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vonmoxie
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Default Sep 17, 2014 at 01:24 PM
 
Quote:
Originally Posted by zinco14532323 View Post
I find that a pretty incomplete and insufficient definition. It implies that anti depressants are some magic pills and that if you don't respond to two of them you are treatment resistant. We all know they are not magic pills and many people don't respond to them but may respond to therapy.

Am I treatment resistant?
I have been on many anti depressants over the last 20 years most of which have been totally ineffective. That would make me treatment resistant. However a couple have worked. Effexor with a low dose of Celexa worked pretty good for a long time. Effexor has been the best one for me but long ago pooped out. So we tried Pristiq and it didn't do anything. The latest one is Fetzima and it has been more effective than anything ever by far. It seems to be pooping already though. I have had to raise the dose once already and feel like I need to again and it has only been six months. So am I treatment resistant or not? I have no doubt that my recurrent cyclical depression will return fetzima or no fetzima like it always does.

This is why I think in the big picture I am treatment resistant-
I'm surprised you would want to take it on in terms of "I am" -- are you, yourself, resisting treatment? Or is it simply the condition that been resistant to a cure?

I daresay that anyone whose depression could be considered treatment-resistant does not consider anti-depressants particularly magical. (50% success rate doesn't much speak to that either.) I understand that the terminology doesn't encompass everything that one might prefer to catalog as treatments that don't consistently work, but since the actual definition does only refer to the efficacy of anti-depressants it seems as though re-purposing the terminology in conversation to carry variant definitions could be cause for some misunderstanding, and about what can only be a sensitive topic for all of us.
Treatment-resistant depression
From Wikipedia, the free encyclopedia
Treatment-resistant depression Classification and external resources MeSH D061218

Treatment-resistant depression (TRD) or treatment-refractory depression is a term used in clinical psychiatry to describe cases of major depressive disorder (MDD) that do not respond adequately to adequate courses of at least two antidepressants.[1] The term was first coined with the development of the concept in 1974. Inadequate response has traditionally been defined as no response whatsoever. However, many clinicians consider a response inadequate if the patient does not achieve full remission of symptoms.[2] Cases of treatment-resistant depression in which the course of treatment was not adequate are sometimes referred to as pseudoresistant.[3] Some factors that contribute to inadequate treatment are: early discontinuation of treatment, insufficient dosage of medication, patient noncompliance, misdiagnosis, and concurrent psychiatric disorders.[3] Cases of treatment-resistant depression may also be referred to by which medications they are resistant to (i.e.: SSRI-resistant).[4]

Prevalence
Treatment-resistance is relatively common in cases of MDD. Rates of total remission following antidepressant treatment are only 50.4%. In cases of depression treated by a primary-care physician, 32% of patients partially responded to treatment and 45% did not respond at all.[2]
I'm not suggesting that those of us with treatment-resistant depression not talk about all the things that do (ha) and don't work for us. I am suggesting there's an inherent value in knowing and utilizing the meaning of already established terminology. I don't myself much want to be described with words that were only ever meant to describe my condition's resistance to a family of drugs that only has 50% efficacy anyway. Depressed as I am, I'm better than that.

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“We use our minds not to discover facts but to hide them. One of things the screen hides most effectively is the body, our own body, by which I mean, the ins and outs of it, its interiors. Like a veil thrown over the skin to secure its modesty, the screen partially removes from the mind the inner states of the body, those that constitute the flow of life as it wanders in the journey of each day.
Antonio R. Damasio, “The Feeling of What Happens: Body and Emotion in the Making of Consciousness” (p.28)
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