Signs That You Have TRD (Treatment-Resistant Depression)

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Antidepressant medication was introduced in the 1950s and, since then, has revolutionized depression treatment and physicians’ understanding of depression. However, today, roughly one-third of individuals who have been diagnosed with depression are recognized as having treatment-resistant depression — meaning they don’t respond to these medications.

The cause of treatment-resistant depression is currently unknown, although scientists believe that a mix of genetic, health, and environmental factors can contribute to the condition. So, how can you recognize the signs of treatment-resistant depression?

If You Have Symptoms of Severe Depression

The World Health Organization defines depression as depressive symptoms that last longer than two weeks. Severe depressive symptoms have been associated with treatment resistant depression. Severe depression can be difficult to diagnose because there is no single recognized definition. However, your doctor may look for the following signs when making an assessment of severe depression:

  • Talking about the will to die and attempted suicide

  • Delusions and hallucinations (separation with reality)

  • Profound depression (melancholia)

  • Excessive sleep or insomnia

  • Inability to care for oneself

  • Reduced or elimination of physical activity

  • Significant weight loss

If You’ve Tried An Antidepressant Medication, but Have Not Experienced Symptom Relief

If you’ve taken two or more different types of antidepressant medications and you don’t experience symptom relief, or if your symptoms have worsened, you may have treatment-resistant depression.

There are multiple types of antidepressants: for example, selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs). Each type works to relieve depressive symptoms using a different mechanism. For this reason, doctors recommend trying two types of antidepressants before considering treatment-resistant depression as a possible diagnosis.

Scientists are working to understand why certain individuals don’t respond to antidepressant medication. A recent study evaluated levels of metabolites (substances produced by the process of metabolism) in 33 adolescents and young adults who have well-documented treatment-resistant depression. Out of 33 subjects, 21 had metabolite abnormalities, with folate deficiency in the cerebrospinal fluid (a fluid that cushions and protects the brain and the spinal cord) as the most common abnormality. This suggests that metabolic disorders may affect how an individual responds to an antidepressant and therefore may contribute to treatment-resistant depression.  

If You’re Unable to Tolerate Antidepressant Medication Due to Side Effects

Many individuals are not able to tolerate antidepressants due to the side effects, like weight gain and low libido, and choose to stop taking their medication. If the side effects of your antidepressant are unpleasant and affecting your daily life in an unpleasant way, talk to your doctor. It can be difficult to know if you have treatment-resistant depression or if you’re merely treatment intolerant. Your doctor will need to evaluate your symptoms to determine whether you may have treatment-resistant depression.

If you’re experiencing adverse side effects, talk to your doctor before making any changes to your medication. If you stop taking an antidepressant medication suddenly, you may have recurrence or worsening of depressive symptoms. You may also risk experiencing severe withdrawal symptoms that can include:

  • Insomnia

  • Irritability

  • Flu-like symptoms

  • Nausea

  • Anxiety

Dignity Brain Health is Here to Help Individuals With Treatment-Resistant Depression

If you have any questions about depression, your symptoms, or any potential treatments you’ve heard of, know that you can contact our caring and attentive staff at Dignity Brain Health. We’re here to answer questions, help with treatment, and most importantly, serve as a support system for your depression treatment.


Omar Haque