Treatment-Resistant Depression
Treatment For When Relief Feels Out Of Reach
For some people, depression doesn’t respond to conventional treatment the way it should. Medications may create side effects. Therapy brings insight, but the deeper symptoms don’t go away. Even simple tasks begin to feel heavy or unmanageable.
If that sounds familiar, you're not alone—and you’re not out of options. Treatment-resistant depression (TRD) isn’t a dead end. It simply means your brain may need a different approach.
At Paxina Health, we specialize in helping people who haven’t found relief through traditional treatments. With interventional TRD therapy like TMS and SPRAVATO®, plus experienced psychiatric support, we help patients move forward when nothing else has worked.
What Is Treatment-Resistant Depression?
Treatment-resistant depression (or refractory depression) isn’t a separate diagnosis. It’s a term used when someone has tried at least two antidepressants without lasting improvement.
It doesn’t mean your depression is untreatable. It means your brain may not be responding to medication alone.
Many people with TRD have experiences like these:
You’ve tried multiple medications, but nothing sticks
One may have helped for a little while. Another came with side effects that felt worse than the symptoms. And now, you’re unsure what to try next.
Therapy helped… but only up to a point
Maybe you gained insight and skills but still feel stuck. You’re doing the work, but something deeper still isn’t shifting.
Your depression feels physical
It’s not just emotional. You feel heavy, foggy, or flat. Like your energy’s been drained. You may even feel numb—going through the motions without really being present.
You’ve started to wonder if it’s your fault
If you’ve ever questioned your effort or strength, we want to be clear. It’s not your fault. Treatment-resistant depression is a clinical condition, not a personal failure.
Common Symptoms of Treatment-Resistant Depression
Persistent Fatigue
You sleep, but you never truly feel rested.
Foggy Thinking
Concentration slips. Decisions feel harder than they should.
Low Motivation
You know what needs to get done, but you can’t access the energy or drive.
Emotional Flatness or Numbness
You’re not breaking down, but you’re not feeling much joy either. Everything feels muted.
Hopelessness or Disconnection
You feel distant from yourself, your purpose, or the people you care about
Not everyone fits the textbook picture of depression. Some people function well outwardly while feeling deeply stuck inside. However your symptoms appear, we meet you where you are.
Why Conventional Treatment Doesn’t Always Work
For many people, conventional treatments like antidepressants and talk therapy bring real relief. But that’s not the case for everyone.
If you’ve cycled through multiple medications or tried therapy without meaningful progress, it’s not because you’re doing something wrong. It may be because traditional treatments weren’t designed with your specific brain chemistry or experience in mind.
Some common challenges we see when conventional depression treatment is not working:
Partial Or Temporary Relief
The medication works at first—but the effect fades, or the symptoms shift. You find yourself stuck in a cycle of constant adjustments.
Unmanageable Side Effects
From fatigue and fog to emotional numbness, the side effects of medication sometimes feel just as limiting as the depression itself.
Talk Therapy That Doesn’t Go Deep Enough
Therapy can be powerful, but when it’s not paired with the right treatment plan or clinical support, it may feel like insight without change.
Oversimplified Treatment Plans
Too often, patients are given a cookie-cutter plan. At Paxina, we recognize that your situation is more complex—and your treatment should reflect that.
How Paxina Health Helps
At Paxina Health, we specialize in TRD therapy that goes beyond conventional care—especially for those with refractory depression who have tried first-line treatments without success.
Here are the primary ways we help:
TMS (Transcranial Magnetic Stimulation)
A non-invasive therapy that uses magnetic pulses to stimulate underactive areas of the brain involved in mood regulation.
- Appropriate for people who haven’t responded to medications
- No sedation, anesthesia, or daily pills
- Often considered an alternative to antidepressants or a powerful complement to them
- Covered by most insurance plans
SPRAVATO® (Esketamine for TRD)
An FDA-approved medication for treatment-resistant depression, administered in our clinic under supervision. Expected availability in March 2026.
- Works through a different pathway than traditional antidepressants
- May bring relief even when other medications have failed
- Especially helpful for those who feel emotionally numb, disconnected, or hopeless
General Psychiatry
Comprehensive psychiatric care that supports long-term recovery—not just symptom control. Expected availability in March 2026.
- Led by experienced psychiatrists who listen, explain, and adapt care to you
- Includes diagnostic assessments, medication management, and coordination with other treatments
- Designed to support healing across mind, body, and life context
What You Can Expect From Us
Living with treatment-resistant depression can feel isolating, especially if you’ve tried multiple treatments that didn’t help. At Paxina, our process is designed to be grounding, thoughtful, and collaborative.
A Thorough Evaluation
We start by understanding your full story—not just your symptoms. That means reviewing your treatment history, current challenges, and goals. Every decision stems from a deep understanding of who you are.
A Tailored Treatment Plan
There’s no one-size-fits-all path. Depending on your needs, we may recommend TMS, SPRAVATO®, medication adjustments, or a combination of TRD therapies. We’ll walk through every option together so you feel informed and confident.
Flexible By Design
Your needs can change. Your treatment should too. We reassess regularly and adjust your plan when your symptoms, goals, or life circumstances shift.
Whole-Person Oriented
We look beyond symptoms to understand the full picture. That includes how you’re functioning day to day, what’s affecting your stress level, how your relationships and environment factor in, and where you feel stuck. Our goal is to support your healing in practical, thoughtful ways.
Why Patients Trust
Paxina Health
Your Care Comes First
Too many interventional clinics are built around volume, not people. At Paxina, your care comes first. We never recommend treatments that aren’t right for you, and we never rush the process. Every decision, from the treatment approach to the pace of your care, comes back to one question: what is truly best for you?
You’ll Be Heard, Never Rushed
An Environment That Supports Healing
Physician-Led Treatment
Who We Are
Paxina Health was founded by psychiatrists Dr. Todd Young and Dr. Nicodemus Watts with a shared mission: to create a practice where patients are truly seen, heard, and cared for.
Here, recovery starts with compassion, grows with understanding, and evolves as your needs change.
Healing Starts Here
Wherever you are on your journey, Paxina is ready to help you heal the whole you. All you have to do is take the first step by reaching out.
