Understanding Treatment-Resistant Depression: How to Detect the Signs Early

Depression doesn’t always play fair. For many people, the right combination of therapy, lifestyle changes, and medication brings noticeable relief. But for others, even after trying multiple treatments, the cloud never seems to lift. If that sounds familiar, you might be dealing with treatment-resistant depression, or TRD.

TRD can be confusing, frustrating, and deeply isolating — but you’re not alone. Drew Pittman, PMHNP, offers virtual psychiatric care through Sound Psychiatry and Wellness to adults in Colorado, Ohio, Florida, and Massachusetts. The earlier we recognize the signs of TRD, the sooner we can develop a more effective plan.

Here, Drew explains what TRD is, how to spot it early, and how he can help you navigate it through personalized, compassionate telehealth care.

What is treatment-resistant depression?

Put simply, TRD is depression that doesn’t improve after trying at least two different antidepressants at adequate doses for a sufficient length of time. That means you've been consistent with treatment, and still, your symptoms linger — or even worsen.

Here’s what sets TRD apart from other types of depression:

• Symptoms don’t respond to typical first-line antidepressants
• You may feel emotionally numb or stuck despite “doing everything right”
• You might experience frequent medication changes with little to no relief
• The condition may impact your sleep, appetite, energy, and motivation in more extreme ways

It’s not just about mood — it’s about function. When depression continues to interfere with your ability to work, care for yourself, or maintain relationships, even with treatment, that’s a major red flag.

Early signs to watch for

Though we typically diagnose TRD after standard treatments haven’t worked, there are early signs that can help us and you spot it sooner. Recognizing these hints allows us to adjust our approach more quickly, thereby avoiding unnecessary frustration.

Keep an eye out for:

• Little or no relief after multiple medication trials
• Worsening symptoms even while on treatment
• Frequent feelings of hopelessness or emotional flatness
• Trouble concentrating or thinking clearly
• A growing sense that nothing is working, no matter what you try

If you’ve said things like, “I’ve tried everything,” or “I don’t feel like myself, even on meds,”—those are cues worth paying attention to.

How to get help through telepsychiatry

At Sound Psychiatry and Wellness, we specialize in helping clients identify and manage complex mental health challenges like TRD. Through telehealth services, Drew meets with you in the comfort of your own home, without the added stress of commuting or waiting in a doctor’s office.

Here’s what treatment can look like:

• A full psychiatric evaluation to understand your personal and medical history
• A review of what’s already been tried and what hasn’t been explored yet
• Thoughtful medication management with an eye toward newer or alternative options
• A personalized care plan that may include lifestyle support, therapy referrals, or additional interventions

The goal is more than just symptom relief—it’s helping you get back to feeling like you.

You’re not out of options

TRD doesn’t mean hopeless depression. It just means you need a different approach — and a provider who listens, adjusts, and stays with you through the ups and downs.

If you’re feeling stuck or overlooked in your mental health journey, call or go online to schedule a telehealth consultation with Drew at Sound Psychiatry and Wellness.