Treatment Options for Major Depressive Disorder
When considering treatments for depression, particularly treatment-resistant depression, there are many options. A few of the most common kinds of depression treatment for those suffering from major depressive disorder (MDD) are talk therapy, depression medication, electroconvulsive therapy (ECT), and transcranial magnetic stimulation (TMS). When thinking about how to treat depression, it is important to look at a wide array of possible depression treatment options, as just one may be insufficient for a particularly severe case.
- Talk therapies, like cognitive behavioral therapy (CBT) or interpersonal psychotherapy (IPT), are crucial treatments for depression. It is important for patients to identify stressors and develop positive coping mechanisms or adjustment strategies. In order for talk therapy to be completely effective, however, an accompanying medication for depression is usually necessary.
- A common treatment for depression, depression medication, can be quite effective, if the side effects of antidepressants can be tolerated. In cases of treatment-resistant depression, options can be limited, as antidepressants do not tend to be successful in treating those cases.
- ECT is one of the more powerful treatments for depression and can be effective for patients who are at imminent risk for suicide or depressive cases marked by psychotic features, but the side effects of ECT can be severe.
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Treatment-Resistant Depression Defined:
Treatment-Resistant Depression is a term used in clinical psychiatry to describe cases of depression that have not responded to at least one failed trial of antidepressants.
Factors that contribute to nonresponsive, or inadequate, treatment include insufficient dosage, concurrent disorders, patient noncompliance or early discontinuation of treatment.
A common cause of early discontinuation of treatment is the side effects from the medication itself: patients are affected too negatively and opt to stop taking the medication altogether. Treatment-resistant depression options do exist. TMS is proven to be successful without the concurrent use of antidepressants; it is very helpful for patients with resistant depression or who are averse to taking depression medication because of side effects.
Electroconvulsive Therapy Has Risks and Side Effects
Another oft-taken course of action for severely depressed patients is electroconvulsive therapy (ECT). ECT is an effective option for patients whose depression is severe enough to warrant hospitalization. It is, unlike TMS, highly intrusive with has many severe and long-lasting side effects. Some common side effects of ECT:
- Confusion or disorientation is common after undergoing ECT treatment. It may last several days or longer.
- Memory loss is commonly experienced during the weeks of treatment, generally improving within a couple of months after treatment has ended.
- Physical side effects include, but are not limited to, lightheadedness, possibly severe headaches, facial numbness, fatigue and sleepiness, and nausea.
- ECT treatments are administered 2-3 times a week and require the use of anesthesia. A single instance of being anesthetized has the potential side effects of nausea and vomiting, sore throat, postoperative delirium, muscle aches, and hypothermic chills and shivers.
Transcranial Magnetic Stimulation Has Very Few Side Effects
Transcranial magnetic stimulation is the ideal option for those whose depression is treatment-resistant or who are concerned about potential negative side effects of antidepressant drugs or ECT.
- TMS has a longer durability of benefit, or longevity of positive outcomes after treatment than ECT and fewer, milder side effects than both ECT and depression medication. Commonly-reported potential side effects of TMS are scalp pain/discomfort and headache.
- TMS has a longer durability of benefit, or longevity of positive outcomes after treatment than ECT and fewer, milder side effects than both ECT and depression medication. Commonly-reported potential side effects of TMS are scalp pain/discomfort and headache.
- TMS works well without the concurrent use of depression medication; ECT patients will often be pre scribed antidepressant drugs after treatment to amplify the effects of the procedure.
Transcranial magnetic stimulation side effects are mild and few, thus making it and appropriate therapy for treatment-resistant depression.
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Treatment
Treatment for depression typically involves medication and/or psychotherapy. When those strategies are ineffective, the consulting medical professional may recommend treatment alternatives, including deep transcranial magnetic stimulation therapy.
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At Active Recovery TMS, our goal is to provide a safe and effective alternative treatment for depression. Transcranial Magnetic Stimulation (TMS) is an especially important treatment option for those who have not had success with standard depression treatments like medication and/or therapy.
Our co-founder, Dr. Horey, became familiar with TMS while training and working at Columbia University in New York City where many of the early and important studies on TMS were conducted. Dr. Horey has since completed more extensive training in TMS and keeps himself up-to-date with the latest research on brain stimulation techniques, including TMS.
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