Condition guide
Treatment-Resistant Depression
When two or more medications haven't been enough
Overview
Treatment-resistant depression describes major depression that has not responded adequately to at least two antidepressant trials of sufficient dose and duration.
It is not a sign that you failed treatment or that nothing will work. It means the medication pathway alone isn't the right lever for your brain — and it's the situation TMS was specifically developed and FDA-cleared to address.
Common symptoms
- Ongoing depressive symptoms despite months or years of medication
- Partial improvement that never quite reaches remission
- Intolerable side effects that force medication changes
- Growing hopelessness about treatment itself
- Functional decline at work, school, or home
- Increasing isolation from people who care about you
Causes and risk factors
- Individual differences in brain-network activity that medication doesn't reach
- Undertreated or missed contributors such as trauma, ADHD, or bipolar spectrum illness
- Medical contributors: thyroid dysfunction, sleep apnea, chronic pain, vitamin deficiency
- Inadequate dose or duration in prior medication trials
- Ongoing substance use or unaddressed chronic stress
Treatment options we offer
- Comprehensive review of every prior trial — dose, duration, and response
- TMS therapy, the FDA-cleared option for this exact diagnosis
- Therapy targeting rumination, avoidance, and hopelessness
- Screening for missed contributors including bipolar spectrum and ADHD
- Coordination with your prescriber rather than duplicate care
Therapy approaches used
- CBT for depression
- Behavioral activation
- EMDR when trauma underlies the depression
- Relapse-prevention planning
How TMS fits in
This is TMS's core indication. Around half to two-thirds of patients with treatment-resistant depression respond meaningfully and roughly a third reach remission — response rates that generally exceed those of adding yet another medication after two failed trials.
Learn more about TMS therapyFrequently asked questions
Services that treat Treatment-Resistant Depression
Start with one conversation
Tell us what you've tried. We'll confirm eligibility, verify your benefits, and map out what treatment would look like.