Self-Management of Depression

With strategies such as Transcranial Magnetic Stimulation (TMS), Ketamine, and psychedelics becoming more prevalent for treatment-resistant depression, it is helpful to take a look at what this entity really means. Not everyone who is being referred for either TMS or treatment with Ketamine may have "true" treatment-resistant depression, and then there is what is called "pseudo-resistance." In simple terms, treatment-resistant depression implies that depression has not reached sufficient remission after adequate treatment. Remission is defined as clinical improvement with few signs of depression still remaining and a lower likelihood of subsequent exacerbations. About 15% of people with depression may eventually develop treatment-resistant depression (Berlim & Turecki, 2007). Treatment-resistant depression has been variously defined, but the most commonly accepted definition is as follows (Souery et al., 2007): A person with depression is considered ...

Bipolar depression is a depressive episode occurring in context of bipolar disorder. When diagnosing depression, it is imperative to first exclude an underlying bipolar disorder. This is because the medication treatment for bipolar depression differs from that for   “unipolar”  depression. People with bipolar disorder have   manic  or  hypomanic  episodes. These are periods of persistently elevated or irritable mood along with feelings of grandiosity, decreased need for sleep, talkativeness, racing thoughts, increase in sexual drive, increased goal-directed activity, or excessive involvement in risky or impulsive activities. Individuals with bipolar disorder spend around 40% of the symptomatic time being depressed (Judd et al., 2002). Moreover, people with bipolar disorder are more likely to seek help when they are depressed. Therefore, it is not uncommon for bipolar depression to be   misdiagnosed   as unipolar depression or majo...