This unique book presents the treatment "roadmap" implemented by the University of Michigan Comprehensive Depression Center's Treatment Resistant Depression Program, step-by-step guidance that has long eluded clinicians, patients, and their families.

As many as 35-40% of patients afflicted with Major Depressive Disorder (MDD) are treatment resistant, a situation that places a massive emotional and financial burden on society and challenges the mental health profession to develop new treatment paradigms and practices. Even the most astute clinicians can be frustrated when treatment options fail to be effective or work for only a brief time, leaving them to wonder what course to pursue next. Treatment Resistant Depression: A Roadmap for Effective Care gives clinicians and their patients what they need most desperately: a sequence of steps that reflect state-of-the-art diagnostic procedures and integrates all evidence-based treatment modalities -- in short, a roadmap to wellness and recovery.

Based primarily on the experiences of the authors, all of whom are leading researchers and/or clinicians in Treatment Resistant Depression and affiliated with the University of Michigan Comprehensive Depression Center, the book also draws upon the clinical research advances and treatment innovations of programs around the world. Although the book's step-by-step organization is clear and easy to follow, its coverage, scope, and level of sophistication are anything but simplified. This book • Is comprehensive, addressing treatment options, including psychopharmacotherapy, psychotherapy, neuromodulation (ECT, transcranial magnetic stimulation, deep brain stimulation, vagus nerve stimulation), exercise, nutrition, self-management approaches to enhance adherence, behavioral sleep programs, and others• Addresses treatment resistant depression across the lifespan, reflecting the diverse demographics of depression, which knows no age, gender, or socioeconomic status• Emphasizes the authors' commitment to early intervention and provides techniques for identifying young people who are at risk for developing depression or already expressing symptoms of the disease• Recognizes the chronicity of depression, rather than focusing on only the acute stage, and in this way allows for more effective treatment over the patient's lifetime• Introduces self-management as playing a critical role in the patient's prognosis, engagement, adherence to clinical steps that help maintain recovery, and self-esteem• Promotes the development of new, personalized, and predictive biomarkers to target treatment more effectively.

Designed to be useful across disciplines and treatment modalities, the book includes a multitude of tables, graphs, and learning aids that will benefit students, instructors, and clinicians. At the same time, the book promises to be a valuable resource for patients and their families, since Treatment Resistant Depression is both difficult to live with and little understood. No other book offers so much practical guidance, sound research and hope.

ContributorsDisclosure of InterestsForewordPrefaceDedication and AcknowledgementsChapter 1. Treatment resistant depression: overview of the University of Michigan Depression Center roadmapChapter 2. Psychopharmacological roadmap for treatment resistant depressionChapter 3. Treatment resistant depression in adolescentsChapter 4. Recognizing and treating depression and bipolar disorder on college campuses: early identification and interventionChapter 5. Treatment resistant depression in pregnant womenChapter 6. Treatment resistant depression in later lifeChapter 7. Treatment resistant depression and comorbid medical problems: Cardiovascular disease nd cancerChapter 8. Alcohol and drug use: Contributions to treatment resistance for patients with depressionChapter 9. Sleep and circadian rhythms: A understudied area in treatment resistant depressionChapter 10. Psychotherapy strategies for treatment resistant depressionChapter 11. Device-related neuromodulation in treatment resistant depressionChapter 12. Exercise, nutrition, and treatment resistant depressionChapter 13. The bipolar disorder medical care model: A collaborative approach for reducing disparities in medical care among patients with bipolar disorderChapter 14. Expanding services for patients with treatment resistant depression: The role of peer supportChapter 15. Genetics of mood disorders: general principles and potential applications for treatment resistant depressionIndex