What is Treatment Resistant Depression?

Each year, between 10% and 15% of people living in the United States are diagnosed with Major Depressive Disorder (MDD). The lives of these patients are often functionally impaired, reducing their quality of life significantly. The traditional treatments they receive may help for a short time, but symptoms return. Unfortunately, medications don’t work for many people at all. In fact only about 30% of people will become completely well after trying a single antidepressant.


Mental health experts agree that a TRD diagnosis should only be given to “patients who have not been helped by two or more antidepressant treatment trials of adequate dose and duration, “as one study (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3363299/) published by the National Institures of Health states.

If you have tried more than two antidepressant treatments without successful results, you may have Treatment Resistant Depression. Treatment Resistant Depression is a complex issue, and often needs a psychiatrist who specializes in mood disorder to diagnose and treat. Psychiatrists are able to screen for reasons why patients may not be responding to medications, and then develop more sophisticated treatment plans which might include the combination of medications or non-medication therapies.


According to the National Institutes of Health (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3363299/), at any one time 14 million people suffer from depression but only half receive any kind of treatment.

Of the half that do receive treatment, only about one third of those get the medicine right on the first try. Finding the correct antidepressant treatment can be tricky.

It’s common for most people to go to a Primary Care Physician when they have symptoms like fatigue, changes in appetite or trouble sleeping. However, if you suspect you have TRD and you have only worked with a Primary Care Physician, you might consider your other options. You may ask for a referral to see a psychiatrist. A psychiatrist is a medical doctor who specializes in mental health issues and can re-evaluate your diagnosis as well as recommend other treatment avenues.

Sometimes a second opinion can bring back your hope and motivation to get better. There are many treatment options that a psychiatrist might recommend to help you get your joy back. Some of the other treatment options include:

  • Medication dosages might need to be changed
  • Psychological counseling may be necessary
  • TMS (Transcranial Magnetic Stimulation) is an alternative treatment option
  • Ketamine Infusion Therapy is another alternative treatment option

Don’t settle for sadness, Dr. St John is a Board Certified Psychiatrist and has experience treating patients with TRD. You don’t have to live with TRD. If you are ready to try another path, Dr. St John and her staff can help you find your way to happiness.