Treatment-Resistant Depression in West Hartford, CT: What It Means and What Comes Next

When depression has continued despite treatment, it is hard to know what to try next, and easy to conclude that nothing will work. Treatment-resistant depression has a definition, a careful review attached to it, and defined next steps. New Horizon Behavioral Health evaluates and treats adults with treatment-resistant depression in person at its West Hartford, Connecticut office.

What treatment-resistant depression means

Treatment-resistant depression, or TRD, commonly describes major depression that has not improved enough after at least two adequate antidepressant trials. An adequate trial considers the medication, the dose reached, how long it was taken, and whether it could be taken consistently. Many people say a medication "did not work" when what happened is that they took a starter dose for nine days, got a headache and stopped. Others stayed on something for years that only ever helped halfway. Sorting true non-response from an unfinished trial is the first job of the evaluation.

Why a careful review comes first

Persistent symptoms can have several explanations. The evaluation reviews the diagnosis itself, since bipolar depression treated as unipolar depression is one of the more consequential errors in psychiatry. It reviews side effects, other health conditions, sleep, substance use and access to treatment. An underactive thyroid, severe iron or vitamin D deficiency, and sleep apnea can all look like depression that refuses to lift. Where it makes sense, routine blood work is ordered or coordinated with your primary care doctor. None of this is about blaming you for treatments that did not help.

Signs you may recognize

• Depression continues despite previous treatment.
• Benefits have been partial or have not lasted.
• Side effects made medication difficult to continue.
• Daily tasks, sleep or relationships remain affected.
• You are unsure which treatments to consider next.

What comes next

Revisit the current plan. Depending on your history, options may include adjusting or changing medication, adding another medication, or revisiting the therapy approach. A new plan should include clear reasons and a date to review whether it is helping.

Consider Spravato. Spravato is esketamine nasal spray, FDA approved for treatment-resistant depression in adults, alone or with an oral antidepressant. It is given in a certified healthcare setting with at least two hours of monitoring after every dose. New Horizon provides it on site. Not everyone with TRD receives Spravato; an evaluation weighs benefits, risks, medical history and preferences.

Discuss other settings. Some people benefit from transcranial magnetic stimulation or electroconvulsive therapy. Those are different treatments with their own care settings. New Horizon does not provide them but will discuss whether an outside referral is appropriate.

Your first visit

About 60 minutes with a prescriber: what has been happening, how long, what you have tried, medical and family history, and what you want to be different. A list of past antidepressants with doses, approximate dates, side effects and any benefit is especially useful. Missing records do not need to stop you from reaching out. All visits are in person; the practice does not offer telehealth.

Questions people ask

Does this mean nothing will help? No. A lack of response to earlier treatment does not mean all options are exhausted.

Is Spravato the same as ketamine infusions? No. Spravato is a specific esketamine nasal spray with an FDA indication and a restricted safety program. IV ketamine is a different formulation and route.

Do I need a referral? No. You can request an appointment directly, and the office checks whether your plan requires a referral or authorization before you are scheduled.

Read more on the treatment-resistant depression page, or request an appointment.

New Horizon Behavioral Health
10 Princeton St, Ste N, West Hartford, CT 06110
Phone: (860) 838-8799
By appointment, Monday through Friday. In person only. Adults 18 and over.
In a crisis, call or text 988, or call 911.