1.
J Clin Psychiatry
; 84(3)2023 04 05.
Article
in English
| MEDLINE
| ID: mdl-37022756
ABSTRACT
Although consensus in the field is lacking, the most common definition for treatment-resistant depression (TRD) requires a minimum of 2 prior treatment failures with confirmed adequate dose and duration. This article presents a clinical example of TRD in a patient with a long history of depression and inadequate response to treatment. The prominent feature is the patient's persistent self-criticism that might have predisposed him to unrelenting depression symptoms, intense anger, self-doubt, and self-disapproval. We explore potential underlying causes for self-criticism, its impact on depression and help-seeking, and plausible treatment approaches.