Treatment-Resistant Depression Care (Telehealth in Minnesota)

Depression that persists after multiple medication trials is common—and it often signals that the diagnosis, contributing factors, medication history, or treatment strategy needs a careful reset. I work with adults who have tried “the usual options” and want a methodical, evidence-based plan rather than another rapid medication change.

What this work emphasizes

• A structured review of past trials (dose, duration, adherence, side effects, interactions)

• Clarifying the type of depression (unipolar vs bipolar spectrum, trauma-related, ADHD/ASD-related burnout, substance/sleep factors)

• Identifying medical or iatrogenic contributors (sleep apnea risk, endocrine issues, medication-induced symptoms)

• A plan that balances effectiveness, tolerability, and functional recovery

You may be a good fit if you:

• Have persistent symptoms despite 2+ adequate antidepressant trials

• Have partial response with side effects or emotional blunting

• Suspect misdiagnosis (e.g., bipolar spectrum, OCD, ADHD, ASD-related overload)

• Want a psychiatrist who will take your medication history seriously and proceed deliberately

Comprehensive TRD consultation

• A detailed timeline of symptoms, treatments, and life context

• Review of prior medications and augmentation strategies

• A clear formulation + staged plan

Medication strategy (when appropriate)

• Simplifying regimens that are working against you

• Evidence-based augmentation (selected case-by-case)

• Monitoring for activation, cognitive effects, sexual side effects, and sleep disruption

Coordination and referrals (when appropriate)
When standard approaches aren’t enough, I can help you evaluate and coordinate referrals for advanced interventions (e.g., TMS, ketamine/esketamine clinics, ECT consultation), while keeping your overall plan coherent.

Note: This practice does not prescribe controlled substances.

What TRD care looks like here

• Fewer, better changes rather than frequent switches

• Decisions grounded in what you’ve already tried and what actually happened

• Tracking outcomes with function-focused targets (sleep, energy, cognition, work capacity)

If you’ve been told you’ve “run out of options,” the next step is often better problem-definition—not more trial-and-error. Schedule an initial consultation to review your history and map a plan.