TRD can initially be difficult to diagnose, it always requires a review of the entire treatment process for your depression so far. This may have been limited to prescription medication from your GP, where full analysis of type of medication and dosage used will be required, to see if there is an alternative drug which could prove more beneficial.
When you first meet with your specialist at Priory, you will be able to discuss the reasons why treatment hasn’t worked so far, and confirm that you haven’t been misdiagnosed.
Your specialist will reassess you and review the diagnosis. This may involve blood tests, and other medical investigations, which will confirm that we are not missing another physical or psychiatric disorder.
Inpatient treatment for TRD
While we can offer treatment for depression on an outpatient, inpatient and day care basis, when receiving treatment for TRD, you may receive more intensive residential based depression treatment at one of our hospitals. This involves a more structured treatment programme in an attempt to find a solution to your TRD, and can help remove any negative influences on your depression from your environment.
The time, care and attention available during your stay can greatly improve your quality of life, and helps both yourself and Priory staff work through the reasons why your initial treatment for depression may not have been successful, including any emotional or physical issues that may not have been addressed.
Evidence based therapies will be used that are suited to your individual circumstances, targeting the aspects of your depression that have not yet been resolved, providing the best possible chance of recovery.
Diagnosis of TRD
There are other conditions such as bipolar depression which doesn’t respond as well to anti-depressants, hypothyroidism, alcohol and substance addiction which can have similar symptoms but require different treatment methods.
It is also important to determine whether you have other disorders such as an anxiety disorder or eating disorder which may be further complicating your treatment.
Medication for TRD
Making sure you have been regularly taking prescribed anti-depressants at the right dose and length of time to have a sufficient effect will be the next stage of treatment for TRD.
While you may find it frustrating when several medications to treat your depression don’t work as they should, our consultants will work with you to find the right medication or combination of medications for your individual circumstances.
If you have severe or long-term depression, it can take time to find medication that is effective. The challenge is to find a particular type of anti-depressant, which affects the part of brain which controls your mood, which works to effectively improve your symptoms where other drugs haven’t.
Switching from one type of anti-depressant to another which has different properties can help, while it is also possible to add a second anti-depressant or other medications that aren’t usually used for treating depression. This can be especially useful when you are feeling some relief from depression symptoms but the condition is not yet completely under control.
It may be that you were not able to take the prescribed medication because of adverse effects. A change of medication will allow us to treat you more effectively with medication that you are able to tolerate.
Therapy for TRD
A combination of medication and therapy treatment is often the most effective way to treat depression and TRD where medication alone has not proved to be effective. While medication can relieve many of the most problematic symptoms of depression, individual or group-based psychotherapy allows you to work with your specialist therapist to understand specific issues or concerns which may be contributing to the illness.
Therapy sessions at Priory for treating TRD can help you:
- Learn new coping mechanisms to copy with stressful life events
- Manage relationships more effectively
- Work through past trauma which may be stopping you from recovering sufficiently
- Discuss any patterns of substance abuse and understand how this may worsen or cause symptoms of depression
- Replace or adjust negative emotions or beliefs with more positive thinking
The evidence-based treatment therapies we most commonly use to treat depression and TRD at Priory include:
Cognitive behavioural therapy (CBT)
This form of therapy is used worldwide for treating a variety of mental health conditions. CBT allows you to address any issues with your therapist regarding the thoughts, feelings and behaviours you have which are linked to your mood when you have depression.
The aim of CBT sessions is to challenge any negative thinking or beliefs you may have that may be contributing to your depression, and encourage lifelong methods of dealing with challenges in a more positive mindset.
Effective CBT sessions can help ensure that you are equipped with sufficient coping mechanisms throughout your life, so that there is less chance that you will become depressed again.
Group therapy
While group therapy sessions can appear daunting at first, particularly when following a period of one-to-one sessions, they are often very therapeutic experiences where you are able to listen to and exchange personal stories of depression and the recovery process with other patients.
This format can offer mutual support and guidance in a compassionate setting when you are seeking a solution to TRD, and can be particularly effective when trying to overcome symptoms of depression.
Family therapy
Because depression can impact the lives of those closest to you as well as yourself, family therapy works by involving family members and yourself in the therapeutic process. This can help establish new lines of communication and improve understanding of what is ultimately a complex condition, and allows you see how your illness is affecting others as well as yourself.
Family therapy can be hugely beneficial for families living with depression, where you are all able to contribute to supporting each other through what can be a lengthy treatment and recovery process requiring patience from all involved.
Behavioural activation
A highly effective therapy which focuses on your personal schedule of activity and how it could be altered to ensure that your lifestyle is as varied and pro-active as possible.
If you have TRD, then the evidence based lifestyle advice we can offer at Priory can ensure you take steps to reduce your alcohol intake, ensuring you are getting enough sleep, and promote physical and social activity as much as possible.