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What Is Treatment-Resistant Depression

What Is Treatment-Resistant Depression

Depression symptoms can be hard to treat. Even if you’ve tried multiple options – antidepressants, therapy, support group, lifestyle changes – sometimes your depression still doesn’t get better. You may be suffering from treatment-resistant depression.

The Impact Of Depression

Depression is one of the most common mental health problems worldwide. By some estimates, it affects nearly 300 million people, resulting in loss of income, lower national productivity, harmful effects on personal relationships, and is a key driver of disability. In the U.S., nearly 19 million adults exhibit depression symptoms each year. Depression also exacts a heavy toll of mortality, suspected of being responsible for nearly 800,000 deaths around the world. But treatment is available.

How Depression Affects The Brain

The human brain is the most complex organ known to man. It’s made up of 170 billion cells, and how those cells communicate with one another is a key driver in our perception of pain, emotions, and mental health. Depression affects several regions of the brain (the hippocampus, thalamus, amygdala, frontal, and prefrontal cortices), resulting in shrinkage, inflammation, oxygen restriction, and structural and cognitive changes. Inability to control these changes can lead to other problems.

What Is Treatment-Resistant Depression

If you’re undergoing treatment for depression without symptoms improving, you may suffer from treatment-resistant depression. A doctor or mental healthcare provider may recommend different kinds of treatment to ease depression symptoms for most people, but treatment-resistant depression is a different animal – normal therapy isn’t usually enough. In fact, they may help little if any, symptoms could be reduced, only to come back with a vengeance.


  • Unrelenting sad, fearful, or low moods
  • Feelings of despair, or pessimism
  • Bad temper
  • Feeling guilty, worthless, or helpless
  • No longer interested in once-pleasurable hobbies and activities
  • Low energy or tiredness
  • You talk or move slowly
  • You can’t sit still or feel restless
  • Problems concentrating, recollecting, or making decisions
  • Trouble sleeping, waking early, or oversleeping
  • Hunger issues resulting in weight gain or loss
  • Preoccupied with thoughts of suicide, or suicide attempts
  • You have mysterious discomfort or pain, headaches, cramps, or gastrointestinal issues – and none subside, even with treatment

Fortunately, many symptoms can be managed in a variety of ways, including the use of ketamine infusion or nasal spray, both administered at licensed clinics nationwide.

Types of depression

There are many kinds of depression that your doctor or therapist may discuss. Some have overlapping symptoms, but all are unique in one way or another. The most common forms include:

  • Dysthymia is a depressed feeling which persists for at least two years. If you’ve been diagnosed with dysthymia, you could have periods of major depression plus times of less serious symptoms.
  • Postpartum depression shouldn’t be confused with a case of the “baby blues” (relatively moderate depression and anxiety symptoms which normally subside two weeks after childbirth) that many women suffer from after giving birth. Women with postpartum depression suffer from complete, major depression while pregnant or after delivery.
  • Psychotic depression happens if you experience severe depression plus psychosis, like having unsettling erroneous fixed beliefs (delusions) or perceiving disturbing things that someone else can’t hear or see (hallucinations).
  • Seasonal affective disorder is a kind of depression that happens during the winter months, as these months offer reduced hours of natural sunlight. It normally eases during the spring and summer.
  • Bipolar disorder is different from depression, but someone with it may experience instances of very low moods that jibe with the criteria of major depression.

Risk factors of depression may include:

  • You or your family have a history of depression
  • Major life changes (trauma, stress)
  • Certain physical ailments or medicine

Diagnosis & Treatment

Treatment-resistant depression normally follows a two-step process for diagnosis to occur.

  • A physical exam by a medical professional. This is designed to see if an underlying medical problem is causing the symptoms and may involve blood tests or other diagnostic procedures.
  • A psychiatric assessment by a mental health professional who specializes in depression. You’ll be asked your thoughts, feelings, and behavior, and your personal and family history of mental illness. You may also be asked to complete a brief questionnaire.

Symptoms are then compared to criteria in the DSM-5 before any treatment is recommended, including psychotherapy or ketamine.


If you’re experiencing long-term depression and your therapy has reached a standstill, your condition may have morphed into treatment-resistant depression – but that doesn’t mean you can’t fight the symptoms and enjoy a productive life. Contact us at NeuroRelief today to learn more about how we can help you fight your treatment-resistant depression.

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