About 2/3 of people treated for depression get better. About half of this number are symptom free.
Psychiatric treatment can alleviate many of the symptoms of depression( mood, decreased interest, guilt, shame, decreased energy, poor concentration, sleep problems, appetite change, suicidal thoughts or behavior, agitation or slowed down feelings).
Unfortunately some of these symptoms do not completely resolve with treatment. People may continue to have one or more of these symptoms persist. They experience significant interference with the quality of their lives. Among the most frequent persistent symptoms are diminished energy, sleep disturbance, and difficulty in thinking and concentration.
If depressive symptoms persist, people not only have ongoing impairment, but up to four times the risk of having a full-blown Major Depressive Disorder recurrence.
Do you have treatment resistant depression? Here is a simple test to find out:
- On a 10-point scale–where #1 means you feel as bad as you can imagine, and #10 means you feel as good as you can imagine–WHERE ARE YOU NOW?
- If you answered with 7 or below, your depressive symptoms are severe enough to warrant further treatment.
Most people treated with antidepressants are still depressed after a two-month treatment course. While the majority are feeling better, only about a third of the people given antidepressant medication at an adequate dosage for at least 8-10 weeks achieve remission (the absence of depressive symptoms). There are many reasons for this situation including, the severity and complexity of depressive illness, history of prior episodes, ongoing social or relational stressors, and the ineffectiveness or side effects of traditional antidepressants.
What can been done? Among the most effective ways to improve patient response to treatment is to utilize combination and augmentation strategies. Combination strategies involves adding another psychotropic or antidepressant medication to the one a person is already taking. Augmentation involves adding a non- psychiatric medication such as thyroid hormone to the anti- depressant to make it work better.
No matter what strategy is used, the goal remains the same–to get well. Better is not good enough when it comes to depression.