How To Conquer Treatment Resistant Depression

The good thing is if you can think that far ahead there are many different therapies you can try, unrelated to antidepressants and cognitive therapy.

Treatment Resistant Depression and Alternative Therapies

- Hormone Therapy (estrogen, progesterone, testosterone)

- Thyroid Optimization (T3, T4)

- Adrenal Fatigue Treatment (hydrocortisone, pregnenolone, DHEA)

- Advanced Nutritional Therapy (protein, carbohydrate, and fat ratios)

Hormone Therapy

Deficient or unbalanced hormones is a common cause of treatment resistant depression. Hormones and neurotransmitters and intimately linked together and may have a significant impact on mood.

In case you’re not aware, most antidepressants involve increasing the neurotransmitters serotonin, norepinephrine and dopamine. The problem is, if your hormones are out of whack, your antidepressants won't be very effective.

Hormones and Neurotransmitter Relationships

The ratios of the different hormones and neurotransmitters affect men and women differently. Women are generally more sensitive to progesterone and estrogen whereas men are more sensitive to testosterone.

Imbalances in these hormones can cause physical, mental, and emotional decline. Hormone levels need to be tailored to each gender.

This is why women generally tend to do better on SSRI (serotonin) antidepressants than men. Most men don’t need more progesterone for health and well-being whereas for woman it is crucial. Men get the most bang for their buck with dopaminergic antidepressants and/or testosterone replacement, if their levels are deficient.

If you have treatment resistant depression you may want to try some different antidepressants which are more gender friendly, (like dopaminergic drugs for men). You may also want to get your hormones checked by your doctor to make sure your testosterone is within range. It can make a difference between night and day in your well-being.

Thyroid Optimization

Having an under active or over active thyroid can pose different problems for emotional health and treatment resistant depression. Hypothyroidism (under active thyroid) can contribute to low testosterone/dopamine and high estrogen/norephinephrine levels. The “spark plug to your body’s furnace” is underperforming which produces the motivation and drive to get you through the day.

Conversely, hyperthyroidism (over active thyroid) can make you burn through fuel/energy/food at too quickly a rate. It can lead to low estrogen/norepinephrine levels leaving you tired with poor concentration.

If you are overly cold or hot most of the time it may be a good idea to get your thyroid checked. Your doctor can perform the requisite blood tests to make sure you are within normal ranges.

Adrenal Fatigue Treatment

Sluggish adrenals can prevent you from having the get up and go during the day as well as impairing your ability to handle stress. The busier our lives get, the more stress builds leading to burning the candle at both ends, and eventually burnout.

Getting your cortisol tested, either with a blood test at early morning or a four point saliva test throughout the day is most recommended. Low cortisol levels may cause disruptions at all levels of health. Due to our busy schedules, it’s no wonder an estimated 67% of people have adrenal fatigue.

The most common treatment for adrenal fatigue is 10 mg of hydrocortisone taken mostly in the morning, with the other 10mg spread throughout the day.

A good resource on >adrenal fatigue is the book “Adrenal Fatigue: The 21st Century Stress Syndrome” by James L. Wilson, ND., D.C., PhD. It's a good read and has the most up to date information on adrenal fatigue.

Advanced Nutritional Therapy

Just as hormones control neurotransmitters so does the food you eat. The general relationship goes;

- Carbohydrates increase serotonin.
- Protein increases dopamine.
- Fat increases norepinephrine.

The protein/dopamine/testosterone relationship ties in to men’s needs and is why they tend to be eat more meat than women. They need the extra protein to fuel testosterone for their physical and mental well-being.

Depending what you may need more or less of, you should control the ratios of carbohydrates, protein, and fat. I for one, need a high protein and fat diet to increase my dopamine and norepinephrine levels, and a low carbohydrate diet to lower my serotonin. This has probably been the number one factor in my recovery from treatment resistant depression.

You may have to play around with the ratios a little to see what works best for you. For a greater understanding on the topic “The Metabolic Typing Diet” by William Wolcott goes in to further detail on the interplay between carbohydrates, protein, and fats. Unfortunately there is no mention of neurotransmitters and hormones.

The details of diet, neurotransmitters, and hormones have been taken from many sources. I will write an article in the future further exploring these concepts.