Goldstone Psychiatry & Neuromodulation Center
Goldstone
Psychiatry & Neuromodulation Center
Treatment-Resistant Depression Consultations
When Depression Hasn't Improved
If you’ve tried everything, you haven’t run out of options — you’ve just run out of the standard ones.
Treatment-resistant depression is exhausting in a particular way. Each new medication brings hope, then disappointment. After a while, the hope starts to feel risky.
A treatment-resistant depression consultation at Goldstone is for people who have been through that cycle — and want a deeper look at what’s been missed and what may still help.
What "treatment-resistant" actually means
Generally, depression is called treatment-resistant when it hasn’t responded to two or more antidepressants tried at the right dose for the right length of time.
But not all stuck depression is truly resistant. Sometimes it’s depression with a missed bipolar component. Sometimes it’s depression sitting on top of untreated trauma, ADHD, or sleep loss. Sometimes the medication trials weren’t long enough, or the right dose was never reached.
The first job of this consultation is to figure out which it is.
What we look at
During your consultation, we’ll go through your story carefully:
- Every medication you’ve tried — what dose, how long, how it felt
- How your symptoms have evolved over time
- Whether there’s an undetected condition complicating recovery
- Sleep, hormones, thyroid, pain, and other medical contributors
- Therapy history and what kind has actually fit
- Where you are now, and what would feel like progress
Where the plan might go
Most treatment-resistant depression has a path forward — it just often isn’t the obvious one. Depending on what we find, your plan may involve:
- Medication optimization — refining the regimen you have, not just stacking more on top
- Diagnostic refinement — treating the actual condition, not just the surface symptoms
- Therapy that fits — matching modality to the real driver
- Sleep and medical optimization — often the unsung hero of recovery
✦ Coming Soon
As Goldstone expands its neuromodulation program, your plan may also include TMS therapy, Spravato (esketamine), or ketamine therapy when standard care hasn’t been enough. We’ll be ready to bring these advanced options in the months ahead.
After your evaluation
By the end of your visit, you’ll leave with a clearer picture and a plan we’ve shaped together. Depending on what we find, that plan might include medication, therapy recommendations, lifestyle adjustments, lab work, or coordination with your other clinicians.
✦ Coming Soon
In the near future, our plans also include advanced options like TMS, Spravato (esketamine), and ketamine therapy — coming to Goldstone as we expand our neuromodulation services.
Who this is for
This consultation tends to fit if you:
- Have tried two or more antidepressants without meaningful relief
- Feel only partially better despite ongoing treatment
- Keep cycling through depressive episodes
- Aren’t sure your current diagnosis is the whole picture
- Want a second perspective before any major medication changes
- Are interested in advanced treatments as they become available
Common questions
How is this different from a regular psychiatric evaluation?
It goes deeper into your treatment history. We focus heavily on what’s been tried, how it went, and why standard approaches may not have worked — then we build a more strategic plan from there.
Will I have to switch psychiatrists if I do this?
No. Some patients use the consultation to inform care with their current clinician. Others continue with us. Either way works.
What records help most?
If you can bring a list of medications you’ve tried (with rough doses and durations), recent labs, and any prior psychiatric notes, we can move further in one visit.
Can this be done virtually?
Yes. The consultation works well by telehealth. If we recommend in-person follow-up, you can come to our in-person location.
Book a Treatment-Resistant Depression Consultation. We’ll take a careful look at what’s been tried, what may have been missed, and what comes next.
All Services
- Psychiatric Evaluation
- Treatment-Resistant Depression Consultations
- Medication Management
- Medication Simplification & Deprescribing
- Telepsychiatry
- Neuromodulation and Interventional Psychiatry Treatments
- Second-Opinion & Diagnostic Clarification
- Executive, Professional & Athlete Support
- First Responder & Healthcare Worker Support
- Military & Veterans Mental Health
- Burnout, Stress & Performance Optimization
- Young Adult GPS Program
- Retirement Transition Support
Contact Us
(832) 637-6403
(949) 890-1104
(832) 300-8990
info@goldstonepsychiatry.com
3120 Southwest Fwy, Ste. 617 Houston, TX 77098
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