Treatment-Resistant Depression (TRD)

Depression that persists despite treatment, requiring reassessment and tailored therapeutic approaches.

1) What it is

Treatment-resistant depression is when depressive symptoms continue despite trying standard treatments. It does not mean recovery is impossible, but that the treatment plan needs review.

2) What it feels like

  • “Nothing works.”
  • “I’m exhausted from trying.”

3) Common signs & symptoms

  • ongoing depression
  • low energy
  • numbness
  • sleep and appetite changes

4) Why it happens

  • untreated trauma
  • misdiagnosis
  • hormonal or physical factors
  • chronic stress
  • medication mismatch

5) Triggers

  • burnout
  • hopelessness
  • repeated treatment disappointment

6) What helps now

  • support basics
  • micro goals
  • track symptoms
  • reduce isolation

7) Daily self-help support

  • consistent routine
  • gentle expectations

8) Professional treatment options

  • GP review
  • specialist mental health referral
  • alternative therapy models
  • medication adjustments

9) Medication

Medication review or combinations may be needed, specialist-led.

10) Practical tips

  • needing review is not failure
  • persistence matters

11) When to seek urgent help

Urgent help if:

  • suicidal thoughts occur
  • functioning collapses

12) Where to get help (UK)

  • GP (request review)
  • NHS Talking Therapies
  • Samaritans 116 123 if unsafe