How to Cope with Treatment-Resistant Depression

Jul 18, 2023 | Adult Treatment, Adolescent Treatment, Depression, Mental Health

Depression is a mental health disorder that affects countless people worldwide, each to a varying degree. Although many individuals respond well to various treatments, there’s a subset that continues to battle persistent symptoms and it’s known as treatment-resistant depression. In this blog, we’ll dive into the intricacies of TRD, exploring why some treatments fall short and uncovering potential solutions to overcome this condition.

Defining Treatment-Resistant Depression

Treatment-resistant depression occurs when standard treatments like medication or therapy fail to alleviate symptoms adequately. Believe it or not, around 30% of people diagnosed with depression fall into this category. It’s like hitting a wall—a real struggle that leads to emotional distress, impaired functioning, and a lower quality of life. It is generally agreed upon that TRD is diagnosable once two or more antidepressants are unable to improve depression symptoms, though some will say it takes as many as four attempts to be true TRD. Working with your own healthcare provider will guide you as you navigate your major depressive disorder diagnosis.

What Causes Treatment-Resistant Depression?

Understanding why some individuals experience treatment resistance is key to finding effective solutions. Several factors contribute to TRD, including:

  • Biological Factors: Genetics, irregular brain structure or function, and imbalances in neurotransmitters can make individuals more resistant to treatment.
  • Psychosocial Factors: Co-existing mental health conditions, chronic stress, early-life trauma, and limited social support can hinder treatment success.
  • Treatment-related Factors: Inadequate medication dosage, poor adherence, inappropriate therapy techniques, and inconsistent follow-up care can all impact treatment outcomes.


How Is It Diagnosed?

The diagnosis of treatment-resistant depression lacks standardized criteria, but medical professionals typically arrive at this conclusion when a patient has experimented with at least two distinct classes of antidepressant medications without experiencing any noticeable improvement.

If you suspect that you are dealing with treatment-resistant depression, it is crucial to seek a diagnosis from a qualified physician. While your situation might align with treatment-resistant depression, a psychiatrist can conduct thorough evaluations to ensure accuracy. These evaluations may include:

  • Verifying the initial diagnosis of depression for its correctness.
  • Exploring the possibility of other conditions that may contribute to or exacerbate the symptoms.
  • Assessing whether the antidepressant was administered at an appropriate dosage.
  • Evaluating the adherence to the prescribed antidepressant regimen.
  • Examining whether the antidepressant was given an adequate trial duration.


Implications of TRD
  • Relentless Suffering: Dealing with treatment-resistant depression means enduring prolonged periods of distress. The persistent symptoms often lead to feelings of hopelessness, frustration, and despair, making it challenging to find relief.
  • Inability to Function: Treatment-resistant depression can significantly hinder a person’s ability to function in their day-to-day life. Work or school performance might suffer and everyday activities may feel overwhelming. Ultimately, this can also lead to social withdrawal or isolation.
  • Greater Risk of Suicide: People with treatment-resistant depression are at a higher risk of experiencing thoughts of suicide or engaging in self-harming behaviors. The prolonged and intense emotional pain associated with this condition significantly increases a person’s risk of suicide over time.
  • Negative Impact on Physical Health: TRD takes a toll on a person’s physical health as well. Changes in appetite, disrupted sleep patterns, chronic fatigue, and heightened vulnerability to other health issues are common.
  • Financial Stress: Managing treatment-resistant depression usually involves seeking alternative treatments or engaging in long-term therapy, which can result in massive healthcare costs. Additionally, the functional limitations associated with this condition may lead to decreased work productivity or an inability to work, causing even more financial strain.


Treating Treatment-Resistant Depression

Dealing with TRD is like a puzzle, but it’s a puzzle we can solve. Below are some promising treatment options:

  • Medication Adjustments: If standard antidepressants aren’t doing the trick, psychiatrists may try different medication classes, combinations, or dosages tailored to each person’s needs.
  • Psychotherapy Modifications: Therapists can employ alternative approaches like cognitive-behavioral therapy, dialectical behavior therapy, or interpersonal therapy to tackle specific symptoms or underlying issues.
  • Brain Stimulation Therapies: Techniques like electroconvulsive therapy, transcranial magnetic stimulation, or deep brain stimulation can be considered for severe or treatment-resistant depression.
  • Ketamine Treatment: Ketamine, an anesthetic with rapid-acting antidepressant properties, has shown promise in TRD treatment, often given intravenously or as a nasal spray.
  • Augmentation Strategies: Adding medications such as lithium, atypical antipsychotics, or thyroid hormone to the existing treatment plan can enhance effectiveness.
  • Psychoeducation and Self-Management: Equipping individuals with knowledge about depression, stress reduction techniques, self-care strategies, and coping skills can empower them to better manage their symptoms and improve overall well-being.


The Importance of Collaborative Care

Successful management of TRD often requires a team effort. Collaborative care involving mental health professionals, primary care physicians, psychiatrists, and therapists is crucial. Regular communication, close monitoring of treatment response, and shared decision-making empower individuals to create a tailored treatment plan that works best for them.

Take Care Of Yourself

Taking the time to engage in regular exercise, even if it’s just a leisurely walk or doing yoga in your living room, can boost mood and improve overall mental health. In addition to this, pay attention to your diet, aiming for a balanced intake of nutritious foods that fuel your body and mind. Quality sleep is also vital, so establish a bedtime routine that promotes relaxation and restful slumber.

Finding healthy ways to manage stress is another non-negotiable when dealing with TRD. Explore techniques like meditation, deep breathing exercises, or simply engaging in hobbies that bring you joy and relaxation. Building a strong support system of friends can also provide invaluable emotional support.

Avoid Depressive Substances

With any degree of depression, it is important to avoid depressive-inducing substances whenever possible. For those with TRD, this is especially critical. Consuming alcohol, caffeine or illicit drugs can intensify any feelings of depression. On top of this, it can have negative interactions with antidepressants that might be taken. In general, little to no consumption of these substances is recommended.

In the event that alcohol or caffeine is consumed, taking proactive measures to support your mental health can be beneficial. This could range from taking probiotics to support gut health to engaging in physical activity to induce endorphins.


Treatment-resistant depression poses unique challenges, but it’s not insurmountable. By understanding the causes and exploring various treatment options, we can offer hope and effective solutions to those struggling with TRD. While it may take some trial and error to find the right combination of treatments, it’s important to remain persistent and never give up.

TRD is unique in that it impacts each person differently. What works for one person may not work for another. Because of this, maintaining open and honest communication with your healthcare team is essential. Don’t hesitate to voice your concerns, ask questions, and actively participate in your treatment decisions.

Conquering treatment-resistant depression takes time, patience, and resilience. It’s important to celebrate small victories along the way and acknowledge your progress, no matter how small it may seem. You are not alone in this journey, and there is hope for brighter days ahead. 

Treatment-resistant depression can be an uphill battle for many, but there are effective solutions available. With determination, support, and a comprehensive approach, it’s possible to overcome the challenges of treatment-resistant depression and reclaim a fulfilling and joyful life.

New Dimensions Can Help!

If you are struggling with treatment-resistant depression, New Dimensions can help.  New Dimensions provides Partial Hospitalization (PHP) and Intensive Outpatient Treatment (IOP) for adolescents and adults with depression, anxiety, trauma, PTSD, OCD, panic attacks, alcoholism, addictions, and other mental health issues.  To learn more about our treatment programs, contact us at 800-685-9796 or visit our website at  You can also locate individual therapy services by visiting