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No matter how much we all want to improve our mental health, sometimes it feels like our minds just won’t let us. Having a mental health condition can make you feel like you have little to no control over your thoughts and feelings. When you try to gain some of that control by treating your disorder symptoms, your brain may not always respond to it.

When you’re diagnosed with depression, your mental health provider will provide treatment options meant to manage your symptoms daily. These treatments can help you work toward a happier and healthier future. But what does it mean if your symptoms aren’t responding to the treatment? There are still options. That’s what we’re here to explore.

Read on to learn about the basics of treatment-resistant depression and how you can treat it with esketamine and TMS.

What is treatment-resistant depression?

Depression, or major depressive disorder, is a mood disorder that causes overwhelming and persistent negative feelings and thoughts. The most common symptoms include pervasive feelings of sadness and hopelessness and isolation from loved ones. You may also experience lack of motivation or enjoyment in activities.

One of the first courses of action for treating depression is often a prescription of antidepressants from your mental health provider. The goal of antidepressants is to alleviate your symptoms so that they have less of an impact on your overall quality of life. If you don’t have an improvement after a couple of antidepressant trials, your provider will likely label your major depressive disorder as treatment-resistant depression.

Treatment-resistant depression, or TRD, means that your symptoms haven’t decreased after at least two trials of antidepressants. It’s common among people with depression. About 30.9% of people with major depressive disorder are considered as treatment resistant.

If you have treatment-resistant depression, that doesn’t mean that there aren’t other ways to help you progress through your mental health journey.

How esketamine can help treatment-resistant depression

If the trials of antidepressants don’t work on their own, your mental health provider may recommend coupling it up with Spravato, or esketamine. This is an offshoot of ketamine that’s administered as a nasal spray. 

Esketamine was approved by the U.S. Food and Drug Administration in 2019. It’s a controlled drug and must be administered in a REMS certified treatment center. A study showed that people with TRD experience a significant decrease in their symptoms by week four of the therapy, with two sessions per week. 

Esketamine works to decrease your symptoms by helping improve brain cell connections that are impacted by depression. Spravato works differently than other medications for treatment-resistant depression. Unlike most oral antidepressants that treat depression by increasing levels of neurotransmitters such as serotonin, norepinephrine or dopamine, esketamine targets the NMDA receptor. NMDA receptors balance the effects of other neurotransmitters and as a result, helps the brain overcome depression.

Esketamine is recommended for people with TRD as well as major depressive disorder and suicidal ideation.

How TMS can help treatment-resistant depression

If you’re looking for a non-medication option for your treatment-resistant depression, then TMS may be the way to go. Transcranial magnetic stimulation, or TMS, is a neurostimulation therapy. It involves using magnetic pulses to stimulate neural cell activity. It’s aimed toward underactive areas of the brain that contribute to your emotional balance.

TMS is an FDA-approved, noninvasive option for treatment-resistant depression. It also can be used to treat anxious depression and treatment-resistant OCD. TMS therapy requires 36 sessions: five sessions scheduled per week over six weeks and then a taper. 

Active Path Mental Health can help you address treatment-resistant depression

If you have TRD, there’s still hope. Even though antidepressants may not have worked for you, there are other options that you can explore with your mental health provider. Whether you decide to take esketamine alongside an oral depressant or you want to try TMS therapy, you can always keep working toward an improved quality of life despite your treatment-resistant depression.
If you’re ready to alleviate your TRD symptoms, then be sure that you contact our team today for more information or to schedule an initial appointment.

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