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Treatment-Resistant Mood Disorders: A Psychodynamic Approach

Treatment-Resistant Mood Disorders: A Psychodynamic Approach

  • Slide 1: Treatment-resistant mood disorders
  • Slide 2: False assumptions
  • Slide 3: Research
  • Slide 4: What does work?
  • Slide 5: Principles of a psychodynamic approach


We have asked Dr Eric Plakun to give us an overview of key points and psychodynamic principles on treatment-resistent mood disorders, based on research and clinical experience. He is a presenter at this year's APA Annual Meeting in a course titled "A Psychodynamic Approach to Treatment-Resistant Mood Disorders: Breaking Through Treatment Resistance by Focusing on Comorbid Personality Disorders."

Dr Plakun is the Associate Medical Director and Director of Admissions at the Austen Riggs Center, in Stockbridge, Mass. He is editor of New Perspectives on Narcissism (American Psychiatric Press, 1990) and Treatment Resistance and Patient Authority: The Austen Riggs Reader (Norton Professional Books, 2011).


Dr Plakun

Thank you for your very informative paper. As a psychiatrist in Australia, working since 1985 in a psychotherapy unit dedicated to personality disorders and treatment resistant depressions, we are unable to get a paper published with statistics on TRD and psychodynamic psychotherapy from our unit. Comments have not been directed to the statistics, but the rest of the paper. Psychiatrists are placing all their 'bets' on drugs, to the detriment of people and their families, and that must change.


Treatment-resistant mood disorders [TRMD] are difficult to treat and when personality disorders are comorbid conditions of TRMD, they are further difficult to treat. Psychodynamic psychotherapies will not perform well untill and unless appropriate medications are combined with psychotherapy. These patients pose treatment challenges to mental health professionals and need an all out efforts from them for managing their TRMD plus personality disorders.

Naseem @

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