The Pills Don’t Work
It can seem like a bitter pill to swallow when your depression treatment doesn’t work.
If this is you, you’re not alone.
In a study published in November 2016 entitled, ‘Brain, Behaviour and Immunity,’[i] researchers found that between a whopping 30% and 50% of people diagnosed with depression, prescribed antidepressants don’t work.
More worryingly, the researchers say that the experts don’t actually know why.
Silvia Poggini, researcher, Intituto Superiore di Sanita, Rome stated in the summary abstract,
‘In a certain way it seems that the SSRI's open the brain to being moved from a fixed state of unhappiness, to a condition where other circumstances can determine whether or not you recover’.
New Doubts Over The Effectiveness of SSRI’s
I think what’s being said here is that SSRI’s (Selective Serotonin Reuptake Inhibitors - a widely used type of antidepressant mainly prescribed to treat depression, and are usually the first choice medication for depression because they generally have fewer side effects than most other types of antidepressant) don’t actually work by directly increasing serotonin, which is what we've been led to believe.
Instead, explains the research, SSRI's are more likely to help people recover by increasing the brain’s plasticity.
Placisity is how the neural pathways in the brain reorganize themselves. This happens when we memorize information or learn new things. It’s a bit like when you press your thumb into a lump of soft clay. In order for the impression of the thumb to appear in the clay, changes must occur in the clay; the shape changes as the thumb is pressed into it. Similarly, the neural pathways of a brain reorganize itself in response to new experiences.
Once the plasticity is increased, the research says, it’s more likely that the depression is susceptible to lifting as a consequence of changes in environmental and lifestyle factors.
Have You Been Diagnosed With Treatment-Resistant Depression?
In the wake of consistent findings that pharmaceutical treatments don’t work for a high number of people, the medical profession has formulated a name for this: treatment-resistant depression or TRD.
Treatment-resistant depression is a term used in clinical psychiatry to describe cases of major depressive disorder (MDD) that do not respond adequately to appropriate courses of at least two antidepressants.
If you’ve been placed in the category of someone with TRD, you maybe wondering what to do next. Without the certainty of meds fixing your mental health, and then don’t work, it’s hard to know what to do next.
The Alternatives To Work Through, With The Doctor
Before you dismiss all medication, it may be that your doctor wants to look at different medication strategies and may suggest various approaches such as:
Giving your current medication more time because antidepressants can take up to 8 weeks to work
Increasing the dosage as some people can benefit from a higher dose
Switching to a different antidepressant
Using a combination of antidepressants
Using a type of medication usually prescribed for other conditions but has some history of helping people with depression
*** It’s important to bear in mind you’ve already made the important step of getting onto antidepressants and you may as well attempt every approach to try and make them work for you before you abandon them altogether.
To find out in depth information about the different types of antidepressants and how they work, read my blog: What’s The Best Medication For Depression?
So, What’s The Alternative?
If your depression treatment hasn’t worked, it can leave you feeling even more depressed than before.
When we’ve put our faith and hope into the doctor being able to help us, and it hasn’t, it can leave us feeling hopeless and demoralised.
Depression thrives on hopelessness and when hope has been removed, it can feel as if nothing’s going to get better. I’ve certainly had this experience to the point that the thought of ending it all seemed like the only solution.
However, There Is Hope
The new research on depression is telling us that the old ways of treating depression are now seen as coming from the dark ages. There’s a continuing shift away from the idea that it’s all about brain chemicals and more to do with the idea that depression can be caused by chronic oxidative stress.
The Role Of Chronic Oxidative Stress In Depression
Chronic oxidative stress describes an imbalance between the production of free radicals and the ability of the body to counteract or detoxify their harmful effects through neutralization by antioxidants.
A prime example oxidative stress is when an apple turns brown, our cells can “rust” in exactly the same way.
Oxidative stress happens when our bodies process the oxygen that we breathe and then our cells produce energy but also produce free radicals. The free radicals interact with the molecules within our cells which results in stressing them out. Free radicals are normal but when the amount of free radicals outstrips the amount of antioxidants, we have damage.
Oxidative stress happens as a result of our lifestyles. Although our standard of living is better than any time in history, modern life has a lot to answer for and our bodies can’t handle our sedentary lifestyles, high stress levels, lack of community support, fast food and lack of sleep. Depression is one of the results of our modern lifestyle.
The Good News - Lifestyle Medicine for Depression
This is great news. The science is telling us that because depression maybe due to our modern lifestyle, it means we can take matters into our own hands. We are no longer powerless; we can take back control.
An article published in the US National Library of Medicine National Institutes of Health in 2014 called ‘Lifestyle Medicine for Depression’ [ii] explains that there is now compelling evidence that a range of lifestyle factors are involved in the creation of depression.
They way I read into this new research is that there’s strong evidence showing how various lifestyle and behavioural factors ease the symptoms of depression.
These include meditation, exercise, reduced stress, diet, sleep, and mental clarity. These have been found to change the structure and function of the brain in ways that promote a healthy brain.
Many of these factors can potentially be easily implemented, yet they receive little attention by our doctor. The doctor’s ‘go to’ treatment for depression is medication.
This new “Lifestyle Medicine” provides the link between how the government encourages us to take a walk & eat our 5 a day, and, clinical treatments.
It’s important to steer our doctors towards helping us to tell us if this could work for us; not simply writing the script as a matter of course.
Lifestyle Medicine has been found to change the structure and function of the brain in ways that promotes plasticity in a healthier way than antidepressants. And, at least there’s no negative side affects.
The idea that healing our depression can be accelerated or even achieved by changing our lifestyle is nothing new but now there’s concrete research backing this theory with evidential support that gives us hope.
There Is Light At The End Of The Tunnel
When antidepressants fail to bring any relief to depression, it can ramp up the hopelessness beyond finding a good reason to continue. And for up to 50% of people, medication makes no dent at all in the symptoms.
It seems that the effect of antidepressants may be more ambiguous than once thought. These new studies conclude that lifestyle and environmental factors maybe able to support the healing of depression as effectively, and maybe even more effectively, than antidepressants.
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