/ Treatment-resistant depression
Coral Gables · Telehealth across Florida
Nothing has worked. That doesn’t mean nothing will.
If you have tried more than one depression treatment and still feel stuck, you are not out of options. A careful evaluation can clarify what happened, what was never fully addressed, and what a more structured next step could look like.
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A clearer starting point
You did everything right.
You took the medication, waited, returned, and tried again. The next step should not be another guess.
Review each past medication, dose, duration, benefit, and side effect.
Clarify sleep, anxiety, attention, medical factors, and day-to-day function.
Build a written plan with specific checkpoints and reasons for each decision.
Recognition
Does this sound like you?
You kept functioning. People may not know how hard it has become. But sleep is off, the color has drained out of things, and ordinary responsibilities cost more energy than they should.
You took treatment seriously. You waited through the expected adjustment period. You returned when it did not help enough. Maybe the dose changed, another medicine was added, or therapy helped some but not enough.
That history is not proof that you cannot improve. It is useful clinical information. A complete evaluation looks at whether each trial was adequate, whether the diagnosis still fits, what symptoms remain, and which options have not yet been considered.
Review
What you tried and how long you tried it.
Measure
What changed in mood, sleep, focus, and function.
Plan
What deserves a different approach now.
Private self-check
Have you tried these?
This is not a diagnosis. It is a simple way to recognize when a more complete depression evaluation may be worth considering.
A measured process
What treatment looks like here.
The aim is not to rush toward a particular treatment. It is to build a clear record, explain the options, and know when to keep going or change course.
1
Evaluate
Review symptoms, previous diagnoses, medication trials, therapy, medical history, sleep, substance use, and current stressors.
2
Measure
Establish a baseline for mood, anxiety, sleep, focus, side effects, and the parts of daily life you want treatment to improve.
3
Treat
Discuss appropriate options, including medication strategies, psychotherapy coordination, and interventional treatment when indicated.
4
Adjust
Review progress at planned checkpoints. Keep what is helping, change what is not, and explain the reasoning behind the next step.
Coverage before surprises
Interventional treatment — covered by insurance.
Many patients use commercial insurance for psychiatric care. Benefits are verified before the first appointment so you can understand expected coverage and costs before moving forward.
We check first.
Coverage varies by plan and treatment. Verification is not a guarantee of payment, but it gives you a clearer picture before care begins.
Free coverage check
See if you’re covered.
Share only your contact and insurance information. Do not include medical details. The practice can verify benefits and follow up with the next step.
For the person reading at 2am
You don’t have to solve everything tonight.
If you are in immediate danger, call 911 or go to the nearest emergency department. For thoughts of suicide or self-harm, call or text 988. If you are safe enough to wait, one small decision can be enough for tonight: learn what an evaluation involves and return when you are ready.
Common questions
Clear answers before you begin.
An evaluation should reduce uncertainty, not add to it. These answers explain the starting process.
JB
Medically reviewed by Dr. Jay Borrego, DNP, PMHNP-BC, CRNA
Updated July 26, 2026 · Florida psychiatric practice information