Do you sometimes feel very sad, lonely, and not in the mood to do anything? We all have those days in our lives. It's normal. But if this situation continues for weeks or months, if your mood is so low that you can't do your daily activities, it may be something more than just normal sadness. In medicine, we call this condition Major Depressive Disorder (MDD) . This is not a weakness of the mind, but a real illness that requires treatment.
What is drug-resistant depression (TRD)?
Usually, when a doctor starts treating someone with depression, most people start to feel better after a while. But some people don't. For example, if your symptoms don't improve even after taking at least two antidepressants prescribed by your doctor, at the right dosage, for a long time (usually 4 to 6 weeks), we call that treatment- resistant depression (TRD) .
Simply put, it means that your body and brain are not responding well to typical antidepressant medications. Don't be alarmed by this. This doesn't mean you'll never get better. It just means we need to consider other, more effective treatments.
The most important thing is to talk openly with your doctor if you feel like you're not getting any relief from the medication, without keeping it to yourself.
What are the common symptoms of depression and TRD?
The symptoms of treatment-resistant depression (TRD) are similar to those of major depressive disorder (MDD). The difference is that these symptoms persist even after taking medication. Let's take a look at what these symptoms are. You may have experienced some of these yourself.
| Symptom | What does this mean? |
|---|---|
| Depression and low energy | A feeling of sadness and emptiness that lasts all day. A lifeless body, feeling lazy to do even the smallest tasks. |
| Anhedonia (lack of pleasure from anything) | Things you used to enjoy doing (e.g. watching a movie, talking to friends, hobbies) now seem pointless. |
| Disappointment about the future | Negative thoughts like "I'll never get well" and "My life is over" constantly come to mind. |
| Difficulty concentrating | Having difficulty reading a book, doing work, making decisions. Not being able to keep your mind in one place. |
| Feeling guilty about yourself | Feeling worthless, blaming yourself for even the smallest things. |
| Sleep changes | Either sleeping too much (drowsiness during the day), or not being able to sleep at night or waking up from sleep. |
| Changes in appetite and weight | Weight loss due to loss of appetite or weight gain due to overeating. |
| Thoughts about death or suicide | Feeling like you wish you could end your life. This is a very serious symptom, and if you have these thoughts, it is imperative to seek medical advice immediately. |
What happens if this condition is not treated?
Untreated depression can lead to things like not being able to take care of yourself and withdrawing from others. You may not be able to do your job properly. You may have problems with family life and friendships. In the worst cases, it can even be life-threatening.
So don't take these symptoms lightly. It's not your fault. It's a medical condition caused by an imbalance of chemicals in the brain. There's no shame in getting help for it. It's just like taking medication for diabetes or high blood pressure.
Is there hope? Modern treatments!
Here's the good news! Medical science has made great strides in treating depression in the past few years. Unlike in the past, there are now many effective treatments available, even for those with treatment-resistant depression (TRD).
Older medications mainly targeted chemicals (neurotransmitters) in the brain like serotonin, dopamine, and norepinephrine. But newer treatments work differently, working through other pathways in the brain.
Fast-Acting Medications
One of the biggest advantages of these modern treatments is their speed. Think about it, in the past, you had to wait weeks, maybe a month or two, to feel the effects of a drug. But with some of the modern treatments available now, you can start to feel relief from symptoms within a few hours or days.
How much hope is this for someone suffering from TRD and feeling down about their life? The only great mental strength that can help them recover from their miserable condition quickly. You can ask your doctor for information about these modern treatments. Not all treatments are suitable for everyone. Therefore, it is your doctor who will carefully examine your condition and decide which treatment is best for you.
Take-Home Message
- Depression is an illness: it's not a weakness of the heart, nor is it your fault. It's a real condition that requires treatment.
- Tell your doctor if medication isn't working: If you're not feeling better with the medication you're taking, don't hold it in and suffer, but definitely tell your doctor. You may have treatment-resistant depression (TRD).
- Modern treatments are available: Even those with TRD can now have hope. Modern treatments are now available that are fast-acting and highly effective.
- Don't be afraid to ask for help: Mental health is just as important as physical health. Asking for help is a sign of strength, not weakness. Your doctor is always there to help you.
- You are not alone: millions of people in Sri Lanka and around the world live with depression. With the right treatment and support, you too can live a healthy life again.
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