As the days get shorter, many people notice their mood dipping. You may feel tired, sleep more, or pull away from friends. For some, these feelings lift when spring comes back. For others, the low mood stays no matter the season or the treatment they try.
Knowing the difference between seasonal depression and treatment-resistant depression can help you find the right kind of care. This post explains how the two are different, how they can overlap, and how ketamine therapy may help people who have not found relief with other treatments.
What Is Seasonal Depression?
Seasonal affective disorder (SAD) is a type of depression that comes and goes with the seasons. According to the National Institute of Mental Health, symptoms usually last about 4 to 5 months out of the year.
Most people with SAD have a winter pattern. Symptoms start in late fall or early winter and ease in spring. Common signs include:
- Sleeping more than usual
- Craving carbohydrates and gaining weight
- Pulling away from friends and activities
- Low energy and trouble focusing
A less common summer pattern can bring trouble sleeping, poor appetite, restlessness, and anxiety.
SAD is more common in women and in people who live farther north, where winter days are shorter. Common treatments include light therapy, talk therapy, and antidepressant medicine. Many people find these helpful.
What Is Treatment-Resistant Depression?
Treatment-resistant depression (TRD) is depression that does not improve enough after trying standard treatments. NAMI describes it as trying two or more antidepressants for several months each and still having symptoms.
TRD is more common than many people think. NAMI notes that about 60% of people who start depression medicine need to try more than one before they feel better. Needing more options is not a personal failure. It often means your brain may respond better to a different approach.
The two can also overlap. Someone with seasonal depression may find that standard treatments stop working, or that their symptoms no longer lift in spring. Only a provider can help sort out what you are experiencing.
How Ketamine May Help Treatment-Resistant Depression
Most antidepressants work on the brain chemicals serotonin and norepinepherine. These medicines often take several weeks to show results. Ketamine works in a different way. While It primary works through the modulation of glutamate, the exact mechanism of action has yet to be completely understood and likely involves several different pathways. The beneficial effects definitely last longer than the drug is in the body. There is evidence that ketamine increases the number of synapses in certain parts of the brain. Unfortunately, this increase is temporary, at least for the first few months of treatment. Without continued ketamine treatments whatever caused those synapses not to be there to begin with is still present and the new synapses can wither over time. That said, the long-term effectiveness varies greatly between patients. Most patients need regular treatments for at least the first five to six months.
For some people, ketamine may:
- Ease depression symptoms within hours or days, instead of weeks
- Help when other antidepressants have not worked
- Offer a new path forward for people who feel stuck
Results vary from person to person, and research on long-term effects is still ongoing. Your provider can help you decide if ketamine is a good fit.
What to Expect During Ketamine Treatment
Ketamine treatment takes place in a clinic with medical staff watching over you. A typical visit may look like this:
- History. Your provider reviews your health history, past treatments, and goals.
- Treatment session. You relax in a calm, comfortable room while you receive your treatment. Staff check your blood pressure and comfort level throughout.
- Recovery time. You rest until any side effects fade. This is often within about two hours.
- Ride home. You will need someone to drive you home after each session.
Most treatment plans include a series of sessions over a few weeks. Your provider will talk with you about how often you may need follow-up care.
Risks and Considerations
As with any treatment, ketamine has possible side effects. According to Johns Hopkins Medicine, these can include:
- Feeling disconnected from yourself or your surroundings (dissociation)
- Nausea or drowsiness
- A short-term rise in blood pressure
- Headache or dizziness
These effects are usually short-lived and wear off within a couple of hours. Ketamine is not right for everyone. People with certain heart conditions, uncontrolled high blood pressure, or a history of substance use may need other options. Be open with your provider about your full health history.
When to Talk to a Provider
It is a good idea to reach out to a provider if:
- Your low mood lasts more than two weeks
- You have tried two or more antidepressants without enough relief
- Your seasonal symptoms don’t respond to other treatments or lift when the season changes
- Depression is making it hard to work, sleep, or connect with others
If you are having thoughts of harming yourself, call or text 988 to reach the 988 Suicide & Crisis Lifeline right away.
Finding Relief for Treatment-Resistant Depression in Charleston
Seasonal depression and treatment-resistant depression can feel alike, but they often need different care. If standard treatments have not helped, ketamine therapy may be worth exploring.
The team at Charleston Ketamine Center is here to answer your questions and help you understand your options. https://charlestonketaminecenter.com/contact/#consultation
This article is for educational purposes only and is not medical advice. Talk with your healthcare provider about your symptoms and treatment options.