You’ve started taking a new antidepressant. You’re hopeful that your depression symptoms will improve, and you’re waiting to feel better. But if it’s been weeks and you don’t notice any improvements in your mood, energy, or sleep, what’s next? Here are 4 things you should know when your depression medications aren’t working.
If you find that your medications aren’t working, you’re not alone. For many people it takes trial and error to find the right treatment plan for treating depression and other mental health conditions. Depression treatment is different for everyone. Sometimes a medication will work for a long time but eventually no longer provide the same results. Other people take longer to respond to medication or find that antidepressant medication is inadequate altogether. In fact, one in three people continue to have symptoms of depression after trying several different medications.
Decades ago, depression treatment, for most people, meant either antidepressants or talk therapy. There wasn’t a good option for people who weren’t responding to medication but who didn’t want to risk the side effects of ECT (electroconvulsive therapy), which is associated with memory problems and often requires hospitalization. Medicine has come a long way since then with different classes, each with a unique mechanism of action. Genetic testing can assist with medication selection, though not all physicians are convinced of its utility and the science clarifying how to use this is rapidly advancing. Nasal esketamine is a new option for patients, but it must be administered in a certified treatment center and patients must be monitored for at least 2 hours after each dose.
Another option is Transcranial Magnetic Stimulation (TMS). TMS is a drug-free therapy that uses gentle magnetic pulses to stimulate the parts of the brain responsible for depression. Because it is performed in an outpatient setting with no significant downtime after each 20-40 minute procedure, it can be a good choice for people who are still struggling with depression after trying antidepressants.
If your depression treatment isn’t going as well as you’d hoped— if you’re still experiencing symptoms or your medication is giving you side effects, don’t settle. You should feel confident in speaking to your doctor openly and freely. Come to your doctor with questions. Don’t be afraid to ask your doctor what they’ve done for other patients with similar experiences, or where they think that your treatment should go. Perhaps your doctor thinks you need to give the current medication more time to work or they may want to try another antidepressant. Either way, ask them to map out your treatment journey and be honest with them if the current course isn’t working for you.
Statistically, each next antidepressant a person tries has a smaller chance of working than the last. If your doctor doesn’t want to try something different in your treatment plan, know that getting a second opinion for mental health treatment is no different than getting a second opinion for any other medical treatment or other part of your life. You deserve to know all of your options. When you’ve tried a few antidepressants and none of them have worked adequately for you, it’s a good idea to look into a different approach.
Navigating depression can feel daunting, especially if you’ve tried several medications that just haven’t seemed to work. Luckily, there are other options available, including non-drug treatments like TMS therapy.
If Covid-19 and social isolation are heightening your symptoms of depression, Greenbrook TMS therapy may be able to help. At Greenbrook, we specialize in TMS therapy — an FDA-cleared, non-invasive treatment for treatment-resistant depression and OCD without harmful side effects. See if TMS therapy is right for you by clicking here to take a brief assessment: