Treatment-Resistant Depression Treatment in [City], [State]

When You Have Tried More Than One Treatment and Still Do Not Feel Like Yourself

You took the medication. You gave it time. Maybe you tried another medication, talk therapy, or more than one approach. You kept showing up and doing what you were told, but depression continued to affect your energy, relationships, responsibilities, and ability to feel connected to your life.

It can be easy to conclude that nothing will help. It can be even easier to blame yourself.

You have not failed because previous treatment did not give you the relief you needed.

At [Clinic], we provide private, individualized care for adults with treatment-resistant depression in [City] and throughout [Region]. We begin by understanding what you are experiencing, what you have already tried, and which options may be clinically appropriate for you.

Understanding Treatment-Resistant Depression

Treatment-resistant depression generally refers to depression that has not improved sufficiently after at least two appropriate antidepressant treatment trials.

The exact determination depends on more than the number of medications you have tried. A clinician may also consider:

• The medications and doses used
• How long each treatment was taken
• Whether the medication was taken consistently
• How your symptoms responded
• Side effects that made treatment difficult to continue
• Other medical or mental health conditions that may be affecting your symptoms

Treatment resistance does not necessarily mean that a medication had no effect at all. You may have experienced:

• Little or no meaningful improvement
• Some improvement followed by returning symptoms
• Relief in one area while other symptoms remained
• Side effects that outweighed the benefits
• Repeated medication changes without enough progress
• Depression that continues to interfere with daily life

A careful psychiatric evaluation helps us understand your treatment history and determine what may make sense next.

How Treatment-Resistant Depression May Affect Daily Life

Treatment-resistant depression can affect far more than mood. It may shape how you think, move, sleep, work, connect with other people, and manage ordinary responsibilities.

You may experience:

• Persistent sadness, emptiness, or emotional numbness
• Loss of interest in people or activities that once mattered
• Low energy or a sense that basic tasks require too much effort
• Changes in sleep or appetite
• Difficulty concentrating, remembering, or making decisions
• Irritability, guilt, hopelessness, or harsh self-criticism
• Pulling away from family, friends, work, or daily routines
• Feeling physically present but emotionally disconnected

Some people continue meeting every obligation while struggling privately. You may still go to work, care for your family, and appear composed to everyone around you.

That does not make the depression less real.

Treatment Options for Treatment-Resistant Depression at [Clinic]

Treatment-resistant depression does not automatically point to one treatment. The right next step depends on your symptoms, previous care, medications, health history, goals, and individual clinical evaluation.

We provide several care options for eligible adults with treatment-resistant depression.

Psychiatric Evaluation

Every patient journey begins with a psychiatric evaluation.

We review your symptoms, psychiatric and medical history, current medications, previous treatment responses, substance use, and goals. This helps us understand what has and has not worked and whether another concern may be affecting your response to treatment.

You do not need to know which service to request before reaching out.

Medication Management

Medication Management may include reviewing your current prescriptions, discussing previous medications and responses, identifying side effects or remaining symptoms, and considering whether changes may be appropriate.

Another medication is not automatically the answer, but reviewing and adjusting the medication plan may still be an important part of care.

Do not stop or change psychiatric medication without guidance from the clinician who prescribes it.

Talk Therapy

Talk Therapy provides a private place to address the thoughts, emotions, behaviors, and experiences connected to depression.

Depending on your needs, care may draw from cognitive behavioral therapy, dialectical behavior therapy, or trauma-focused approaches. Talk Therapy may be used on its own or alongside medication or another clinically appropriate treatment.

Your current symptoms, goals, previous therapy experiences, and broader care plan can help determine whether talk therapy may still have a role in your care.

IV Ketamine Infusion Therapy

IV Ketamine Infusion Therapy is [Clinic]’s cornerstone interventional treatment. It may be considered for eligible adults with treatment-resistant depression.

Ketamine is FDA-approved as an anesthetic. Its use for depression and other mental health conditions is off-label.

Clinical research has found that some participants with treatment-resistant depression experienced changes in depressive symptoms within hours or days after IV ketamine. Individual responses vary, and no outcome or timeline can be promised.

[Clinic]’s standard induction series includes six medically supervised infusions over two to three weeks. Candidacy is determined through a psychiatric evaluation.

SPRAVATO®

SPRAVATO® is a prescription esketamine nasal spray that is FDA-approved for treatment-resistant depression in eligible adults, either alone or with an oral antidepressant.

SPRAVATO® is distinct from ketamine. It is self-administered under clinical supervision in a certified healthcare setting, followed by required monitoring.

Whether SPRAVATO® may be appropriate depends on your diagnosis, previous treatment, health history, current medications, and individual clinical evaluation.

Not every patient with treatment-resistant depression will be a candidate for IV ketamine or SPRAVATO®. We will discuss the benefits, limitations, and clinical considerations of the options that may apply to you.

How Care Begins

You do not need to know whether your depression officially meets a particular definition before reaching out.

Share as much as you can about:

• What you are experiencing now
• Treatments and medications you have tried
• What helped, what did not, and any side effects
• How depression is affecting your daily life
• What you hope will change

We use that information to develop individualized recommendations.

Sometimes the next step may be adjusting medication or beginning talk therapy. Sometimes an interventional treatment may be considered. Sometimes another concern needs to be addressed before moving forward.

Our goal is to identify a path that makes clinical sense for you, not to place every patient into the same treatment.

Frequently Asked Questions

What does treatment-resistant depression mean?

Treatment-resistant depression generally means that depression has not improved sufficiently after at least two appropriate antidepressant treatment trials.

The exact determination depends on factors such as which medications you received, the doses used, how long you took them, how consistently they were taken, your response, side effects, and whether other conditions may be contributing to your symptoms.

Does treatment-resistant depression mean nothing will work?

No. It means previous treatments have not provided enough improvement. It does not mean every possible approach has failed.

A psychiatric evaluation can help clarify what you have tried and whether Medication Management, talk therapy, IV Ketamine Infusion Therapy, SPRAVATO®, or another care pathway may be appropriate.

How is treatment-resistant depression different from severe depression?

Treatment resistance describes how depression has responded to previous antidepressant treatment. Severity describes the intensity of symptoms and how much they affect daily functioning.

Depression can be severe without being treatment-resistant. Treatment-resistant depression can also affect people in different ways. A clinical evaluation is needed to understand your individual situation.

Will I have to stop my current medication?

Do not stop or change medication on your own. We review your current prescriptions, previous responses, and health history before discussing whether any medication changes may be appropriate.

Is IV ketamine FDA-approved for treatment-resistant depression?

No. Ketamine is FDA-approved as an anesthetic. Its use for treatment-resistant depression and other mental health conditions is off-label.

IV ketamine may be considered for eligible adults after an individual psychiatric evaluation.

How do you determine whether IV ketamine or SPRAVATO® may be appropriate?

IV ketamine and SPRAVATO® have different clinical, regulatory, and treatment requirements.

Your psychiatric evaluation helps us consider your diagnosis, previous treatment, current medications, medical history, potential risks, and goals before recommending either option.

Will I receive IV ketamine or SPRAVATO® if I have treatment-resistant depression?

Not necessarily. A diagnosis does not guarantee eligibility for a particular service.

We recommend care based on your individual evaluation and what is clinically appropriate for you.

Can Talk Therapy still help if I have tried therapy before?

Previous therapy that did not provide enough relief does not mean every therapeutic approach or care plan will have the same result.

Your current symptoms, goals, previous therapy experiences, and broader care plan can help determine whether talk therapy may still be appropriate.

Start with a Psychiatric Evaluation

You do not need to prove that you have tried hard enough. You do not need to know which treatment should come next.

Tell us what you have been experiencing and what you have already tried. We will give you an honest assessment of which care options may be appropriate.

Medical Disclaimer

The information on this website is for general educational purposes only and is not a substitute for medical advice, diagnosis, or treatment. Ketamine is FDA-approved as an anesthetic, and its use for mental health conditions is off-label. The care that may be appropriate for you can only be determined through an individual clinical evaluation. Individual responses vary, and no specific outcome or treatment timeline is guaranteed.

Scientific Resources

1. Depression. National Institute of Mental Health.
2. Treatment-Resistant Depression: Definition, Prevalence, Detection, Management, and Investigational Interventions. World Psychiatry, 2023.
3. Antidepressant Efficacy of Ketamine in Treatment-Resistant Major Depression: A Two-Site Randomized Controlled Trial. American Journal of Psychiatry, 2013.
4. SPRAVATO® Prescribing Information. U.S. Food and Drug Administration, 2025.