Treatment Resistant Depression

Have you tried different treatments for depression but are still struggling? Whether your depression is mild or severe, treatment-resistant depression often produces additional feelings of frustration and hopelessness. Understandably, there may be a temptation to give up on treatment all together, but it is important to explore all of your options if there is a chance of treatment helping you lead a meaningful, worthwhile, and satisfying life.

If this is your first time struggling with depression and you have had no prior treatment, the odds are that you can expect a complete recovery (American Psychiatric Association, 2000). However, without appropriate treatment, about 20-30% of individuals who experience a major depressive episode continue to have some degree of impaired functioning or distress months to years longer than would be expected. For some individuals, symptoms can persist even after having tried various types of medication or therapy. The Depression Treatment Program at Portland Psychotherapy is designed to help people who have tried other treatments without success.

Medical doctors use the term “treatment resistant” depression when two or more medications have failed to relieve depressive symptoms. Typically, the initial medical response to this situation is to continue rotating through medications and to address other possible medical causes of the symptoms (e.g., respiratory problems). It is also possible that you have tried alternative medical treatments (e.g., electroconvulsive therapy, vagus nerve stimulation, transcranial magnetic stimulation) without achieving the desired effects. Likewise, you may have had limited success with psychotherapy if you are struggling with treatment-resistant depression. Clearly, treatment-resistant depression calls for specialized, high quality attention and care.


  • Was your care evidence based? For all their good intentions, not all health care providers deliver evidence-based treatments. There is literally no reason to expect a treatment to work if there has not been high quality research showing it to be effective. All therapy delivered at Portland Psychotherapy is evidence based.
  • Was your care substandard? Not all treatments are created equally. Even if there is some evidence that a particular treatment works, there may be other treatments you haven’t tried that have been shown to work even better. Furthermore, no treatment is one-size-fits all. The Depression Treatment Program at Portland Psychotherapy will provide you with access to the highest quality individual and group psychotherapy for depression, with an emphasis on meeting your unique treatment needs as an individual.
  • Was your care thorough? It’s likely that the depression you are facing touches many aspects of your life, and addressing problems in one area may not automatically lead to improvements in other areas. For example, masking difficult emotions with medications does not necessarily lead to finding a sense of meaning and purpose in life. The Depression Treatment Program helps you explore and consider your full experience in helping you make choices and move forward.
  • Was your care coordinated? You may be working with different organizations and providers in managing your health, and poor communication between these resources can have a negative impact on outcomes. As a part of your services with the Depression Treatment Program, we will be sure to communicate with your other providers to create a coordinated team that will insure your best possible overall treatment.