Still down : what to do when antidepressants fail
(Book)

"Major depressive disorder is a common medical condition that can be disabling and can persist for months, even years. Many people experience depression symptoms that resist treatment. Although they try various combinations of medications, psychotherapy, or electroconvulsive therapy, their symptoms don't improve. What can people who have treatment-resistant depression do to overcome their depression and feel better? In Still Down, Dr. Dean F. MacKinnon, a psychiatrist at Johns Hopkins Medical School, presents nine composite stories drawn from patients he has seen in his twenty years as an expert in treatment-resistant mood disorders. The first section of the book features people diagnosed with depression who have not yet received appropriate treatment. The next section looks at misdiagnosis, focusing on people who feel and appear depressed but who have different mood disorders and need treatment for them. Finally, Dr. MacKinnon describes people who have severe depression that does not respond to any treatment, regardless of how finely tuned the treatment might be. These people, who suffer from true treatment-resistant depression (TRD), can benefit from a variety of treatments to feel better. Dr. MacKinnon provides commentary to explain and extend the discussion of the patients and situations in each case. He also discusses common obstacles to improvement, including overly conservative dosing, problems stemming from not adhering to treatment, antidepressant failure, and high sensitivity to side effects. By identifying aspects of the individual's qualities, behaviors, and experiences that may account for poor response to treatment, Still Down points the way for people with TRD and their families to find appropriate diagnoses and the best possible care"--,Provided by publisher.

"Many people have depression symptoms that resist treatment. Despite medications, psychotherapy, and sometimes electroconvulsive therapy, these people don't feel well. What can they do to feel better? Dr. Dean MacKinnon, a psychiatrist at Johns Hopkins Hospital in Baltimore, specializes in finding out why treatment hasn't been helpful for a patient, and in helping that patient feel better. In Still Down, Dr. MacKinnon uses case studies of such individuals to reassess treatment-resistant depression (TRD) and explore what's going on with people who don't feel better, even with treatment. As some of the cases illustrate, some people who have been diagnosed with treatment-resistant depression have depression that actually will respond to appropriate treatment--but they have not yet received appropriate treatment. Other cases illustrate what happens when someone is incorrectly diagnosed with depression; that person needs treatment for a different disorder, not for depression. Finally, some cases illustrate people who have depression that does not respond to treatment for depression, regardless of how finely tuned the treatment is. These people, who have true TRD, can benefit from a variety of treatments alone or in combination, and even though they may not feel entirely well, they can feel better. Writing for people who have treatment-resistant depression and their families, as well as medical professionals and mental health care providers, MacKinnon hopes to help people with depression get appropriate diagnoses and treatment. He also hopes to improve care providers' understanding of treatment-resistant depression, by identifying aspects of the individual's qualities, behaviors, and experiences that may account for poor response to treatment"--,Provided by publisher.

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