Depression can affect a person once or multiple times throughout their life. Fortunately, the majority of these episodes are mild to moderate and can be successfully treated with talk therapy and/or medications.

Unfortunately, there is still a sizable group of depression sufferers who do not respond to medication or talk therapy.

These people have a more severe form of depression called treatment-resistant depression and may require more advanced treatment options, such as electroconvulsive therapy (ECT)vagus nerve stimulation (VNS)transcranial magnetic stimulation (TMS), or even deep brain stimulation (DBS).

First steps

If you’ve tried multiple medications, talk therapy and feel as if you’ve tried everything to relieve your depression, we offer help for patients currently seeing a primary care provider or psychiatrist for their depression treatment. Referrals are required.

In addition to psychiatrist- or primary care-referred patients, anyone with depressive symptoms may self-refer to our clinic for transcranial magnetic stimulation (TMS), a non-invasive brain stimulation therapy that uses briefly pulsed, powerful magnetic fields to induce focused electrical currents in the brain, depolarizing brain cells.

Before you arrive

Once you have an appointment, you will be asked to forward your complete psychiatric medical record in advance of your visit so we have plenty of time to review. Our physicians will carefully go through it to see which treatments have been attempted, what response was, which treatments have not been tried and which would be best as the next step.

It is important that we know the full history of your depression to determine treatment. This includes the details of all of the medication you have used, when and for how long you took them, what the dosages were and how well they worked for you.

Your appointment

Initial visits last several hours. At your appointment, you will speak with our team of doctors about the details of your past depression treatment and how your depression and mental status are currently. A short physical exam will be performed and there will be a series of tests to assess your depression. After this evaluation, the doctors will meet to discuss your condition.

At the end of the visit, the doctors will speak with you about the best treatment option for you. This recommendation, along with details of your appointment and guidelines for moving forward, will be sent to your referring psychiatrist or primary care physician and your Washington University psychiatrist will work with them to set up an action plan.