How can a 42-year-old manage chronic recurrent MDD?

Question

Hello doctor,

I am 42 years old and have suffered from major depressive disorder (MDD) for over ten years. During all this time, I have undergone various kinds of treatment and used different drugs, yet the symptoms of the disease continue to appear again and again. There were periods when I felt better, but I never felt completely fine.

What are the commonly recommended strategies for long-term management of a history of recurrent MDD for more than ten years?
What other modes of treatment can be considered when the use of medications for depression does not provide a long-term effect?
How can I know if TMS or other procedures would be suitable for me?

Thanks for your time and guidance. Would really appreciate any recommendations you have.

Answer 1

Hello,

Welcome to icliniq.com

Thank you for your question. I understand your concerns.

For recurrent depressive disorder, it is common for an antidepressant, which once was effective, to become less and less effective over time. Once an antidepressant fails to show any improvement after taking an adequate dose for about six to eight weeks, it might be advisable to change to another one. It is also good to switch to another antidepressant within the same class of medication.

If you have responded partially to the current medication, augmentation methods, such as the use of other medications to improve effectiveness, might be recommended before you make a complete change.

There is also lifestyle modification, which plays a crucial part in depression treatment. Exercising regularly, being socially active, refraining from alcohol and drug abuse, sleeping and waking up at fixed times, and learning new skills are some of the ways of improving one’s state of mind.

There are various treatment methods that have been scientifically verified for use in patients with treatment-resistant depression. These treatment approaches include modern approaches, such as repetitive transcranial magnetic stimulation (rTMS), ketamine therapies, and occasionally, electroconvulsive therapy (ECT). These treatments have proved to be quite effective and safe.

The treatment method to choose depends on many factors, including the severity of symptoms, previous experience with treatment methods, and others. The assessment that a psychiatrist will conduct will help determine the appropriate treatment approach for you.

Do not worry, since depression is a very treatable disorder and there are many treatment methods that are available even in cases where the regular treatment has failed.

I hope this information is helpful.

Take care, and wish you the very best in your recovery.

Thank you.