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Best Fit Counseling & PsychiatryAnn Arbor, Michigan
Are We the Right Fit?
HomeConditionsTreatment-resistant depression
Have you tried treatment after treatment with little change?

Not responding to treatment does not mean you are out of options.

When standard treatment has not brought relief, we look beyond the usual approach and build a coordinated plan for what you need now.

View the Spravato® Plus Program Are We the Right Fit?

Signs Your Depression May Be Treatment-Resistant

  • You've tried two or more antidepressant medications without lasting relief
  • Symptoms improve briefly, then return
  • You've completed a course of therapy but still feel stuck
  • You're experiencing depression alongside suicidal thoughts

We specialize in helping people who haven't gotten better.

Why it happens

Why Standard Treatment Doesn't Work for Everyone

About 30% of people with depression go on to develop treatment resistance, and the exact cause isn't fully understood. Contributing factors researchers point to include chronic stress disrupting the body's stress-response system in ways that blunt treatment response, undiagnosed conditions like bipolar depression or thyroid issues, genetic differences in how a person processes medication, co-occurring anxiety or trauma, and, in some cases, medication that simply wasn't dosed or continued long enough to work. A "treatment-resistant" label describes how your depression has responded so far, not a permanent verdict.

More than one next step

The Full Range of Options Beyond a First Antidepressant

Augmentation

Adding a second medication rather than switching, such as an atypical antipsychotic or lithium, to boost your current treatment.

Spravato®

An FDA-approved nasal spray for treatment-resistant depression, used alongside an oral antidepressant, delivered here as part of a full program.

Learn more

TMS

Transcranial magnetic stimulation, a non-invasive option with strong evidence, generally tried before more intensive procedures.

ECT

Electroconvulsive therapy remains the most effective option for severe, treatment-resistant depression, especially with safety concerns.

Our approach

Spravato®, Delivered as Part of a Full Program

Rather than offering one more isolated treatment, we built a coordinated program: psychiatry, integration counseling, CBT-I, and lifestyle medicine, all built around Spravato® treatment.

Learn How Spravato® Works
Frequently asked questions

Treatment-Resistant Depression, Explained

No. It describes how your depression has responded to treatment so far, not a life sentence. Most people who don't respond to the first one or two medications do eventually find an effective combination. Each unsuccessful trial actually gives your care team useful information for what to try next.
Clinically, it means you've tried at least two different antidepressants, each at an adequate dose for an adequate length of time, typically six to eight weeks, without lasting relief. If that sounds like your experience, it's worth a fresh evaluation rather than trying a third similar medication on your own.
No. Augmentation strategies, TMS, and ECT are all legitimate options depending on your situation and severity. We'll walk through the full range with you. Spravato®, delivered through our Spravato® Plus program, is often a strong next step because of its rapid-acting effects and the strength of research behind it.
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There's More Than One Path Forward.

Request an appointment to find out which next step makes sense for you.

Are We the Right Fit?