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以下資料來源: http://www.symbyax.com/Pages/understanding-treatment-resistant-depression.aspx

Understanding Treatment-Resistant Depression

Depression affects many people. Worldwide, it's estimated that more than 121 million people are affected by the condition. For some, finding the right treatment for their depression can be more difficult.

There are many medicines that help to treat depression. But some people have a type of depression called Treatment-Resistant Depression (TRD). A person may have TRD if, during an episode of depression he or she has had little or no response to treatment with 2 different antidepressants. This may happen even when the person takes the right dose for the right amount of time.

The Impact of TRD

If you are living with TRD, the condition can make your life more difficult. You may even feel that you are the source of your problems, and not your condition. After several unsuccessful attempts to treat your depression, you may feel skeptical that anything will be able to help. But without treatment, your TRD symptoms may continue to have an impact on your life.

Seeking Help

If you are affected by the condition, the first steps toward getting relief can be learning more about TRD and talking to your healthcare professional about TRD. You can also learn more about Symbyax, the first antidepressant approved by the FDA for acute treatment of TRD.

To help you talk to your healthcare professional about your depression experience and to learn if you could have TRD, complete and print the online Doctor Discussion Guide.

What Is Treatment-Resistant Depression?

Although you may have taken antidepressants exactly as prescribed, your depression symptoms may not have improved.

Treatment-Resistant Depression (TRD) is not your fault, and you are not alone in your struggle to find a treatment. In clinical studies of people with depression, nearly 1 person in 3 may have TRD.

Below is a list of examples of how someone with TRD may describe trying to treat their depression.

"I tried to treat my depression, but it didn't work.""My treatment helped some, but I still felt some depression symptoms.""The first medication my healthcare professional tried didn't work. My doctor then gave me another one to try. That one didn’t work either."

If any of the statements above describe your experience with depression, talk with your healthcare professional to determine if your depression could be TRD.

To help determine if you have TRD, it's important to provide your healthcare professional with an accurate health history and details about your daily life. To help talk to your healthcare professional about all the factors that could be impacting your health, complete our online Doctor Discussion Guide.

Treatment-Resistant Depression Symptoms

People with Treatment-Resistant Depression (TRD) may have the same symptoms as people who have depression. The only difference for people with TRD is that their depression symptoms continue, even after repeated attempts to treat them.

People with depression may feel a range of symptoms. Each person affected by depression experiences it differently. Many people with depression experience a range of emotional and physical symptoms. These individual differences may also make it more difficult for a healthcare professional to recognize the condition in each person.

In general, your healthcare professional may diagnose you as having depression when you experience a combination of the symptoms below. You should have felt these symptoms for more than 2 weeks and determine that it interferes with your daily life.

Being unable to concentrateConstant sadnessChanges in one's weight or appetiteExcessive or inappropriate feelings of guiltFeeling fatigued or out of energyFeeling restless or being slowed downFeelings of worthlessnessHaving problems making decisionsHaving various aches and painsLoss of interest in favorite activitiesSleeping too much or too littleThoughts of death or suicide

Remember that before you can be diagnosed with TRD, you must have tried to treat your symptoms at least two times with different antidepressants, but continued to feel symptoms.

Although these symptoms can be scary, there are available treatment options for TRD. You should talk with your healthcare professional to determine which treatment options are best for you. To help you prepare for your appointment, complete our online Doctor Discussion Guide.

Treatment for Treatment-Resistant Depression

As its name implies, Treatment-Resistant Depression (TRD) is a form of depression that is more difficult to treat. But that doesn't mean that TRD cannot be treated. Some people just have to keep working with their healthcare professional over time to find a treatment that does work.

If you're suffering from depression and the treatments you've tried haven't been successful, it can be a very frustrating experience. Sometimes it may feel like there's nothing that can help, but there are available treatment options. Though it can be difficult, don't get discouraged, and don't stop trying to find the right treatment. You can only stop experiencing the symptoms of TRD if you continue working with your healthcare professional to find the right treatment.

There are several different forms of treatment that your healthcare professional may recommend for your TRD. These kinds of treatment may include:

Medication
Symbyax was the first antidepressant approved by the FDA for acute treatment of TRD. Learn more about Symbyax and how the medication works.Lifestyle changes and therapy
In addition to medication, your healthcare professional may also recommend some other ways to treat your depression. Find out more about the different kinds of depression treatment and learn more about different kinds of therapy that are available.

To help determine if you have TRD and which forms of treatment are right for you, you should talk with your healthcare professional. To help talk to your healthcare professional about all the factors that could be impacting your health, complete our online Doctor Discussion Guide.

Additional Treatment Options

Besides medication, there are a number of other treatments your healthcare professional may recommend for your Treatment-Resistant Depression (TRD). These additional treatment options could include:

Exercise
When you have TRD, you may feel like your condition has taken over your life. Getting some exercise may help. It has been shown that physical activity can help relieve depression symptoms. While jogging, swimming, and other forms of exercise can help, it doesn't have to be intense. Even walking and performing simple household tasks may help you feel better.Support from others
If you have TRD, you may feel like you have disappointed your family and that you have let down the important people in your life. However, it's very important that you not let your condition make you feel isolated. Whether it's joining a support group or just reaching out to friends and family members, keeping in contact with others about how you're feeling can make a big difference.

Therapy
Talking through your TRD can help you think differently about your condition. Some forms of therapy, such as talk therapy and counseling, can help sufferers of depression in a variety of ways. Therapy may be able to help you solve problems, manage stress, help identify positive changes you want to make, and more. Learn more about the different kinds of therapy that your healthcare professional may choose for you.

Talk to your healthcare professional to determine if you have TRD and what changes to your lifestyle you can make for your condition. To help you talk with your healthcare professional, complete and print the online Doctor Discussion Guide.

Types of Therapy

Many people with Treatment-Resistant Depression (TRD) who have worked to treat their symptoms in the past may be familiar with therapy as a treatment option. If so, they know that therapy is a lot more than telling someone your life story. It's a form of treatment for your depression where you can work with a trained professional to identify what things you struggle with and develop strategies for dealing with them.

Some different types of therapy that your healthcare professional may recommend for your depression are:

Talk therapy
Also known as counseling or psychotherapy, talk therapy can help you with a variety of issues you may be facing in your life. Some examples of these include problem solving, identifying how to handle stress, improving your relationships with others, and stopping unhealthy behaviors (like drug and alcohol abuse) that can make your depression worse.Interpersonal therapy
Interpersonal therapy does not focus on motivations and dreams. Instead, it focuses on how you want to improve and make these changes in your daily life. Examples of things that you can use interpersonal therapy for include learning how to improve your communication skills and how to develop a healthy routine.Cognitive behavioral therapy
Cognitive behavioral therapy works on changing the negative mental habits. In this form of therapy, you can learn techniques for replacing distorted thoughts with more accurate perceptions.

Talk to your healthcare professional to determine if you have TRD and if he or she recommends therapy for your condition. To help you talk with your healthcare professional, complete and print the online Doctor Discussion Guide.

Talking to Your Healthcare Professional

If you have taken 2 or more different antidepressants in one episode of depression and you still have depression symptoms, you may have Treatment-Resistant Depression (TRD). Be sure to talk with your healthcare provider. Only your healthcare provider can diagnose TRD.

For those with TRD or who think they may have the condition, continuing to work with one's healthcare professional over time is a vital step. It may be easy for you to get discouraged if you don't immediately find the right treatment. However, the only way for you to stop experiencing the symptoms of TRD is to keep working with your healthcare professional.
Questions For Your Doctor

One way you can help work with your healthcare professional in treating your condition is to become familiar with the issues surrounding your personal health. When you have questions, ask your healthcare professional to get the answers about your treatment and condition that are important to you.

To make sure that you get all of your questions answered, it can be helpful to prepare a list of questions ahead of time. Think about what questions you have about your condition and possible treatment options. Here are some you may want to consider:

* What is the difference between depression and TRD?
* Do you think I have TRD? Why or why not?
* How can I tell my friends and family members about my condition?
* Should I take a medication for my condition? If so, do you recommend Symbyax?
* How soon should I expect Symbyax to make me feel different?
* How often do I need to take my Symbyax?
* What should I do if I forget to take a dose of Symbyax?
* What side effects might I feel from taking Symbyax?
* What will happen if Symbyax doesn't improve my condition?
* Besides taking Symbyax, do you recommend any additional treatments for my condition?
* How can I contact you if I have additional questions about my condition and treatment?

Questions Your Doctor May Have For You

Because there is no single test for TRD, your healthcare provider may examine you to rule out other medical conditions. He or she may also ask the following questions. Your answers to these questions can help your healthcare provider know if you have TRD.

* Have you been diagnosed with depression by a healthcare provider?
* If yes:
o What symptoms are most difficult for you to manage?
o How severe are your symptoms?
o How are your symptoms affecting your life?
* Have you taken 2 or more antidepressants in this episode of depression?
* If yes:
o Were you on them for the recommended length of time?
o Did any of your symptoms improve?

Take Suicidal Thoughts Seriously

If you experience any thoughts of death or suicide with your condition, it's important to take such thoughts seriously. If you feel like giving up or as if you might hurt yourself, get help immediately.

* Call your doctor
* Go to the emergency room
* Call 911
* Call the National Suicide Prevention Helpline, 1-800-SUICIDE (1-800-784-2433)

In addition to preparing a list of questions for your healthcare professional, it can also be helpful to provide some facts about your health history and whether depression runs in your family. To help you talk about these items with your healthcare professional and to further prepare for your appointment, you can complete the online Doctor Discussion Guide.