Beyond Medication: A Fresh Approach to Treating Treatment Resistant Depression (TRD)
Medication can be life-changing for many people living with depression. Antidepressants can ease symptoms, restore balance, and make daily life feel more manageable. But what happens when medication isn’t enough?
This is the reality for people with treatment-resistant depression (TRD)—when symptoms persist despite trying different medications or combinations. In these moments, it’s not about giving up hope. It’s about looking at treatment from a fresh angle.
Why Skills Matter as Much as Medication
While medication targets brain chemistry, it doesn’t always teach us how to live with difficult emotions, cope with setbacks, or rebuild confidence. That’s where skills-based therapies step in.
Dialectical Behaviour Therapy (DBT) is one such approach. DBT provides practical coping tools for managing intense emotions, breaking out of self-defeating cycles, and handling stress without making things worse. Over time, these skills create space for hope and change.
Behavioural Activation is another powerful tool which is taught as part of the ABC skills. When depression tells you to withdraw, shut down, or give up, behavioural activation helps you set small, achievable goals. Step by step, these actions rebuild self-efficacy—helping you feel capable again. And as mastery grows, so does self-esteem.
What the Research Shows
Emerging research suggests that DBT is not just another therapy option—it may actually be more effective than some medication augmentation strategies for treatment-resistant depression. By targeting behaviour, emotion regulation, and resilience, DBT addresses what medication alone often can’t reach.
Your Next Step
If you’ve felt stuck—if medication hasn’t brought you the relief you hoped for—it might be time to try a new path. Skills training can give you back a sense of agency and control, even in the face of depression.
We’re opening enrolment for our next DBT skills group, starting 3 October. Spaces are limited, so if this resonates with you, I encourage you to book soon.
You don’t have to keep fighting the same battle the same way. A fresh approach is possible. And change is closer than you think.
By Dr Michelle Beukes-King
