Condition We Treat

Treatment-Resistant Depression Care in Portland, ME

When two or more medications haven't worked, it's not the end of the road.

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Understanding Treatment-Resistant Depression

What Is Treatment-Resistant Depression?

Treatment-resistant depression (TRD) describes major depression that has not improved after two or more adequate trials of antidepressant medication. It is common — and it is not a reflection of your effort or character. It simply means the standard approaches haven't reached the right targets in your brain.

This is the exact situation interventional psychiatry was built for. Spravato (esketamine) and TMS work through different mechanisms than traditional antidepressants, and they help many people who had stopped believing relief was possible.

Portland Mental Health & Psychiatry reception area in Portland, Maine
Our Portland, Maine clinic
Recognizing the Signs

Common Signs & Symptoms

Everyone is different, and this list is not exhaustive. A licensed clinician can provide an accurate evaluation.

By the Numbers

Treatment-Resistant Depression in Context

~30%

of people with depression meet criteria for treatment resistance

Days

many patients feel relief from Spravato within the first week

62%

of TRD patients reach remission with a full course of TMS

Sources: National Institute of Mental Health; peer-reviewed interventional psychiatry trials.

Types & Presentations

Interventional Options for TRD

Spravato (Esketamine)

What it is: An FDA-approved nasal spray for treatment-resistant depression, given in-office with monitoring.

Signs: For those who've failed two or more antidepressants; also approved for depression with suicidal ideation.

How we treat it: Administered under supervision alongside an oral antidepressant.

TMS Therapy

What it is: Non-invasive magnetic stimulation of mood-regulating brain circuits.

Signs: For patients who prefer a medication-free, side-effect-sparing option.

How we treat it: 36 outpatient sessions over 6–9 weeks.

How We Help

Treatment for Treatment-Resistant Depression at Portland Mental Health & Psychiatry

Having every interventional option in one practice matters most for treatment-resistant depression. We can compare Spravato and TMS for your situation — and pivot between them without starting over somewhere new.

Primary Treatment

Spravato (Esketamine)

For treatment-resistant depression, we most often lead with Spravato (Esketamine). Explore how it works and whether it's right for you.

Learn About Spravato (Esketamine)

Other treatments we may combine or consider:

TMS Therapy Psychiatry & Medication Management
Our Approach

Evidence-Based Care

Our clinicians tailor proven approaches to your needs.

Spravato (esketamine)

rapid-acting, FDA-approved, and covered by most plans for TRD.

TMS therapy

durable, drug-free stimulation of depression circuits.

Coordinated psychiatry

expert medication optimization alongside interventional care.

Medication Management

Interventional treatments work best inside a well-managed medication plan. Our prescribers optimize your antidepressant regimen and coordinate it directly with your Spravato or TMS course.

Explore Psychiatry
Common Questions

Frequently Asked Questions

If you've tried two or more antidepressants at adequate doses and duration without sufficient relief, you likely meet criteria. We'll review your history to confirm and recommend options.
It depends on your history, urgency, insurance, and preferences. Because we offer both, we'll help you weigh them rather than fitting you to whatever one clinic happens to provide.
Yes — Spravato is FDA-approved for TRD and covered by most plans, Medicare, and MaineCare when criteria are met. We manage the authorization.
Yes, when properly supervised. Spravato is given in-office with monitoring; TMS is non-invasive with no systemic side effects.

References & Resources

Get Started

Ready to Try a Different Approach?

If antidepressants haven't been enough, interventional care may be the answer. Let's talk.

Request a Consultation Call (207) 910-6580