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What if you've tried everything, but are still depressed? Did you know that  one third of people with depression don’t get enough relief from antidepressants? In this episode, I talk to psychiatrist and CMO of Neuronetics, Dr. Geoffrey Grammer, about what should people do when our mainstream treatments for depression fails us. He sheds light on new advancements for treatment-resistant depression: transcranial magnetic stimulation (TMS) and nasal esketamine, two evidence-based treatments that target the brain differently and raise the odds after meds stall.

We first talk about just how disappointing traditional medications and psychotherapies can be for chronically depressed patients. Then, Dr. Grammer explains how TMS works (precise, noninvasive brain stimulation that strengthens underactive mood circuits), what a session feels like, timelines for improvement, and why side effects are minimal compared to systemic drugs. We also explore nasal esketamine (Spravato) and how it works. Along the way, we dig into augmentation meds, common pitfalls, and the role of psychotherapy in turning short-term gains into lasting change.

Real patient stories ground the science in hope: remission after years of struggle, renewed presence with family, and the hard-won confidence that life can feel different. If you’ve tried two antidepressants without clear progress or hate the side effects, your next step shouldn’t be “another pill” - it should be to advocate for yourself with your providers and explore these new options.

Resources:

• NeuroStar website: https://neurostar.com/
• NeuroStar's assessment quiz for depression: https://neurostar.com/self-assessment-for-depression/
• Find a doctor page: https://neurostar.com/enter-zip-code/?as=0
• Connect to Dr. Grammer on social:
  • https://www.instagram.com/NeuroStarAdvancedTMS/
  • https://www.facebook.com/NeuroStarAdvancedTMS/
  • https://www.youtube.com/user/NeuroStarTMSTherapy

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