In the video Treatment Resistant Depression Causes & Treatment, Robert D. McMullen, MD discusses:
• The definition of Treatment-Resistant Depression• Possible causes• Natural supplement treatments• Statin medication treatments• Anti-depression medications• TMS treatment• The goal of treating this debilitating condition
Dr. McMullen is a psychiatrist who specializes in treating people with depression and other psychiatric illnesses. His approach to treating depression is to implement a comprehensive treatment plan which has proven to be effective.
In the past few years, Dr. Mullen has incorporated Transcranial Magnetic Stimulation (TMS) into his line of treatment options, especially for patients who are not responding completely to supplements and medications.
Definition of Treatment Resistant Depression
Treatment Resistant Depression is defined as a depression that has been adequately treated by three or more anti-depressant medications in adequate doses for at least six weeks, resulting in little response and not entered remission for the depression.
Furthermore, the patient’s depression level does not improve to a satisfactory level with the use of medications. Although the patient’s depression may improve, the scores do not come down over 50%.
Causes of Treatment Resistant Depression
In the same way as some people can be severely diabetic, other people can have a severe case of depression. The thyroid can be a contributing factor. A person suffering from depression who has even a slightly sluggish thyroid may be helped with the hormone Cytomel.
Low levels of the vitamin B12 can be a factor.
New research indicates that checking the inflammation level in the body may lead to effective treatment. This is done by performing the hs-CRP (high-sensitivity C-reactive protein) test. This test measures the inflammatory hormones that are active in the bloodstream.
These hormone levels rise when there is an infection or cut in the body. Their job is to alert the immune system to mobilize more white blood cells to fight infection and repair the damage.
It has been found that a high level of CRP in the body is associated with an increased rate of depression as well as an increased rate of heart attacks. Cardiologists pay close attention to CRP levels and if they are high, a statin drug will likely be prescribed to reduce the risk of heart attack.
In the same way that cardiologists have found statins to be helpful, Dr. Mullen has found if CRP levels are high in depression patients, treating the body for inflammation may reduce depression levels.
Natural anti-inflammatories, such using a lot of fish oil, may help in this regard.
Also, an adequate intake of vitamin D (5,000 IU daily for an adult) is recommended to get this vitamin’s level up above 40 or 50 nanograms/milliliter.
Statins Can Help Depression
Furthermore, there are studies that show that statins, which are normally used to combat cholesterol, also help depression. This is particular true when the body has the more fat-soluble cholesterol that easily get into the brain. Effective statins in this case are Simvastatin and Crestor (rosuvastatin). These statins may have a slow, yet positive, effect on the person’s depression.
In the past year, Dr. Mullen has had an interesting case where a patient who was on a variety of supplements ran out of their statin medication. The effect was an almost immediate and significant return of the depression.
In a second case, a woman cut her Lipitor dosage in half and experienced a similar affect – the return of severe depression, which had been completely gone prior to the removal of the statin. When both these people restarted their statin medication, they came out of their depression.
The conclusion of these and other studies is that statins can help some people with depression, although relief may take time to manifest.
Anti-Depressions Should be Part of the Treatment Plan
People with Treatment Resistant Depression find only a partial relief even when taking a good dose of anti-depression medication. For this reason, other things are added, each contributing to the goal of reaching complete remission.
For example, a tiny dose of Lithium can augment the treatment plan.
TMS (Transcranial Magnetic Stimulation) Can Help Depression
If the person does not find complete relief from depression using natural supplements, statins and anti-depressants, TMS can be added to introduced.
To get optimal results, a person should have 30 treatments with an intensity of 4,000 pulses.
The ultimate goal of treating any type of depression, including Treatment Resistant Depression, should always to be to reach the level of complete relief.
No one wants to go for years suffering with even mild depression. Furthermore, studies have shown that if a person has mild depression, they are at a higher risk for falling into a deep depression. Residual symptoms of depression are abnormal sleep patterns, low self-esteem, low energy and difficulty concentrating.
The ultimate goal of depression treatment, whether it be with natural means, statins, anti-depressants or TMS, is to eliminate all signs of residual depression and get the person all the way to feeling normal.
The chances of reaching this health goal are increased when a comprehensive treatment plan, tailored to each individual, is implemented.