What Is Treatment-Resistant Depression, and What Are My Options for Getting Better?

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What Is Treatment-Resistant Depression, and What Are My Options for Getting Better?

If you’re one of the 17.3 million Americans who suffer from a major depressive disorder, you’re no stranger to the sense of hopelessness. But if you’re also one of the 30-40% of those folks whose depression resists traditional treatments, you may have discovered a whole new dimension of hopelessness.

Take heart — there’s hope for treatment-resistant depression in the form of several evidence-based options. 

Dr. Karen Giles and our team at Breakthru Psychiatric Solutions in Sandy Springs, Georgia, specialize in treatment-resistant depression (TRD) and the life-changing therapies that can finally help you break free from TRD. 

Things you may not know about TRD

The name says it all, right? Treatment-resistant depression is depression that doesn’t respond to treatment. But there's more to it than that, and Dr. Giles, one of the leading experts in the field, is here to explain.

As an interventionist, Dr. Giles has dedicated her education and career to out-of-the-box healthcare. Rather than relying on status quo medical fixes, she explores beyond the standard treatment options and has become an expert in the art and science of alternative methods that have proven highly successful in treating depression.

For many people, antidepressants adequately control their depression symptoms. It may take a while to get the dose and medication right, but given time, this treatment approach is highly effective. 

For others, antidepressants never really work. The reason for this isn’t clearly known, but several theories exist. Here’s what we know about treatment-resistant depression.

Other health issues may be interfering

Battling depression is challenging, but if you’re also fighting other health issues, such as substance abuse, sleep problems, chronic pain, thyroid disease, or an eating disorder, your body’s defenses are divided, putting you at a greater risk for TRD.

Neurotransmitters may not be your problem

Depressive disorder usually involves low levels of neurotransmitters, such as norepinephrine and serotonin, which is why antidepressants that increase those levels are so effective. But if your depression stems from a different factor, traditional antidepressant treatments won’t work. 

Antidepressants are still the best first course of treatment

Don’t assume you have TRD simply because the first round of medication didn’t make a difference. Getting the dose and drug right takes time and patience; you may need a larger dose, a different drug, or more time under your belt. This is called medication optimization, and Dr. Giles excels at it. She even uses genetic testing to zero in on the best course of treatment for you.

If you’ve tried at least two different medications at therapeutic dosages for an adequate amount of time with no relief, you may have TRD.

You have many options for treating TRD

The good news is that medication isn’t the only viable treatment for depression. Dr. Giles specializes in evidence-based medications and non-drug alternatives to treat your treatment-resistant depression.

Hope for treatment-resistant depression

With a name like Breakthru Psychiatric Solutions, it’s no surprise that we offer innovative alternative treatments. Here are three effective options:

Ketamine therapy

Researchers have found that ketamine, used for many years as anesthesia, has mood-lifting properties. Given in controlled doses, ketamine can improve the symptoms of bipolar depression, depression with anxiety, and even treatment-resistant depression.

Dr. Giles administers ketamine intravenously. The treatment session lasts about an hour, and you can expect positive results in about three days.


A refined form of ketamine, Spravato is an FDA-approved nasal spray that helps with treatment-resistant depression by facilitating the formation of new synapses or connections in your brain tissue. Dr. Giles prescribes Spravato along with your other antidepressant medication, which means your insurance company may cover the treatment. 

Transcranial magnetic stimulation (TMS)

Another way to tackle TRD is to use transcranial magnetic stimulation to activate a part of the brain that is known to be inactive or malfunctioning in people with depression. 

TMS is noninvasive, painless, and uses no medication. A device made of electromagnetic coils creates a magnetic field, delivering pulses of energy that painlessless passes through  your skull and into a targeted location in the brain. This restores the normal brain circuitry for mood regulation and promotes the release of neurotransmitters

TMS therapy requires five sessions a week for about six weeks, and you can expect to notice mood improvement around week four.

To find out which of these options might be most helpful for your treatment-resistant depression, call us today or request an appointment using our online booking tool. There’s always hope for TRD.