Depression can be a debilitating and painful mental condition that tends to negatively impact the life of those suffering from it. However treatment for this condition can ensure that those suffering from it are able to manage their symptoms and eventually get better. There are some people though for whom the depression treatment does not work and such a condition may be called treatment resistant depression.

In treatment resistant depression in spite of getting treating people continue to experience the intense sadness and pain associated with this condition. These individuals may continue to find no interest in activities and may feel hopeless and suicidal. Such treatment resistant depression is also called chronic depression.

In treatment resistant depression a person may experience depression symptoms in spite of seeking treatment with three or four separate medications. The factor contributing to this depression may include extreme severity of depression. Wrong diagnosis may also be a possibility and in this some other mental illness like bipolar disorder may be diagnosed as depression. Some other medical conditions like thyroid problems, heart problems, substance abuse issues or anxiety disorders may result in the depression not improving.

A person who is under continuous stress because of some situations in life may be suffering from treatment resistant depression. In some other cases individuals suffering from depression may not strictly follow the treatment regimen as indicated and this can result in reduced effectiveness. In some cases the exact cause for depression that is treatment resistant may not be known.

Different forms of psychotherapy can be successfully used in dealing with treatment resistant depression. Cognitive behavioral therapy is often used in successfully treating depression. Other therapies that may be used include dialectical behavior therapy and behavioral skills to allow individuals deal with stress and to regulate emotions. Short term and goal oriented therapies are also used and if a person suffering from depression is not able to seek relief through therapy then changing the therapist can be one of the options along with trying different therapies.

In treatment resistant depression antidepressants may not be effective and in such cases the patients can undergo a cytochrome P450 genotyping test. This test identifies particular genes that affect the way the body uses antidepressants. Through this test it is easier to predict side effects and to determine if an antidepressant may not work. Augmentation is also one of the ways of treating this form of depression.

In this along with antidepressants other psychiatric medication not actually intended for depression is used. The rationale for this is that it makes the antidepressants more effective as the other medications affect the neurotransmitters. In augmentation blood work is needed from time to time and increased side effects may also be experienced. In combination therapy may be adopted with different antidepressants that are taken at the same time for greater effectiveness. Selective serotonin reuptake inhibitors along with norepinephrine may be taken.

Another way of dealing with treatment resistant depression is to switch to newer medication when the existing medication is not working effectively. In some cases antidepressant medications may take from four up to eight weeks to be completely effective and so trying the medication for longer periods of time can work in some cases.

Other options that can be used for treatment resistant depression include electroconvulsive therapy wherein electrical currents pass through brain and thereby trigger seizures. This can provide relief from the symptoms of depression. Vagus nerve stimulation is another procedure in which a surgically implanted generator is used and this affects the mood centers in the brain through electrical impulses. This is used for chronic cases.

In transcranial magnetic stimulation magnetic fields are used to alter the activity of the brain and this is an experimental procedure. A magnetic coil is used against the scalp to produce electrical current. Deep brain stimulation is another option used in treatment resistant depression and in this stimulation of brain is done through electrodes that are surgically implanted.