What Are My Options If Therapy Doesn't Help My Depression?

Written by Neuro Wellness TMS Centers of AmericaMedically reviewed by Daniel Pietras, MDPublished November 3, 2026Last medically reviewed November 3, 2026Last updated November 3, 2026

If therapy alone hasn't provided adequate relief for your depression, there are additional options. Depression is often treated with a combination of psychotherapy and medication, and adding medication or a brain stimulation treatment may help. TMS and SAINT® are FDA-cleared magnetic brain stimulation treatments that work through a different mechanism than therapy or medication. SPRAVATO® (esketamine) is an FDA-approved nasal spray for treatment-resistant depression. A psychiatric evaluation can help determine which combination of treatments may be appropriate. Therapy often remains valuable alongside other treatments.

Key takeaways

Therapy alone may not be enough for moderate-to-severe depression.
Adding medication or brain stimulation may help.
TMS and SAINT® work through a different mechanism than therapy.
Therapy often remains valuable alongside other treatments.
A psychiatric evaluation guides the treatment plan.

Why Therapy Alone May Not Be Enough

Therapy can be ineffective for several reasons: the specific therapy type may not match your needs (CBT, psychodynamic, interpersonal, and behavioral activation all work differently), the therapist-client fit may not be right, therapy alone may be insufficient for moderate-to-severe depression, or an underlying condition (like bipolar disorder or a medical issue) may need different treatment. For moderate-to-severe depression, combining therapy with medication or other treatments is often more effective than therapy alone.

Options Beyond Therapy Alone

If therapy hasn't provided adequate relief, additional options include:

Antidepressant medication — often combined with therapy
TMS — FDA-cleared magnetic brain stimulation
SAINT® — FDA-cleared accelerated 5-day fMRI-guided TMS
SPRAVATO® — FDA-approved esketamine nasal spray
Combined treatment — therapy plus medication and/or brain stimulation

Therapy Still Has Value

Even if therapy alone hasn't been enough, therapy often remains valuable alongside other treatments. Combined treatment — therapy plus medication and/or brain stimulation — is often more effective than any single approach. A psychiatric evaluation can help determine the right combination for your situation.

Is it really SAINT®? 5 checks

Before you pay for any 5-day program advertised as SAINT®, confirm these five points.

1
Is the clinic listed on Magnus Medical's provider locator?
If a clinic isn't on the official Magnus Medical locator (magnusmedical.com), it is not a verified SAINT® provider. Magnus Medical locator
2
Do they do a brain MRI to personalize your target?
SAINT® requires a brain MRI to find your individual target. No scan = not SAINT®.
3
Which TMS machine and software do they use?
SAINT® runs only on the Magnus Medical system with its FDA-cleared targeting software.
4
Is the 5-day protocol FDA-cleared, or off-label?
Ask the clinic to state in writing whether their 5-day protocol is FDA-cleared or an off-label schedule.
5
Do they offer it to minors?
SAINT® is FDA-cleared for adults only. Be cautious if a clinic offers an accelerated course to a teen or child.

Watch & Learn

Understanding SAINT® TMS: How It Works & What to Expect

SAINT® is an FDA-cleared treatment for adults with major depressive disorder who have not improved on antidepressants in the current episode. These videos explain how it works and how it differs from conventional TMS.

SAINT® is an FDA-cleared, fMRI-guided form of TMS developed at Stanford. Most patients complete treatment in one week — not the six weeks standard TMS requires.

Follow a real patient through the five-day SAINT® treatment week

Is SAINT® TMS Right for You?

Tried antidepressants without enough relief? SAINT® TMS is an FDA-cleared, fMRI-guided treatment for adults with major depressive disorder who have not improved enough with antidepressant medication.

SAINT® uses a personalized brain target and delivers treatment over five consecutive days. It differs from standard TMS in its targeting approach, treatment schedule, and research background. In a small randomized trial, 11 of 14 people receiving active treatment reached remission at the four-week assessment, compared with 2 of 15 receiving sham treatment. Results vary, and a five-day treatment course does not guarantee remission in five days.

How SAINT® Works and How It Differs From Conventional TMS

SAINT® is an FDA-cleared treatment for adults with major depressive disorder who have not improved on antidepressants in the current episode. This video explains how it works, and how it differs from conventional TMS.

Conventional TMS usually means about 30 visits over 6 to 9 weeks. SAINT is five visits over five days.

What makes it different: SAINT is the only FDA-cleared depression treatment that uses an fMRI scan to personalize the stimulation target to your individual brain. A 45-minute scan maps your brain and identifies the specific circuit linked to depression. Treatment is then delivered as ten 10-minute sessions per day, with 50-minute breaks between them, across five consecutive days.

In clinical trials, 79% of participants reached remission, with an average of 2.6 days to remission. SAINT is generally well tolerated; the most common side effects reported were mild headache and temporary scalp discomfort at the treatment site.

SAINT® at Neuro Wellness TMS Centers of America

Coral Springs, Florida
Free benefits check · Self-pay options available
Call or Text: 954-827-9793

Sources: Cole et al., American Journal of Psychiatry 2020;177:716-726 and 2022;179(2):132-141. magnusmedical.com/depression-therapy. PubMed 34711062. FDA 510(k) K220177.

Insurance coverage for SAINT is currently limited and varies by plan. Individual results may vary. This video is educational and is not medical advice. Talk to a qualified clinician about whether SAINT is appropriate for you. If you are in crisis, call or text 988.