Understanding Treatment-Resistant Depression

While many individuals find relief from their depression symptoms through psychotherapy, medication, or a combination of both, some do not experience meaningful improvement from these standard treatments. When depression persists after trying multiple therapies, it is considered treatment-resistant depression (TRD). Understanding TRD and how to successfully treat it is a critical step toward reducing stigma and expanding hope for those living with it.

What Is Treatment-Resistant Depression?

Treatment-resistant depression is typically defined as major depressive disorder that does not respond adequately to at least two different antidepressant treatments. For some people, this resistance becomes apparent early, but for others it may develop gradually after years of partial or diminishing levels of symptom improvement.

Symptoms of TRD may include:

• Ongoing and persistent low mood or emotional numbness
• Fatigue or brain fog
• Loss of interest or pleasure
• Feelings of hopelessness or worthlessness
• Difficulty functioning at work, at school, or in relationships

Why Some Depression Is Harder to Treat

Depression involves multiple brain systems, including those related to mood regulation, stress response, inflammation, sleep, and cognition. Traditional antidepressants primarily target serotonin, norepinephrine, and dopamine levels, but this method doesn’t always work for everyone with depression.

Factors that may contribute to TRD include:

• Genetic differences affecting medication metabolism
• Co-occurring anxiety, PTSD, or substance use disorders
• Chronic stress, inflammation, or hormonal issues
• Medical illnesses, such as heart disease, gastrointestinal issues, or diabetes

Living With TRD

What makes TRD especially challenging is the emotional toll of trying various medications without experiencing significant results and feeling stuck, hopeless, and emotionally exhausted.

People living with TRD often face challenges such as:

• Emotional burnout from repeated treatment attempts and the disappointment that follows when each new medication or treatment type fails to yield positive results
• Self-doubt or self-blame, despite depression being a medical condition rather than a personal failure
• Feeling misunderstood or isolated, especially when others assume treatment should have worked by now
• Having difficulty staying motivated to continue trying treatments
• Grief over lost time or missed opportunities, which often increases symptoms of depression

Successfully treating TRD requires access to care that recognizes the complexity of the condition. With new innovative treatments, such as esketamine therapy, many individuals are experiencing new hope and finally finding relief.

How Esketamine Therapy Can Help

Esketamine is a groundbreaking, safe, and effective therapy that can provide relief from treatment-resistant depression. This self-administered FDA-approved nasal spray may improve symptoms for those with TRD even after the first session.

Benefits of esketamine therapy include:

• It provides rapid relief: Esketamine often begins to work immediately and continues to improve symptoms through the course of treatment.
• It’s one of the only therapies that’s effective for TRD: Esketamine is one of the only FDA-approved therapies that has consistently shown, in multiple studies, to improve symptoms for those with treatment-resistant depression.
• It helps combat long-term damage: Untreated depression causes excessive and continuous stress on the brain and body. Esketamine therapy works by repairing the damaged connections in the brain and reducing harmful effects.
• Side effects usually subside quickly: Most side effects of esketamine therapy are mild and subside within several hours after treatment.

SPRAVATO® at LiveWell Counseling

LiveWell Counseling now offers esketamine therapy with SPRAVATO® – the first and only FDA-approved nasal spray for adults with treatment-resistant depression. In our comfortable, calming lounge, clients can now self-administer the SPRAVATO® (esketamine) nasal spray under the supervision of our board-certified psychiatrists and nurses.

To learn more, please call (201) 848-5800 or visit our SPRAVATO® page. This innovative treatment is covered by most insurance providers.