When Treatment Isn’t Working: Understanding TRD

Many people find relief with therapy, medication, or both. But when these first-line treatments don’t work—or stop working—it can feel especially discouraging. If you’ve tried two or more antidepressants without meaningful improvement, you may be facing treatment-resistant depression (TRD). That doesn’t mean your depression is untreatable. It just means your brain may need a different kind of support. TRD can feel like a dead end, but we see it differently. It’s an invitation to take a broader, more individualized approach—one that goes beyond symptom checklists to truly understand your experience and explore what healing might look like for you.

TMS is currently FDA-approved for:

Depression Obsessive-compulsive disorder (OCD) Depression in adolescents (as a supplemental therapy) Smoking cessation Research also shows TMS can help with anxiety, PTSD, and other conditions.

At our clinic, we've observed similar success rates to those reported in clinical studies. Many of our patients experience substantial relief from depression symptoms that had previously not responded to medication or therapy alone. While individual results vary, TMS generally provides: Response rates of 50-60% (significant improvement in symptoms) Remission rates of 30-40% (minimal or no depression symptoms) Enhanced effects when combined with therapy or medication Most importantly, TMS offers renewed hope for many patients who had previously found little relief from traditional depression treatments. Our comprehensive assessment helps determine if TMS is likely to be beneficial for your specific situation.

Depression Treatment | Integrative Mind

Depression affects more than how we feel—it impacts how we live. For millions of people each year, major depressive disorder (MDD) doesn’t just show up as sadness. It can feel like a heavy fog, a loss of connection, or a slow, quiet numbness that makes it hard to show up in your own life.

At Integrative Mind, we know how isolating that can be. We work with people every day who are pushing through their routines—holding it together for family, showing up to work, going through the motions—while carrying a pain that isn’t visible from the outside. Depression can take many shapes: low energy, disrupted sleep, brain fog, irritability, hopelessness. It doesn’t always “look” like depression, but it hurts just the same.

When Treatment Isn’t Working: Understanding TRD
Many people find relief with therapy, medication, or both. But when these first-line treatments don’t work—or stop working—it can feel especially discouraging. If you’ve tried two or more antidepressants without meaningful improvement, you may be facing treatment-resistant depression (TRD).

That doesn’t mean your depression is untreatable. It just means your brain may need a different kind of support.

TRD can feel like a dead end, but we see it differently. It’s an invitation to take a broader, more individualized approach—one that goes beyond symptom checklists to truly understand your experience and explore what healing might look like for you.

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At Integrative Mind, we take a holistic approach to treating depression. That means we consider the whole person - your biology, psychology, relationships, lifestyle, and values - when exploring the best path forward.

We offer a thoughtful blend of evidence-based treatments, and we partner with each patient to co-create a care plan that feels aligned and empowering. For some, that might mean refining talk therapy or medication. For others, it might include movement, nutrition, or nervous system regulation. And for many, especially those facing TRD, it may involve exploring Transcranial Magnetic Stimulation (TMS).

Your TMS Treatment Options

What Happens During Treatment?

How Effective Is Deep TMS?

High response rates: A comprehensive analysis of 1,753 patients revealed that after 30 sessions of dTMS, 81.6% of patients experienced meaningful symptom improvement, with 65.3% achieving clinical remission.
Long-lasting benefits: Most patients who responded to treatment maintained their improvements over time, with benefits extending well beyond the treatment period.
Medication-resistant depression: For patients who haven't responded to multiple medication trials, TMS offers new hope. Multiple controlled studies show TMS significantly outperforms placebo treatment for people with treatment-resistant depression.
Effective for older adults: Research focusing on late-life depression found remission rates nearly three times higher with active dTMS compared to sham treatment (40.0% vs. 14.8%).

Real-World Outcomes
At our clinic, we've observed similar success rates to those reported in clinical studies. Many of our patients experience substantial relief from depression symptoms that had previously not responded to medication or therapy alone.
While individual results vary, TMS generally provides:

Response rates of 50-60% (significant improvement in symptoms)
Remission rates of 30-40% (minimal or no depression symptoms)
Enhanced effects when combined with therapy or medication

Most importantly, TMS offers renewed hope for many patients who had previously found little relief from traditional depression treatments. Our comprehensive assessment helps determine if TMS is likely to be beneficial for your specific situation.

At Integrative Mind, we believe that finances should never stand in the way of receiving effective mental health care. If insurance coverage is not available or high deductibles pose a barrier, we can still support you.

We offer flexible payment plans and financial assistance options. Our Financial Assistance Policy is designed to help eligible patients access Transcranial Magnetic Stimulation (TMS) treatment, even when insurance coverage is not available. We are committed to ensuring our process is fair, transparent, and compliant with all applicable laws and ethical standards.

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Free 10-minute Call

References
Tendler, A., Goerigk, S., Zibman, S., Ouaknine, S., Harmelech, T., Pell, G. S., ... & Roth, Y. (2023). Deep TMS H1 Coil treatment for depression: Results from a large post marketing data analysis. Psychiatry Research, 324, 115179.

Deep TMS H1 Coil Treatment for Depression: Results From a Large Post Marketing Data Analysis.

Hung, Y. Y., Yang, L. H., Stubbs, B., Li, D. J., Tseng, P. T., Yeh, T. C., ... & Chu, C. S. (2020). Efficacy and tolerability of deep transcranial magnetic stimulation for treatment-resistant depression: a systematic review and meta-analysis. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 99, 109850.

Efficacy and Tolerability of Deep Transcranial Magnetic Stimulation for Treatment-Resistant Depression: A Systematic Review and Meta-Analysis.

Levkovitz, Y., Isserles, M., Padberg, F., Lisanby, S. H., Bystritsky, A., Xia, G., ... & Zangen, A. (2015). Efficacy and safety of deep transcranial magnetic stimulation for major depression: a prospective multicenter randomized controlled trial. World Psychiatry, 14(1), 64-73.

Efficacy and Safety of Deep Transcranial Magnetic Stimulation for Major Depression: A Prospective Multicenter Randomized Controlled Trial.

Kaster, T. S., Daskalakis, Z. J., Noda, Y., Knyahnytska, Y., Downar, J., Rajji, T. K., ... & Blumberger, D. M. (2018). Efficacy, tolerability, and cognitive effects of deep transcranial magnetic stimulation for late-life depression: a prospective randomized controlled trial. Neuropsychopharmacology, 43(11), 2231-2238.

Efficacy, Tolerability, and Cognitive Effects of Deep Transcranial Magnetic Stimulation for Late-Life Depression: A Prospective Randomized Controlled Trial.