Over at Shock Doc there’s a post on 9 steps for what’s known as “treatment-resistant depression”. Hearing from your therapist or psychiatrist that you have treatment-resistant depression has to be one of the least encouraging things you could hear. It is exactly what it sounds like. It might be more helpful to refer to it as depression that might take longer to find an effective treatment for. But that’s a lot more words. That treatment is more likely to include medication. Here are the listed 9 steps, but there are other interesting things in the article too. Note well: Medical model.
What can they do about Treatment-Resistant Depression?
1. Be sure they diagnosed the depression properly, subtype of depression
2. Exclude somatic illness
3. Exclude comorbid psychiatric illness
4. Evaluate antidepressant treatment for compliance, tolerabillity, duration, and dosage. If necessary optimize by increasing dosage or extending the duration.
5. Switch to an other antidepressant if previous measures failed
6. Augment the antidepressant
7. After cessation of all antidepressants start a monoamine oxidase inhibitor
8. Reconsider diagnoses and use Electroconvuslive therapy
9. Don’t forget cognitive therapy, Interpersonal psychotherapy, running therapy, family therapy.