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About Treatment Resistant Depression (TRD)

Clinical depression can sometimes be difficult to treat. When a person has tried multiple types of treatment options to treat their depression (sometimes even with multiple professionals) over the course of months or even years, professionals may refer to the depression as “treatment resistant” or treatment-resistant depression (TRD). Treatment resistant depression is simply an episode of depression that resists typical treatments, such as psychotherapy or medications.

If treatment for your depression has not yet worked, don’t give up! Virtually all clinical depression is treatable, but it’s often a matter of finding the right type of treatment for each person. What this usually means is that it’s a matter of trial and error, working with a mental health professional to try different medications at different doses, or different types of psychotherapy strategies.

Traditional Treatments for Treatment Resistant Depression

Medications. Most antidepressants can take 6 to 8 weeks before a person will begin to feel their beneficial effects. This means that you may feel the side effects of the medication long before the clinical benefits of it. Hang in there, but if after 6 to 8 weeks, you still feel no less depression, it’s time to talk to your doctor again.

Doctors will typically try a strategy of increasing your dose, adding another medication, or changing your antidepressant medication altogether. Different doctors will implement different strategies. Research has shown that only 33 percent of people will respond to the initial medication they are prescribed. So hang in there, as you’re likely to be in that majority and need your doctor to look at adjusting your dose or medication.

In early 2009, Symbax (olanzapine and fluoxetine HCl capsules) was the first (and currently only) medication approved by the FDA for the acute treatment of treatment-resistant depression. Symbyax is a medication that combines long-acting Prozac with Zyprexa. Weight gain is one of the most common side effects of Symbyax.

Psychotherapy. Psychotherapy can also take time to work, although some people might feel the benefits of psychotherapy more immediately as it can work to address immediate life stressors or other problems.

Most psychotherapy for depression focuses on helping a person understand how their thoughts can impact their emotions and feelings of depression. It also seeks to help a person improve their interpersonal relationships and communication with others. If one form of psychotherapy seems unhelpful, you may need to work with your therapist on trying a different form.

About Treatment Resistant Depression (TRD)

John M. Grohol, Psy.D.

Dr. John Grohol is the founder of Psych Central. He is an author, researcher, and expert in mental health online, and has been writing about online behavior, mental health and psychology issues since 1995. Dr. Grohol has a Master's degree and doctorate in clinical psychology from Nova Southeastern University. Dr. Grohol sits on the editorial board of the journal Computers in Human Behavior and is a founding board member of the Society for Participatory Medicine. You can learn more about Dr. John Grohol here.

APA Reference
Grohol, J. (2018). About Treatment Resistant Depression (TRD). Psych Central. Retrieved on September 18, 2020, from
Scientifically Reviewed
Last updated: 8 Oct 2018 (Originally: 17 May 2016)
Last reviewed: By a member of our scientific advisory board on 8 Oct 2018
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