Treatment-Resistant Depression and Disorders: What is the Best Approach?

Updated: Dec 14, 2021

It can be frustrating, and disappointing, trying to get better but finding the treatment isn't

working like it is supposed to. It may be discouraging and scary to find yourself in this kind of situation, but don't despair and know that there are options. First, we have to define "treatment-resistant disorder".


Definitions for a treatment-resistant disorder may vary slightly by specific disorder, however, generally, it is when a condition isn't responding to the first or second lines of treatment as expected (partially or not as all). Typically, it is used in reference to disorders that use medication as one of the first lines of treatment, like depression, but many conditions may become treatment-resistant like, mood and anxiety disorders; substance use disorders; post-traumatic stress disorder (PTSD); and eating disorders. The resistance may be caused by a variety of different factors including genetics, age, gender, tolerance built up or just a misdiagnosis.


Next, how do you approach a treatment-resistant disorder? Depending on the disorder, commonly, treatment would include counselling, CBT (cognitive behavioural therapy) and increased medication. Although, studies have shown that it may be more beneficial to try another approach.


ISTDP (Intensive Short-Term Dynamic Psychotherapy), Direct Neurofeedback and EMDR (Eye Movement Desensitization and Reprocessing) Therapy can be preferable to the traditional approach to treatment-resistant disorders. In one study looking at Treatment-resistant depression specifically, nearly half of participants using ISTDP treatments had at least partial symptom remission, compared to just 8 percent of participants who were receiving "treatment as usual". These treatments may be more desirable compared to upping medication doses and have shown better results in terms of total symptom remission and partial symptom remission.


Every patient is different. At Nōmina Wellness, our highly skilled counsellors are very familiar with treating treatment-resistant disorders and can help you assess and decide which approach is best for you.

At Nomina, we specialize in treatment resistant disorders. Give us a call and see how we can help.


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