9 Life Changing Treatments for Treatment Resistant Depression

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When you’ve tried two or three or six treatments for your depression, anxiety, or PTSD and nothing helps, you might feel even more hopeless, like a fulfilling life is not possible for you. But I have good news for you. There are literally 500–five hundred! [mouth or whisper 500 in a repeat for emphasis]–treatments for depression. We’re talking treatments for severe forms of depression, anxiety, and PTSD. And most of them are surprisingly effective. So let’s explore 9 interventions that science has shown to improve treatment resistant mental health conditions–and at the end I’ll share what hasn’t been proven to work. Some of these might be considered last-ditch efforts to treat treatment-resistant mental health conditions, but if you’ve been there, you know how desperate you feel and why it might be worth talking with your psychiatrist about these.

00:00 Intro
00:52 Nutshell
02:58 Standard Treatments
05:10 OK, when none of this is working, or if your case is really severe-
08:06 Electroconvulsive Therapy (ECT)
09:26 Transcranial Magnetic Stimulation (TMS)
10:37 Ketamine
13:06 Vagus Nerve Stimulation
14:27 Psilocybin
16:36 Stellate Ganglion Block (SGB)
17:37 Fecal transplants
18:56 Metabolic treatments
19:43 Cold Water Immersion

Check out the transcript below:

Therapy in a Nutshell and the information provided by Emma McAdam are solely intended for informational and entertainment purposes and are not a substitute for advice, diagnosis, or treatment regarding medical or mental health conditions. Although Emma McAdam is a licensed marriage and family therapist, the views expressed on this site or any related content should not be taken for medical or psychiatric advice. Always consult your physician before making any decisions related to your physical or mental health.
In therapy I use a combination of Acceptance and Commitment Therapy, Systems Theory, positive psychology, and a bio-psycho-social approach to treating mental illness and other challenges we all face in life. The ideas from my videos are frequently adapted from multiple sources. Many of them come from Acceptance and Commitment Therapy, especially the work of Steven Hayes, Jason Luoma, and Russ Harris. The sections on stress and the mind-body connection derive from the work of Stephen Porges (the Polyvagal theory), Peter Levine (Somatic Experiencing) Francine Shapiro (EMDR), and Bessel Van Der Kolk. I also rely heavily on the work of the Arbinger institute for my overall understanding of our ability to choose our life's direction.

Copyright Therapy in a Nutshell, LLC

[KarencitaSacher]

Psychedelic mushrooms really healed me years back. Totally got rid of depression, anxiety and illicit pill addiction

[tardisgater]

What therapists think they're saying, "Look, even someone who survived the Holocaust can find meaning and fulfillment in life. It's never hopeless."

What a depressed person hears, "Even someone who survived the Holocaust was able to find meaning and fulfillment in their life and I can't... God, I'm so weak... I suck."

[deathsblooms]

It's hard to not give up when you can't find the right shrink for you or you can't afford it - not to mention the amount of energy it takes to go through the process again and again.

[dianeashley-iorh]

Hospitalization does not help me. There’s no one to talk to for help. A staff member said for me to speak to other patients there. The sink in my room didn't work so I couldn't wash my hands after using the restroom. I was also physically ill but was denied laying down and resting. I was falling asleep sitting up. Once I realized it was not helping me at all that a person would get more freedom in a jail, I told them I was ready to leave. I had asked to go in the hospital. They said that I would have to leave AMA. So I told them to get the paperwork ready. Then they said that I would have to wait for the dr. It was an absolute nightmare. Never again !

[johnmcglynn]

Loneliness and no friends and isolation is what is causing a lot of depression now 😢

[Melissa-gp]

Four things I wish I had learned sooner:
Thoughts are not facts—most of them just pass through like clouds.
Meditation isn’t about controlling the mind, but about understanding it.
Shift Your Mind by Alexander Brooks finally made mindfulness make sense to me. (no more anxiety)
Walking in nature is one of the simplest yet most powerful ways to reset the mind.

[amenhotep]

Emma will always remain the best therapist on youtube, you supported me in long hours of depressed moods, for all the credit will go back to you someday, i thank God we have this woman.

[TheIdiotTries]

I just want to comment here and say you have completely changed my life. I subbed to your channel a long time ago, but I started taking these videos seriously about a year ago.

In that time I have worked on CBT and positive thinking. I now no longer have days when I stay in bed anymore, I am able to keep employment, I take care of myself, I go out more I make more friends.

I have some work to do on anxiety and anger but my depression has mostly been entirely resolved. Anxiety is a lot easier to get through along with panic attacks.

Your content is incredibly helpful and I wish more people in these comments would take this more seriously. Absolutely life changing.

[RonaldMa-bkti]

I have gone through two severe depressive episodes in my life and was hospitalized on both occasions. I was suffering so badly that I thought l could never recover. Surprisingly, l have recovered very well and I am leading a pretty happy and active life now. My experience is that recovery results from a combination of different treatments, such as medication, therapy and a change of lifestyle. I don't think any single form of treatment is sufficient.

[RoseAhisha]

I loved that you included Ketamine and psilocybin in your video. Many of the videos I've watched lately focus on CBT or a variant of it that leaves out the emotional aspect of depression, not to mention the root of depression. Psilocybin can bring you to the root of the issue and allow you to safely process the unresolved emotions attached to your current condition.
I wish they stopped forcing people to seek underground therapist that provide Psychedelic-assisted therapy.
It's great to have a different perspective after a psychedelic session to navigate the fractured societies we all live in.
Sending everyone love and hope ❤

[SheilaMoraes_]

i honestly dont have energy to keep trying anymore. its been 20 years already trying different therapists, different medications, different approaches, meditation, yoga, pilates, running.... im tired

[ssyfelix]

I think she means never give up, there are so many solutions available.

[john-oeh]

I honestly believe that have good friends, and a supportive family can help immensely in recovering from depression/anxiety

[carly]

Psychedelics are just an exceptional mental health breakthrough. It's quite fascinating how effective they are against depression and anxiety. Saved my life.

[Teacher-Christine]

I love your positive attitude towards finding ways to treat depression! This alone makes me feel better about my world and the endless possibilities for joy. 🙂

[elenawatkiss]

I think for me, what has helped is realising that my emotions dont define who I am. I am made up of more than my emotions. Emotions are simply experiences that I am having, they do not define me, even the ones that feel strong or overwhelming or seem persistent. Then I follow this with self compassion and acceptance. I fully accept without any other motive that this is how I am feeling and then I speak to myself in a kind and loving way, 'This feels hard and that is okay' 'Im here' 'I care' 'All I can do is my best, that is my only job and that is enough'. I remind myself that it makes me very human and very normal to feel depression, even the considered more extreme experiences of depression because it is normal. I do something else I call 'taking my depression with me' in that I mean I dont try to fix, change, push away or ignore my depression, I just let it be and let it come with me say gently to myself 'Okay we are still going to do this thing and your coming with me' whether that be make a healthy meal or do 5 minutes of excersise or talk to a friend. Emotions can feel like a lot but they are not you, you are person who is having an experience of depression but you are not the depression or your thoughts. There has to be a someone to observe the depression and to observe the thoughts and that is the person who you really are. In my experience I really found that when I fully accepted the depression as it was, and the key was to continue doing the things that promoted self care even though it was difficult, only then did things start to shift. Its like the depression just needed gentle compassion and acceptance. That was the best way to honour myself and my experience, it felt like the love was I missing and it was the love that only I could give to myself. Of course everyones experience is different so please dont compare, this is only what worked for me, maube there is a message in it for you or maybe not? Whatever it is, I hope you honour it for you or not thats cool to.

[susanmercurio]

I have Major Depression and I got an ARMHS worker who wanted to teach me "coping skills." Mind you, she was in her 20s and I'm 78. This little 20-something was going to teach me how to cope!
So you can take your skills and stuff them.
I was in the hospital more times than I can count and they never did any psychological testing.

[Christieinthejourney]

I had a Vagal Nerve Stimulator Implanted due to my TRD. i tried everything under the sun. It's made a huge difference for me.

[victoryamartin]

Your voice was so soothing, I think I'm healed now for the rest of the day.

[rachaelgalvez]

That chart is amazing!! I look forward to getting a closer look on the download. I've been through some of those extreme treatments and maybe they did give me a reset for a while. But eventually I found that paying attention to my thoughts and learning how to redirect them a more hopeful place was the real key for me, along with a bunch of skills you've taught. Thanks again!