Treatment-resistant depression (TRD) is a form of major depressive disorder that does not respond adequately to standard treatments, such as antidepressant medications or psychotherapy. When someone has TRD, they may continue to experience persistent symptoms of depression despite trying two or more different treatments at adequate doses and durations. This can lead to ongoing challenges with mood, energy, motivation, sleep, and daily functioning.

Possible approaches for managing TRD include:

1. Medication Adjustments: Switching to a different antidepressant or combining medications, sometimes with the addition of antipsychotics or mood stabilizers.

2. Psychotherapy: Intensive or alternative therapies, such as cognitive-behavioral therapy (CBT), which can offer different ways of addressing depressive symptoms

3. Lifestyle Interventions: Dietary changes, regular exercise, and mindfulness practices can also help improve mood and reduce stress.

TRD often requires a tailored, multi-faceted approach, with an emphasis on personalized care and close monitoring to identify which therapies may be most effective for each individual.