5 signs your depression treatment isn’t working

Finding the best treatment plan for depression can take some trial and error. Here’s how to tell if your current treatment isn’t working and what to do about it.

When it comes to major depression, there’s no one treatment that works for everyone. Because each person may respond differently to treatment, finding the most effective treatment plan for you can sometimes take several attempts. But with time and effort, major depression can be treated successfully.

“People with major depression need to be patient,” says David Schilling, MD, an associate professor of psychiatry at Loyola University Health System in Maywood, Ill. “Serious depression usually requires medication and may need other types of treatment as well.”

Research shows that the combination of medication and talk therapy (psychotherapy) works better than either of these types of treatments alone for treating major depression. However, making lifestyle changes — including eating well, exercising regularly, and maintaining a strong support system — can also be important. Because finding the right combination of depression treatment options can be tricky, it’s important to know the signs of an ineffective treatment regimen so your doctor can recommend alternatives as soon as possible.

5 Signs Your Depression Treatment Isn’t Working

Here are five warning signs that your depression treatment might not be working and what you can do if it isn’t:

1. You’ve been taking an antidepressant medication for four to six weeks, and you’re not feeling better.

Major depression causes a mood so depressed that you can no longer enjoy life. If your treatment is working, you should feel that most depression symptoms — such as changes in sleep, energy, and appetite — are starting to lose their intensity, Dr. Schilling says. “Although antidepressants take time to work, if you’re not starting to feel better within four to six weeks, your doctor may want to increase your dose, change your medication, or add another medication,” he says. “Another option is to add psychotherapy if you’re only taking medication.”

2. You’ve been trying psychotherapy for several weeks, and you’re not feeling better.

Research shows that people with moderate to severe depression can benefit from a type of psychotherapy called cognitive behavioral therapy, especially if a therapist immediately focuses on techniques to help you break out of negative thought patterns and see life events more realistically. But if talk therapy isn’t working for you, it’s important to evaluate why. Be honest with your therapist so together you can figure out what needs to happen to get you where you need to be in your treatment progression. “Your therapist may suggest seeing a psychiatrist who can prescribe an antidepressant,” Schilling says.

3. You feel less depressed, but you’re also feeling very high and excited.

If this happens, you may have bipolar disorder and not major depression. “Most of the time, people with bipolar disorder are depressed, so it’s not uncommon to be misdiagnosed,” Schilling says. “If you start to feel the opposite of depressed, or if you start to feel invincible, you need to let your doctor or therapist know.” Treatment for bipolar disorder also involves a combination of medication and psychotherapy, but it differs from treatment for major depression.

4. Your treatment is reducing some depression symptoms but not others.

Different types of depression may need different types of treatment. For instance, one type of major depression called psychotic depression may cause you to have false beliefs or see, feel, or hear things that aren’t real. Psychotic depression requires more aggressive treatment than antidepressants alone. Other disorders can also exist along with depression, including substance abuse, anxiety, and post-traumatic stress disorder. These conditions may need to be addressed along with depression to enhance your overall treatment.

5. Side effects of antidepressant medication are affecting your overall treatment.

All antidepressants can have side effects, such as nausea, vomiting, diarrhea, sleepiness, weight gain, and sexual problems. “Side effects can keep treatment from going well, and you need to let your doctor know about them,” Schilling says. If you’re plagued by side effects, you might need to switch to a different antidepressant medication. Or your doctor may lower your dose until side effects fade, which is common. Some side effects, like trouble sleeping or sexual difficulties, may be treated with other medications. But you shouldn’t stop taking medication on your own. Always talk to your doctor first.

About Treatment for Major Depression

Treatment for major depression takes time to work, and you may need to change treatments at some point. “Treatment works for most people with major depression,” Schilling says. “But giving up or avoiding treatment leads to longer and more serious depression symptoms.”

To help boost treatment effectiveness for and speed recovery of major depression, learn as much as you can about depression and work closely with your doctor to find the right combination of treatment options for you.

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