Do I Have Treatment-Resistant Depression?

If you find that your depression medication isn’t working, you may be starting to feel anxious or frustrated. Trying a series of new medications can be a drain on anyone, especially if you’re still dealing with the symptoms of depression. If you’re asking why you can't find a medication that works, know that you are far from the only person asking this question.

Although many people do respond to common depression treatments, such as medication, talk therapy, or a combination of the two, it can take a while to find a treatment that works for you. For some, it eventually becomes clear that depression isn't getting better with medication, and it may be time to look for a different type of treatment. If that's the case for you, you may have  treatment-resistant depression  (TRD). Read on to learn what TRD is and what you can do if you think you may have it.

TRD isn't an official diagnosis. Instead, it's a term used to describe depression that doesn't respond to two or more medications. If your medication isn't helping, you're not out of options—even if it feels that way. It is common to not find relief with the first depression medication you try. In fact, it's estimated that only half of people with depression respond to their first medication trial. 

Some people may experience partial relief with medication, meaning you may still face residual symptoms such as sleep disturbance, lack of interest in activities, or poor concentration. At times, this partial relief is made less beneficial by intolerable side effects like stomach pains, low libido, or insomnia—all on top of residual depression symptoms. There are also some cases where symptoms may seem to get worse after each treatment attempt. If these situations sound familiar to you, remember that you still have options, and there is hope.

On top of the feelings that depression normally brings, trying several treatments and failing to find results probably brings feelings of hopelessness, frustration, or despair. You may feel like you’re the only person who can't feel better with treatment, but you're actually in good company—few people find something that works on the first try. 

Typically, it takes  four to six weeks  for someone to fully respond to medication, so your doctor will want to make sure you've given your current treatment enough time to work. After that time frame has passed, your doctor will likely want you to try another type of medication. A doctor will conclude that you have TRD after you've tried at least two depression medications.

If you think you may have TRD, contact your doctor. Changing a medication routine on your own can be dangerous. Your doctor will also check to see if you have the right dosage and are taking your medication correctly. They might want to try a different class of medication, such as switching from a selective serotonin reuptake inhibitor (SSRI) or serotonin-norepinephrine reuptake Inhibitor (SNRI), or add on a medication (called adjunct therapy) if you are experiencing partial relief.

You have many more options than you think if your symptoms of depression are not getting better with medication. There are many treatment possibilities for those diagnosed with TRD. Some of these options include electroconvulsive therapy, vagus nerve stimulation, ketamine, and  transcranial magnetic stimulation  (TMS). Of these treatments, TMS is arguably the least invasive, as it doesn't require any sedation and doesn't cause any drug-related side effects.

If you're not sure where to turn next for depression treatment, it may be time to consider an alternative treatment. At Greenbrook, we're here to help you figure out your next step together. You might find that there are far more solutions for TRD than you think.