Treatment-Resistant Depression (TRD)

Spela Pausa

At Paracelsus Recovery, we understand that suffering from TRD is as exhausting as it is frightening. We have created a treatment programme that can effectively help reduce the severity of the symptoms. But more than that, we can help you re-find your sense of meaning and energy for life. We only ever treat one client at a time in beautiful and private surroundings.

Spela Pausa
Spela Pausa

Låt vår familj ta hand om din familj

Vi är en helt familjeägd och familjeägd klinik.

A whole new dimension of pain.

Major depressive disorder (MDD) is one of the most debilitating health conditions a person can experience. People navigate exhaustion that can feel like a constant hangover, rage and self-criticism that can grow uncontrollable. They can also struggle to find peace or comfort, to name just a few of the symptoms. These symptoms can go on for weeks, months and even years. However, when people struggle with treatment-resistant depression (TRD), it introduces a whole new dimension of pain. 

Usually, people with MDD can recover once they receive adequate medication and treatment. But, in TRD, medicine offers no relief. Instead, the person's symptoms remain either unchanged or worsen. And this time around, they can start to lose hope that they will ever feel better again, which drastically worsens their condition. They can also begin to feel unsupported by their medical team. Feeling unwell and having doctors tell you your untreatable condition is always painful, especially when it isn't true. 

A person is diagnosed with TRD if they have not responded to at least two antidepressant trials of adequate dose and duration. Worryingly, up to 30% of people suffering from clinical depression will struggle with TRD. 

TRD is Treatable

 

 

However, TRD is, in fact, treatable. At Paracelsus Recovery, we believe that all TRD means is that antidepressants didn't work for you. Instead, you require a more intensive and immersive treatment programme, which we can provide. During treatment, we will identify and address all underlying causes of your TRD, not just the symptoms.

 

Specifically, we will tailor-make your care plan to make sure it addresses all of your unique issues in a complete 360-degree analysis of your health and wellbeing.

We conduct an extensive medical check-up, psychiatric evaluation, comprehensive laboratory tests, a functional health assessment, nutrition and lifestyle assessment. With this information, we can work together (i.e., with the client) to create a comprehensive and individually tailored care plan that will restore your health physically, psychologically, and cellular. 

We only ever have one client at a time, which means our team will be focused exclusively on you. The residential treatment programme takes four weeks, and our team will work with you for 8 – 12 hours a day. If necessary, we can also provide aftercare services.

 

1. Physical Health Restoration

  • Research shows that an imbalanced gut microbiome, known as dysbiosis, is strongly correlated with depression. We will conduct an elaborate testing procedure and then, based on your result, provide a tailored intestinal detoxification programme and pre/probiotics to help restore your intestinal balance.
  • Studies also show that a poor diet can both cause and aggravate depression symptoms. We will provide a nutrient-dense plan for you that will replenish any lab-identified inflammatory or immune system issues. We take your dietary preferences into account, and we will provide anything missing from your diet via nutritional supplements. You will also be provided with a private chef and nutritionist.
  • Studies show that when someone suffers from depression, it can stop them from accessing a state of sleep known as REM sleep (you dream during this stage). Your schedule will also contain regular sleep times and will be tailored to ensure you can access REM sleep (e.g., we will include regular exercise periods, healing massage therapies and other body therapies like acupuncture).

2. Emotional Health Restoration

  • Numerous studies show that psychotherapy can help treat TRD. At Paracelsus Recovery, you will work with a psychologist or psychotherapist in daily one-on-one sessions. While the intensity will depend on the severity of your symptoms, some clients can be in therapy for up to eight hours a day.
  • A live-in therapist will also be available to provide you with emotional support 24/7. The live-in therapist plays a pivotal role in treatment for TRD as their presence means you are seen, heard and supported every second of every day. That will decrease loneliness and help you face the psychological root causes.
  • One of the most challenging parts of depression is how your inner critic begins to run the show. We can provide mindfulness-based cognitive behavioural therapy and compassion-focused meditation to help you turn that voice down and increase your self-love.
  • Our psychiatrist will also review your previous medication and prescribe new types or combinations if deemed necessary. As we adopt a holistic approach to health, we will try numerous other methods and health restoration practices before turning to medication.
  • Countless ground-breaking studies show that psychedelic-assisted psychotherapy is one of the most effective treatments for TRD. While we cannot provide it in Switzerland due to legal reasons, we can help you access treatment elsewhere.

3. Biochemical Restoration

  • We treat clients using an individualised formula of nutritional supplements and IV solutions based on comprehensive laboratory testing where we aim to 'restore' what is missing. Supplements and IVs may include vitamins, minerals, amino acids, and other substances.
  • Bio-resonance treatment is also provided. During bio-resonance, our trained physician places two electrodes on your skin connected to a specialised machine. These electrodes will scan the body's energy wavelengths, identify any imbalances or issues, and restore your electromagnetic frequency to its optimal state.
  • Yoga, mindfulness, breathwork, and wellbeing counselling will also be crucial for your treatment plan.
  • We will provide pharmacogenetic testing to figure out if there are any genetic markers that could explain why antidepressants are not working for you
  • Ketamine Infusion Therapy can also be provided if deemed necessary. Please click here to learn more

WE CAN PROVIDE TREATMENT FOR TRD IN ZURICH AND LONDON.

What Causes Treatment-Resistant Depression?

In our experience, depression becomes treatment-resistant when there are issues (often trauma) blocking the potency of the anti-depressant. We will help you overcome these issues before we even consider re-introducing medication into your treatment plan. Other root causes include:

Medical Conditions:

some medical conditions such as heart disease, cancer or thyroid problems can exacerbate depressive symptoms and hinder the effectiveness of various medications.

Drug Interactions:

Some medications do not mix well with antidepressants in a similar thread. If taken simultaneously, it can result in both failing to work or even leading to harmful interactions. For example, mixing an SSRI with an MAOI can be dangerous, as mixing an antidepressant with a sleeping pill. Painkillers like ibuprofen can also lead to negative interactions, as can other drugs like thyroid medication. Always check with your GP when taking more than just one type of medication.

Co-occurring conditions:

Depression is highly co-occurring with other disorders, particularly substance abuse and anorexia nervosa. In both cases, the symptoms that come with these conditions can weaken the effectiveness of the anti-depressant. For example, alcohol or substance abuse interferes with the drug’s potency, and anorexia nervosa can negatively impact your blood sugar or circulatory system’s capacity, impacting how your body responds to the medication.

Intestinal Perfusion:

Countless studies now show that an imbalanced or unhealthy gut can be a leading factor in the onset of depression and its development into a treatment-resistant form. For example, intestinal perfusion occurs when periods of prolonged stress reduce your intestine’s ability to absorb water, sodium and various other nutrients or chemicals. As a result, it could mean that your body is less able to digest and process antidepressant medication.

Genetic Dispositions:

pharmacogenetic studies show that our genetics play a vital role in how our body can break down various drug combinations. For example, if someone has an ultra-rapid metaboliser gene, then antidepressant medication is often removed from their system too quickly to provide any relief. In such a case, you would need medicines that are not broken down by the specific enzymes which are ultra-rapid. At Paracelsus Recovery, we have a team of experts who will conduct an elaborate genetic-make testing procedure to identify your particular genetics.

Misdiagnoses:

Finally, it is also prevalent to be misdiagnosed with depression and put on antidepressants only to find out years down the line that you were struggling with an issue such as bipolar disorder. Often, people only seek out help or notice something wrong when they are in a depressive episode, and they perceive the mania as ‘things finally looking up.’ However, if you suffer from bipolar, you need specific medication, not antidepressants. The same is true for anxiety disorders, eating disorders and various other conditions. Hence, it is vital to ensure you have received an adequate diagnosis. If there is any doubt, we will conduct an elaborate testing procedure to ensure your

While these are the most common causes, there are numerous others. At Paracelsus Recovery, we will make sure to tackle each one of the TRD's root causes.

FAQs

Frequently Asked Questions

A combination of medication, intensive psychotherapy and a support network is the best treatment for treatment-resistant depression. That said, studies also show that Olanzapine-Fluoxetine (Symbyax) - a combination drug consisting of fluoxetine (Prozac) and olanzapine (Zyprexa) - can successfully treat acute TRD. Transcranial magnetic stimulation is another FDA-approved treatment for TRD.

A person is diagnosed with treatment-resistant depression (TRD) when they have not successfully responded to at least one antidepressant trial of adequate dose and duration. Naturally, a person would first need to be diagnosed with a depressive disorder. TRD is a relatively common condition, with some studies showing up to 60% of patients require a TRD diagnosis.

Unfortunately, suicide rates tend to be higher amongst people diagnosed with TRD than those just diagnosed with depression. However, it always depends on each case and circumstance. But in general, yes, learning that your symptoms of depression may not be 'fixable' and you need to address the issue as though it is a chronic pain condition will always be challenging. The most severe cases would include those diagnosed with severe major depressive disorder and then TRD.

At Paracelsus Recovery, our treatment programme for TRD is holistic and all-encompassing. We use our 360-degree method to identify every area of ill-health that could contribute to your symptoms. These are almost always psychological, physical, and biochemical causes. Our experts will then help you address and heal each of these issues.

While studies are still underway, research would suggest that psychedelics – particularly psilocybin – are remarkably helpful in treating TRD. For example, in one study (2016) conducted by John Hopkins, they discovered a direct correlation between the intensity of the 'mystical experience' and the extent to which the person's depressive symptoms decreased. The team found that psilocybin effectively "reset" specific brain circuits directly linked to depression in the fMRI scans.