Pharmacotherapy and Ketamine Assisted Psychotherapy for Treatment-Resistant Depression: A Patient With Lifelong Self-Doubt and Self-Criticism.
The Journal of clinical psychiatry April 5, 2023 Albert Yeung, Guy Sapirstein, Laura D Crain et al.
Treatment-resistant depression (TRD) is most commonly defined by at least two prior treatment failures with adequate dose and duration, though consensus is lacking. A clinical case illustrates a patient with long-standing depression and inadequate treatment response, where persistent self-criticism appears to drive unrelenting symptoms, intense anger, self-doubt, and self-disapproval. The article explores potential causes of self-criticism, its impact on depression and help-seeking, and plausible treatment approaches.