After 24 of 30 TMS sessions with no meaningful improvement, I wrote the guide I needed: why failed treatment hurts, how to get through the next 72 hours, and what to ask your clinician now.
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Does TMS cause headaches or migraines? Yes, sometimes. This first-person guide explains the pain, how to tell TMS headache from migraine, and the relief tactics—dose ramping, coil adjustments, and other techniques—that helped me keep going.
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What do you do when therapy and medication don’t work? This guest writer spent years battling depression and anxiety, searching for relief that never seemed to come. In this personal story, he shares his journey through treatment-resistant mental illness — the frustration, the hopelessness, and the unexpected places he found support. If you’ve ever felt like giving up, this article is for you.
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Looking for a more affordable alternative to ketamine for treatment-resistant depression? Discover how dextromethorphan/bupropion offers new hope. This article breaks down the differences between ketamine and dextromethorphan, their effectiveness, and how these antidepressants work. If you’ve struggled with depression treatments or face challenges accessing expensive therapies like ketamine, this guide might offer the answers you’ve been searching for. Dive in to learn more about this innovative approach.
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I have spent years of my life with bipolar medication not working — or, at least, bipolar medication not working to the extent that one would want. I know this isn’t the common refrain around medication — the common refrain being, take bipolar medication and get better — but it is a reality that many of us live with. So, the question is, what do you do when the bipolar medication isn’t working? What do you do when you have treatment-resistant bipolar disorder?
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I know what it feels like when your doctor says they can’t help you. I’ve had this happen many times. I’ve experienced everything from being fired by a doctor to having a doctor deny me care altogether. These are rough things. Any time your doctor says they can’t help you, it’s tough to take. But there are things you can do, even at that point. Here’s what to do when your doctor says they can’t help you.
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Recently, Psychiatric Times did a comprehensive piece on new or unusual bipolar depression treatments, treatments that may be an option for treatment-resistant bipolar depression. They are thinking outside the standard bipolar depression treatments. This is critical because many people just aren’t being helped or aren’t being helped enough by standard bipolar depression treatments. These novel bipolar depression treatments come in two flavors: medication-based and non-medication-based. If you’re at a place in your bipolar depression treatment where you’re not getting better, you may want to consider discussing these unique treatments with your psychiatrist.
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While some disagree, it’s important that people understand that antipsychotics need to be used for non-psychotic depression treatment, when appropriate.
At any one time, 14 million people suffer from depression but only 60-70% of these people respond to antidepressant treatment. Of those who do not respond, 10-30% exhibit treatment-resistant symptoms including “difficulties in social and occupational function, decline of physical health, suicidal thoughts, and increased health care utilization.” Treating these people presents a huge issue for healthcare practitioners and one of the options they consider is the use of a medication class known as antipsychotics.
Recently, a group called the Therapeutics Initiative wrote a letter entitled Antipsychotics should not be used for non-psychotic depression. Their conclusions are as the title suggests: this body found little evidence to support the use of antipsychotics in the treatment of non-psychotic major depressive disorder.
And while I respect the work of this body and while they have considered some evidence (in the case of quetiapine [Seroquel], an antipsychotic), there is more to consider on the issue.
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Some people with bipolar disorder are lucky in that when they get treatment, they find something that works for them within some reasonable period of time (and this might be in a year or two, maybe not altogether reasonable, but on the whole, good). However, not all people sick with bipolar are so lucky. Some people with acute bipolar symptoms don’t find anything that works for them for prolonged periods of time. In fact, for many people sick with bipolar, it seems like they will never find any treatment that will work.
So if you’re in this latter group (and I am) what keeps you going? If you still suffer from acute bipolar symptoms and the treatment isn’t working, how do you keep trying to get better, day after day?
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