Depression Evaluation • Frisco, Texas

Depression Not Getting Better? What to Do When Treatment Isn’t Working

You have taken the medication. You have gone to appointments. Maybe you have tried therapy or changed medications. But you are still depressed, or only a little better.

When depression is not getting better, it does not automatically mean you are out of options. If your depression still is not improving, a psychiatric evaluation can help look at why and what treatment options may make sense next.

Schedule a Depression Evaluation Call 972-905-9435

Medication safety: Do not stop an antidepressant or change your dose on your own. Talk with your prescribing clinician first.

How Do I Know If My Depression Treatment Isn’t Working?

Depression treatment may not be working well enough if symptoms continue to affect your daily life after an appropriate period of treatment. Treatment response is not always all-or-nothing.

Symptoms that may continue

Persistent sadness or low mood
Loss of interest or pleasure
Low energy or motivation
Sleep or appetite changes
Trouble concentrating
Difficulty managing work, relationships, or everyday responsibilities

Sometimes treatment helps but not enough

You may be sleeping better but still have very little energy. Your mood may improve while motivation or concentration remains poor.

Clinicians call this a partial response. It means some symptoms have improved, but important symptoms remain.

Your provider may look at how much you have improved, which symptoms remain, side effects, daily functioning, and how long you have received treatment.

Woman experiencing ongoing depression symptoms while considering next treatment steps

Why Isn’t My Depression Getting Better?

There is no single explanation. Depression treatment may need to be reviewed for several different reasons. A psychiatric provider may look at your diagnosis, medication history, physical health, sleep, stress, therapy, and other factors.

Treatment timing or dose

Your clinician may review whether the medication has been taken long enough and whether the dose and length of treatment were appropriate.

Partial response

A medication may be helping somewhat without providing enough improvement in your symptoms or daily functioning.

Side effects

Side effects can sometimes make it difficult to continue a medication or use a dose that might otherwise be considered.

Other contributing factors

Other mental-health conditions, medical problems, sleep issues, substances, medications, stress, and major life events may affect depression symptoms.

My Antidepressant Isn’t Working - What Should I Do?

If your antidepressant does not seem to be helping enough, contact the clinician who manages your treatment rather than stopping the medication yourself.

Your provider may review:

Which medication you are taking
Your current dose
How long you have taken it
Whether doses have been missed
Which symptoms have improved
Which symptoms remain
Any side effects
Previous medications and how you responded
Therapy or other treatments you have tried
Other medications or supplements
Relevant medical and mental-health history

The next step depends on what that review shows.

Depression Still Not Improving?

A psychiatric evaluation can help clarify what may be affecting your response to treatment and what options may be appropriate next.

Schedule an Evaluation

How Long Does It Take to Know Whether Depression Treatment Is Working?

Antidepressants often take several weeks before their full effect can be judged. The exact timing depends on the medication, dose, symptoms, side effects, and your individual response.

Regular follow-up is important. It gives your clinician a chance to compare your symptoms, daily functioning, and side effects over time.

If you think your medication is not helping, you do not need to decide on your own whether you should keep waiting. Contact your clinician so your progress can be reviewed.

What Happens When the First Antidepressant Doesn’t Work?

One antidepressant not working does not automatically mean you have treatment-resistant depression.

People respond differently to antidepressants. A first medication may not provide enough improvement, may cause difficult side effects, or may simply not be the best fit.

Depending on your history, a clinician may consider:

Giving an appropriate treatment more time
Adjusting or optimizing the current treatment when appropriate
Switching to another antidepressant
Using a different medication strategy
Adding another treatment
Starting or coordinating psychotherapy
Reassessing the diagnosis
Looking for medical or psychiatric factors that may be affecting recovery

These decisions are based on your individual history and clinical evaluation.

What Happens After Two Antidepressants Don’t Work?

When depression has not improved enough after more than one appropriate antidepressant treatment, a more detailed review becomes especially important.

Your clinician may look closely at which medications you tried, the doses, how long you took them, whether you took them consistently, side effects, and whether you had any partial improvement.

For some adults, a history of depression that has not improved enough after adequate antidepressant treatment trials may lead to an evaluation for what clinicians call treatment-resistant depression.

That does not mean your depression cannot be treated. It means your clinician may need to consider a different treatment approach.

Could Something Else Be Affecting My Depression Treatment?

Yes. Ongoing depression symptoms can be more complicated than whether one medication worked.

During an evaluation, your provider may consider questions such as:

Is depression still the best explanation for the symptoms?
Were previous medication trials long enough and at appropriate doses?
Were side effects limiting treatment?
Are anxiety, trauma symptoms, bipolar symptoms, ADHD, or other psychiatric concerns present?
Could a medical condition be contributing?
Could another medication or substance be affecting mood?
Are sleep problems making symptoms harder to treat?
Are alcohol or other substances affecting symptoms?
Is major stress, grief, or another life situation affecting recovery?
Has psychotherapy been part of the treatment plan when appropriate?

This does not mean any one of these factors applies to you. The goal is to understand the full picture before deciding what should happen next.

When Does Depression Become “Treatment-Resistant”?

Treatment-resistant depression (TRD) is commonly used to describe depression that has not improved enough after at least two adequate antidepressant treatment trials.

An adequate treatment trial generally means the medication was taken at an appropriate dose for enough time to judge its effect. A clinician may also consider whether the medication was tolerated, taken as prescribed, and whether there was any partial improvement.

Determining whether you have treatment-resistant depression involves more than counting how many medications you have tried.

Your diagnosis, medication history, dose, treatment length, response, side effects, and other clinical factors may all need to be reviewed.

You should not diagnose yourself with TRD based on a webpage or medication count.

Learn more about treatment-resistant depression and available treatment pathways.

What Treatment Options May Be Considered When Depression Isn’t Improving?

The next treatment is not the same for everyone.

Depending on your evaluation, a clinician may consider options such as:

Optimizing an existing medication
Switching antidepressants
Changing medication strategies
Adding another medication or treatment
Psychotherapy or better coordination with a therapist
Addressing sleep, substance use, medical conditions, or other contributing factors
Advanced treatment options when clinically appropriate

Adding another medication or treatment to improve the response to an existing treatment is sometimes called augmentation.

The right approach depends on your symptoms, diagnosis, previous treatment, medical history, safety considerations, preferences, and other factors.

What Is Spravato, and When Might It Be Considered?

Some adults with treatment-resistant depression may have additional treatment options, including Spravato (esketamine).

Spravato is a prescription nasal spray approved for treatment-resistant depression in adults. For treatment-resistant depression, it may be used by itself or together with an oral antidepressant.

Spravato is given in a certified healthcare setting rather than taken home. Patients are monitored after treatment because of important safety risks.

Spravato is available through a special medication safety program called a Risk Evaluation and Mitigation Strategy, or REMS.

Spravato is not appropriate for everyone. Having depression that has not improved does not automatically mean you qualify for treatment.

A clinical evaluation is needed to review your diagnosis, previous treatments, medications, medical history, and safety considerations.

Learn about Spravato treatment in Frisco.

If you are already researching Spravato and want to learn more about evaluation: learn about a Spravato and treatment-resistant depression consultation.

What Happens During an Evaluation for Depression That Isn’t Improving?

The purpose of the evaluation is to understand what has happened so far before deciding what may make sense next.

Your current symptoms

Your provider may review which symptoms remain, how severe they are, and how they affect your daily life.

Your diagnosis

Your provider may consider whether depression remains the best explanation for your symptoms and whether other conditions should be evaluated.

Your treatment history

This may include previous medications, doses when known, treatment length, response, side effects, psychotherapy, and other treatments.

Your medical history

Relevant medical conditions, medications, sleep problems, substance use, and other health factors may also be reviewed.

You do not need to know whether you have treatment-resistant depression before scheduling an evaluation.

Talk With a Psychiatric Provider About Your Next Step

Depression Evaluation and Treatment in Frisco, TX

Wholesome Clinic provides psychiatric evaluation and depression care for adults in Frisco and nearby North Texas communities, including Plano, McKinney, Prosper, and surrounding areas.

Wholesome Clinic
7978 Preston Rd, Suite 804
Frisco, TX 75034
972-905-9435

If depression has continued despite treatment, you can start with an evaluation even if you do not know which type of treatment you need.

The purpose of the visit is to understand your symptoms and treatment history first—not to push you toward a specific medication or procedure.

Meet Your Provider

Stephanie Ukoha, DNP, FNP-BC, PMHNP-BC

Stephanie Ukoha is a dual-board-certified Family Nurse Practitioner and Psychiatric-Mental Health Nurse Practitioner.

Her psychiatric evaluations may include a review of depression symptoms, previous psychiatric treatment, medication history, response to past treatments, and relevant medical history.

When appropriate, she can also evaluate whether a patient’s history may be consistent with treatment-resistant depression and discuss additional treatment options based on the clinical evaluation.

Individual treatment recommendations vary.

Medical Review

Reviewed for clinical accuracy by Stephanie Ukoha, DNP, FNP-BC, PMHNP-BC.

Last reviewed: August 2026

Frequently Asked Questions

Why is my depression not getting better?

There can be many reasons. Your current treatment may not be providing enough benefit, or other medical, psychiatric, sleep, medication, substance-use, or life factors may be affecting your symptoms. A psychiatric evaluation can help determine what needs closer attention.

What should I do if my antidepressant isn’t working?

Contact the clinician who manages your medication. Do not stop the medication or change your dose on your own. Your clinician can review the dose, treatment length, symptom response, side effects, and other factors before recommending a next step.

Can an antidepressant stop working?

Some people find that a medication that previously helped no longer seems to provide the same benefit. Returning symptoms can have several possible causes, so the change should be reviewed with a clinician.

What happens if one antidepressant doesn’t work?

Your clinician may review the medication and your diagnosis before considering next steps. Depending on your history, options may include adjusting treatment, switching medications, adding another treatment, psychotherapy, or addressing other factors that may be affecting your symptoms.

What happens if two antidepressants don’t work?

A more detailed treatment review may be appropriate. Your clinician may review whether previous medication trials were adequate and whether your history could be consistent with treatment-resistant depression.

Does trying several antidepressants mean I have treatment-resistant depression?

Not necessarily. Treatment-resistant depression involves more than counting medications. A clinician may need to review your diagnosis, medication doses, treatment length, response, side effects, and whether previous treatments were adequate.

What treatment options are available when depression medication isn’t working?

Options depend on your individual history. A clinician may consider medication adjustments, switching medications, adding another treatment, psychotherapy, addressing other contributing conditions, or advanced treatment options when clinically appropriate.

What is treatment-resistant depression?

Treatment-resistant depression generally describes depression that has not improved enough after adequate antidepressant treatment trials. It is commonly associated with inadequate improvement after at least two appropriate treatment trials, but a clinician should review your full treatment history before determining whether the term applies to you.

When might Spravato be considered?

Spravato may be considered for certain adults with treatment-resistant depression after a clinical evaluation. Whether it is appropriate depends on your diagnosis, treatment history, medical history, medications, and safety considerations.

Do I have to try multiple antidepressants before Spravato?

Spravato is approved for adults with treatment-resistant depression. Treatment-resistant depression commonly involves depression that has not improved enough after adequate antidepressant treatment trials, but your full treatment history needs to be reviewed by a clinician. Insurance plans may also have their own coverage requirements.

Can I schedule an evaluation if I don’t know whether I have treatment-resistant depression?

Yes. You do not need to diagnose yourself before scheduling. The evaluation can begin with your current symptoms, previous treatments, medication history, and other factors that may be affecting your depression.

Ready to Find Out What Your Next Step Could Be?

If you have followed a depression treatment plan but still do not feel well enough, the next step can begin with a careful review of what you have already tried.

You do not need to know whether you have treatment-resistant depression. You also do not need to decide whether you want Spravato before scheduling.

Start with what you already know: your depression is not getting better enough.

A psychiatric evaluation can help determine what may be contributing to your symptoms and what treatment options may be appropriate for you.

Schedule an Evaluation Call 972-905-9435