Living with depression can be difficult, especially when treatment isn’t providing the relief you hoped for. Sometimes, symptoms can continue even if you’ve tried 2 or more antidepressant treatments of adequate dose and duration. This is a condition known as TRD.1 If that sounds familiar, know that you’re not alone, and it’s something you can talk about with your healthcare provider.
TRD is more common than you might think. About 1 in 3 adults diagnosed with major depressive disorder are considered treatment resistant.2
If your symptoms are still affecting your life despite antidepressant treatments, you haven’t done anything wrong. It may simply mean the treatments you’ve tried aren’t the right fit, and it could be time for a different conversation with your healthcare provider.
There’s more than one way to approach depression treatment.
Depression is complex, and treatments don’t all work in the same way.3 While many traditional antidepressants target brain chemicals such as serotonin or norepinephrine,3 other brain pathways, like glutamate and GABA, may also play a role in depression. For people living with TRD, treatments that work differently may offer another option. It’s important to discuss these options with a healthcare provider.
It can be hard to say, “This still isn’t working.”
Another appointment. Another medication. More waiting to see if things will change. When treatment still doesn’t bring the relief you hoped for, it can be easy to feel discouraged or start wondering whether anything will help.
You may find yourself thinking:
Maybe this is as good as it gets.”
Maybe nothing is going to work for me.”
Maybe ‘fine’ is the best I can hope for.”
Maybe I’m supposed to just live with this.”
“Many people assume they should just accept lingering symptoms of depression, but that’s not always the case. If something still doesn’t feel right, trust that feeling. What you’re experiencing matters, and talking about it can be an important step toward finding the support you need.”
Jessi Gold, MD, MS
How should I talk to my doctor about TRD?
You don’t need the perfect words to start the conversation. Start with what you know: what you’ve tried, what’s changed or hasn’t, and how depression is still affecting your life.
Start with what’s still happening
You might say:
I keep waiting to feel better, but I don’t feel like things are changing.”
I don’t want to keep saying I’m fine when I’m still struggling.”
I’ve tried treatments, but my symptoms are still here.”
I don’t feel like this treatment is working enough for me.”
Ask open questions
You might say:
Could what I’m experiencing be treatment-resistant depression?”
What does it mean if my symptoms continue after trying multiple treatments?”
What other options are available if traditional antidepressants haven’t worked for me?”
Keep a simple treatment history
Writing down which treatments you’ve tried, how long you’ve tried them, and whether they’ve brought meaningful relief can help your healthcare provider understand your experience and guide the conversation.
Learn more
Explore treatment options for TRD.
You don’t have to
settle for “fine” when treatment isn’t working.
If you’re still experiencing depression symptoms after trying multiple treatments, your experience deserves to be heard. Learning about TRD can help you better understand what you’re experiencing and start a conversation with your healthcare provider about what may come next.
References
- Gaynes BN, et al. Definition of treatment-resistant depression in the Medicare population. Agency for Healthcare Research and Quality (AHRQ). February 9, 2018.
- Rush AJ, Trivedi MH, Wisniewski SR, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry. 2006;163(11):1905-1917. doi:10.1176/ajp.2006.163.11.1905
- Sheffler ZM, Patel P, Abdijadid S. Antidepressants. In: StatPearls. Treasure Island (FL): StatPearls Publishing; July 15, 2026. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538182/
