treatment-resistant depression (TRD)

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trd

Resistant depression, also known as treatment-resistant depression (TRD), is a type of depression that does not respond to conventional treatments such as antidepressant medication, psychotherapy, or a combination of both. It is estimated that around one-third of people with depression experience TRD.


There are several reasons why depression may become resistant to treatment. One possibility is that the underlying causes of the depression are not well understood, making it difficult to target the appropriate treatment. Additionally, there may be genetic, environmental, or lifestyle factors that contribute to the resistance of depression.

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symptoms of

TRD

The symptoms of treatment-resistant depression (TRD) are similar to those of depression in general. These may include:



  • Persistent feelings of sadness, hopelessness, or emptiness
  • Loss of interest in activities that were once enjoyable
  • Changes in appetite and/or weight
  • Sleep disturbances (insomnia or oversleeping)
  • Fatigue or loss of energy
  • Feelings of worthlessness or guilt
  • Difficulty concentrating or making decisions
  • Physical symptoms such as headaches, stomachaches, or other unexplained aches and pains
  • Suicidal thoughts or behaviors
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The Blue Umbrella Psychiatry Program

Your initial evaluation begins with a thorough assessment. We’ll learn about your current symptoms and lifestyle and your personal and family medical history. We’ll discuss what efforts you’ve already tried, from medications to alternative medical approaches toward resolving your symptoms. If a diagnosis of depression is made, we’ll discuss evidence-based treatment options with you. We’ll work together to customize a treatment plan to relieve your symptoms and restore your quality of life. If necessary, you’ll be prescribed medication to regulate your brain chemistry and your mood. As your depression symptoms subside, you have more mental clarity and space to focus on exploring and resolving any underlying issues that contribute to your depression in therapy.

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medication management

While not all patients will be prescribed medication, today's psychiatric medications have been a key piece to most of our patients' health improvements. Our medical team will work individually with you to create a treatment plan for your situation, with a goal to help achieve a successful improvement to mental health challenges and an optimal lifestyle. Ideal medication management requires an accurate diagnosis, beginning with a Blue Umbrella Psychiatry comprehensive assessment.


Once you've been prescribed medication we'll work with you to monitor for effectiveness, as well as side effects making adjustments to your treatment as necessary. Some medications take weeks to witness an impact, as with antidepressants, while those that are used to treat anxiety may begin to have an effect after only hours. 


Importantly, medication management is just one piece of the puzzle. Complementary therapy sessions with your Blue Umbrella therapist - or your own therapist - will optimize your mental health and your ability to enjoy your life. 


Should medication prove to not be effective, we can offer patients both Transcranial Magnetic Stimulation (TMS) and Esketamine treatments.

TMS or transcranial magnetic stimulation

TMS is an FDA-approved treatment that uses magnetic pulses to stimulate the root of depression in the brain. It is safe, highly effective and covered by most insurance. Click to learn more about the benefits of TMS or schedule an evaluation to see if it’s right for you. 

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spravato (esketamine)

Spravato is a prescription nasal spray that treats treatment resistant depression and helps diminish symptoms of depression. This nasal spray is for adults of 18 years or older and is administered in our office under careful supervision and usually in tandem with therapeutic counseling. 

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Individual Therapy

Individual therapy, also known as psychotherapy or counseling, is a crucial and effective form of mental health support that focuses on the needs of a single individual. It offers a safe and confidential space where a person can work closely with a trained therapist or counselor to explore their thoughts, emotions, behaviors, and challenges. The importance of individual therapy lies in several key aspects, including:


  • Personalized Attention
  • Confidentiality
  • Targeted Problem-solving
  • Emotional Support
  • Self-Discovery and Insight
  • Building Coping Skills
  • Resolving Trauma
  • Enhancing Relationships
  • Mental Health Maintenance
  • Empowerment and Growth


In order for sustained and profound change to occur, you must work with the psychological, social and cultural aspects of life as well. We offer collaborative and evidence-based care for children, adolescents and adults to create a meaningful life.

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family therapy

Each of our therapists is trained in facilitating family therapy sessions. Goals include improving communication, developing and maintaining healthy boundaries and promoting problem solving behaviors. Each family has its own unique family dynamics and our team will help you to understand current dynamics and move toward an optimal cohesion for improved day to day life and a brighter outlook for the future for each family member, especially for those with mental illness. The main focus is on understanding the family dynamics and communication patterns to improve overall functioning and well-being. The benefits of family therapy include:


  • Improved Communication
  • Strengthened Relationships
  • Enhanced Problem-Solving Skills
  • Family Bonding
  • Resolving Family Conflicts
  • Improved Coping Strategies
  • Addressing Family Changes
  • Understanding Family Patterns
  • Support for Specific Issues
  • Inclusive Approach
  • Prevention of Relapse


Overall, family therapy offers a comprehensive and systemic approach to understanding and addressing family challenges. By improving communication, resolving conflicts, and fostering a supportive environment, family therapy can lead to positive and lasting changes that benefit all family members.

group therapy

You are not alone in your struggles. Blue Umbrella Psychiatry has multiple group therapy programs to allow you to build relationships, find common ground and experiment with new ways of living life.


Group therapy is a valuable and effective form of therapeutic intervention that involves a small group of individuals working together under the guidance of a trained therapist or counselor. The importance of group therapy lies in its unique benefits and outcomes, which complement and sometimes surpass those of individual therapy. Here are some key aspects of its significance:


  • Shared Support and Understanding
  • Normalization of Experiences
  • Feedback and Perspective
  • Social Skills Development
  • Empowerment and Encouragement
  • Cost-Effectiveness
  • Diversity and Inclusivity
  • Real-life Simulation
  • Generalization of Skills
  • Long-lasting Support Network


Overall, group therapy offers a dynamic and enriching experience that complements individual therapy and can lead to significant personal growth and positive change. The combination of shared support, diverse perspectives, and the opportunity for social skills development makes group therapy a valuable and impactful approach to promoting mental health and well-being.


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frequently asked questions

  • Why should I choose Blue Umbrella Psychiatry?

    If you are like many of our patients, you’ve been frustrated with previous psychiatry services and unable to find meaningful or lasting relief from symptoms that make life unpleasant. All of that is about to change.


    Dr. Eric Robbins founded Blue Umbrella Psychiatry after years of working in a fragmented and uncompassionate mental healthcare industry. He noted that patients aligning with disconnected physicians and therapists led to poor communication, mixed messages, and ineffective care. Blue Umbrella Psychiatry was formed to offer all mental health services under one roof, with providers collaborating and patients caring for the whole person.


    If you are looking for a psychiatry service provider who truly cares, then look no further than Blue Umbrella Psychiatry.

  • What conditions do you treat?

    We treat many conditions, such as:

    • Adolescent Mood Disorders
    • Anxiety
    • Bipolar Disorder
    • Depression
    • Treatment Resistant Depression
    • Obsessive Compulsive Disorder
    • ADHD

    and more!

  • How can I contact you?

  • What insurances do you accept?

    We currently accept:

    • Aetna
    • Medicare
    • Memorial Healthcare System
    • Optum
    • UMR
    • Cigna
    • United Healthcare
    • Oscar
    • Meritian
    • Avmed
    • Humana
    • Evernorth
    • Florida Blue

  • I don't want to be on medication. Can I still be a patient of the practice?

    We understand that medications can be stigmatizing and may have potential side effects, and we respect our patients' preferences regarding their treatment. While our providers may recommend medications as part of a comprehensive treatment plan, the final decision is always up to you.


    In addition to medication, we offer a range of non-medicinal treatment options to support your mental health journey, such as Transcranial Magnetic Stimulation (TMS) and various therapy modalities. Our primary goal is to help you achieve better mental health and wellbeing, and we will work closely with you to develop a personalized treatment plan that aligns with your preferences and needs.

  • What will the first appointment look like?

    At the first appointment, you can expect to meet with at least one clinician who will perform a thorough evaluation. Following this assessment, a diagnosis will be provided along with a personalized treatment plan to address your specific needs.

  • To what extent are parents involved in their child's care?

    A family-centered approach to treatment is something we believe in at Blue Umbrella Psychiatry. Parents play a crucial part in their child's care, and the success of the situation depends on their active participation. Beginning with a first evaluation when they offer significant insights, we appreciate parents as partners. We create individualized treatment programs together and provide chances for both group and individual therapy sessions. We also give parents the information and assistance they need to support the mental health of their children. Continuous cooperation and communication make sure that parents are aware of and involved in the process. We stand out because of our dedication to family participation and our understanding of the importance of a nurturing home environment for a child's well-being.

  • What is the difference between psychiatry and therapy?

    Psychiatry and therapy are two ways of addressing mental health issues, but they differ in their approach, focus, and the professionals involved. Psychiatry involves using medications and medical treatments to manage mental health conditions. Therapy, on the other hand, focuses on talking and problem-solving techniques to help individuals cope with emotional or behavioral issues. Psychiatrists are medical doctors who have completed medical school followed by years of specialized training in psychiatry. Psychiatric Nurse Practitioners and Psychiatrists can prescribe medications. Therapists include various professionals like psychologists, licensed clinical social workers, or licensed professional counselors, who have different educational backgrounds and are trained in counseling and psychotherapy techniques. 

  • From what age and up do you treat?

    At Blue Umbrella Psychiatry, we provide treatment for individuals from the age of 5 and above. We understand that mental health concerns can affect people of various age groups, and we are committed to addressing the needs of children, adolescents, and adults alike. Our expert team of specialists is experienced in dealing with individuals throughout all phases of development and adjusting our approaches accordingly. Whether it's assisting young children with behavioral challenges, supporting teenagers facing emotional difficulties, or providing care for adults navigating mental health issues, we strive to offer comprehensive and compassionate treatment. We want to provide effective assistance and foster well-being for people and families throughout their lifetimes, which is why we start providing services from age 5.

  • Are you a virtual or in-person practice?

    We are primarily an in-person clinic with the capability to do telehealth sessions on occasion on an as-needed basis. For the initial evaluation and subsequent follow-up sessions, you will need to be present for in-person sessions. As such we suggest that you be in close enough proximity to our clinic. 

Therapy