternative Options.


What Have I Tried?

Being treatment resistant is horrible. It means I've tried treatment--medications & therapy--& I'm still really sick. Treatment hasn't worked. Living with continual angst & unanswered questions is extremely difficult & rather excruciating. The mental challenges I face on a daily basis are enough to stump even the best of professionals.

I was diagnosed two years ago, though I've struggled with mental illness for nine years now. I've seen a dozen therapists, few of which have said anything beneficial & none of which have helped me overcome anything. I've been in & out of mental health facilities. Some therapists dropped me or moved; others I let go because it wasn't a good match. They've tried a variety of methods, including dialectical behavioural therapy (DBT), cognitive behavioural therapy (CBT), & eye movement desensitization & reprocessing (EMDR). Although therapy has never harmed my life, I can't say it's helped much either.

I've tried two dozen medications, some of which have made things significantly worse & twice I landed in the ER from major side effects. I've tried everything from natural antidepressants (like St. John's Wort) & real antidepressants to stimulants, antipsychotics, sedatives, & mood stabilizers. Although some medications slightly helped, the side effects were always too horrible to stick with them. The other medications didn't help me at all.

These two things, therapy & medications, are the main treatment options available for mental illness.

What Is Treatment Resistant Depression?

What happens when treatment doesn't work? Roughly ten percent of patients prove to be treatment resistant. Being treatment resistant means that typical treatments for mental illnesses haven't worked, that there has been no positive responses from a variety of therapies & medications. These patients have been fighting anywhere from 1-20 years to find proper treatment.

There are, however, other treatments that can be available. Hope is not gone yet.

The first thing anyone will suggest is exhausting the therapy & medication options. Try a new therapist; try a new method in therapy; continue with therapy; try a new psychiatrist; try a new medication; try a different medication dosage; try a different medication combination; continue with medications. Stick to the treatment plan. Stop drinking or using drugs. Manage stress. Sleep well. Get regular exercise. Eat well. These are the basic steps to "getting better."

The Genesight test is available. It test your DNA for information to help decide on a proper medication. This can be helpful & may potentially provide a breakthrough with medications. Unfortunately, it was not helpful for me.

Another aspect of treatment is making sure the diagnosis is correct. Misdiagnosis is extremely common, & when the real issue is not being addressed, it's not surprising that progress isn't being made. Therefore, it is extremely important to ensure a proper diagnosis. For this, I would consult as many mental health professionals as possible. Everyone has a different approach for diagnosing mental illness, & one doctor might catch something or ask an important question that other doctors glazed over.

Another aspect is ensuring that the mental ailments are not caused by a physical ailment, such as a malfunctioning thyroid. I get tested for all these possibilities annually.

What Other Treatment Options Are Available?

But, when none of that works, there are a few other options as well. I've never tried any of these, but they're always an option should the path I'm on now prove unfruitful.

Electroconvulsive therapy (ECT) uses electric currents through the brain to intentionally trigger a brief seizure which causes changes in brain chemistry that can quickly ease symptoms.

Transcranial magnetic stimulation (TMS) uses magnetic fields to stimulate nerve cells in the brain connected with mood control & depression to ease symptoms.

Vagus Nerve Stimulation (VNS) stimulates the vagus nerve with electrical impulses that travel to the mood centers of the brain to ease symptoms.

Ketamine has recently been used in a medical setting to help with depression. Unfortunately, ketamine tolerability is poor, & the positive effects from it only last a few days.

Of course, the land of medicine & science is always changing, always growing, always evolving. I surely hope that more effective treatments will be made available in the future.