Treatment Resistant Depression
Treatment-Resistant Depression is more than persistent sadness. At Adayu, care includes detailed assessment, precision medicine, psychotherapy, lifestyle changes, and advanced options like rTMS. A multidisciplinary team ensures personalized treatment, relapse...
What is Treatment Resistant Depression?
Depression is so much more than merely sadness. To be sad is just the tip of the iceberg with a whole gamut of symptoms lying beneath the surface. Depression affects how we think about ourself and the outside world, bringing in a persistent negative appraisal of the events happening around us. Many a times, it can be disguised as physical distress such as aches and pains, chronic fatigue or the inability to sleep. Sometimes these symptoms can linger on even after the sadness is gone. It is important to understand treatment resistant depression from a comprehensive and detailed perspective, and not just as a set of symptoms to treat.
What is the treatment?
We take a multi-pronged approach to treatment where we explore various aspects of the illness which include enduring habits like the use of substances, experiences of the past, the psychological makeup, and associated medical conditions like cardiovascular diseases and thyroid disorders.
ASSESSMENT: At Adayu, we emphasise on creating an open and optimistic environment enabling you to engage with the treating team with trust. Our method comprises a structured way of assessing the severity of the depressive disorder and its impact on everyday life. We conduct a risk-assessment to mitigate any possibility for self-harming behaviour. We also assess for the presence of other psychiatric and physical illnesses using evidence based tools questionnaires and certain routine medical investigations. A thorough psychological evaluation offers meaningful insight into psychological dynamics, attachment patterns and coping resources.
We follow principles of precision medicine. Using recent advances in pharmacogenomic testing, we will understand how your genetic make-up responds to different medicines. This will ensure a tailored selection and dosage of treatment.
TREATMENT: Often the resistance in achieving full remission in depression is the lack of timely liasoning among the members of the treating team. One of the features which strengthen the Adayu model of treatment is the dense networking among individuals involved in the process of planning and implementation of treatment. Taking a multi-disciplinary approach, our team of psychiatrists, psychologists, nursing staff, medical professionals and other wellness experts work in tandem to ensure the best clinical outcomes.
As depression involves a complex interplay of different neurotransmitters, sometimes it might so happen that it does not respond to initial lines of treatment. It is possible that in spite of all efforts, there may be resistance to the symptoms of depression using conventional medications. In such situations, a more comprehensive evaluation helps the team ascertain the right combination of medicines, psychotherapy and brain stimulation for the best results.
A rational use of different medicines at appropriate, adequate doses would be the first step in treatment. Regular and constant monitoring of the dose chart would be done so that optimum dose is received with least discomfort to the patient.
Adayu is a place where dedicated human effort is combined with state of the art technologies to ensure that an effective model of treatment is formulated. Repeated transcranial magnetic stimulation (rTMS), a novel treatment modality is a step in that direction. We use rTMS in those cases of depression where medicines and therapy have failed to make inroads. In the case of residual symptoms, it is used in conjunction with traditional methods of treatment to gain that extra mile in response. During an rTMS session for depression, an electromagnetic coil is placed against the scalp. This coil delivers magnetic pulses that stimulate nerve cells in the region of the brain involved in mood control and depression. It is a non-invasive, painless process, which can be delivered within a period of 30 to 40 minutes. It is administered without any anaethesia or sedatives and there are no subsequent side effects
PSYCHOTHERAPY: Our team of psychologists will support you as you navigate the distress associated with depression. A strong therapeutic alliance plays an instrumental role in building adherence to medicines and therapy in the long run.
Your psychotherapist will hand-hold you through techniques of behavioural activation to help establish a routine and restore vitality. As your new protocol of medicines begins to take effect and the severity of symptoms reduce, we will utilize a cognitive behavioural approach to work on long-standing core beliefs which may negatively impact your life. Our therapeutic interventions will also be tailored to any comorbid psychological conditions like substance use, emotional instability or a past history of trauma. We also offer avenues for art based therapy which can uplift your mood and bring about a sense of achievement and mastery.
LIFESTYLE MODIFICATION: During your stay at Adayu, we encourage you to engage in physical fitness sessions and yoga. These sessions are integral to boosting psychomotor functioning, uplifting mood and ensuring restful sleep. Recreational activities such as art and craft, board games, reading and gardening through which you learn to be mindful and instil a sense of structure and rhythm to life.
As part of our 360° approach to treatment, we will also involve your loved ones in your path to recovery. Regular family guidance sessions help strengthen support systems and bring about changes in the psychosocial environment that may serve as triggers. Together, these are crucial to preventing relapse.
AFTERCARE: As you plan for discharge from the hospital, our team will support you as you transition back to the home environment, become productive at work and reconnect with ties that were once lost. Along with you and your family, we will create an individualized follow-up treatment plan to help you maintain your treatment gains. Our team will always be available via our 24x7 emergency services, OPD and teleconsultation too.