You’ve already tried the obvious things.
If medication and therapy haven't given you your life back, that's not a failure of effort. It's a signal that what you need is a different kind of evaluation — and a team that knows how to read it.
Treatment-resistant depression is a specific clinical condition. It means standard approaches — even good ones, properly applied — haven’t produced the result you need. It doesn’t mean you can’t get better. It means you need a different kind of care.
We start where most clinics don’t — with a qEEG brain map and a cognitive assessment that tell us what’s actually happening inside your brain, not just what you’re reporting. From there, we build a protocol around your specific findings. TMS if indicated. Psychiatry and psychotherapy from the same chart, with the same team. Measurement at every step.
We don’t offer a program and hope it fits. We find out what’s happening and address that.
If you've already tried the obvious — we start by measuring.
We don't begin with another medication trial. We begin with assessment: qEEG, neuropsych history, medication history, lab work. Then we design a protocol that fits the brain you actually have, not the average one.
TMS, neurofeedback, psychotherapy — designed to work together.
Most clinics offer one tool. We coordinate them. TMS is FDA-cleared for major depressive disorder and OCD. Neurofeedback and psychotherapy are paired with each phase, alongside careful psychiatric medication management.
We re-measure. Every 8 to 12 weeks.
If something isn't working, we see it and we change it. That sounds obvious. In most depression care, it isn't what happens — and that's why people get stuck.
Beyond mood — cognitive symptoms
Depression doesn’t only change how you feel.
Concentration. Memory. Processing speed. Decision-making. These cognitive symptoms are among the most disabling parts of depression — and among the most undertreated. They’re measurable, they’re real, and they often don’t resolve on their own even when mood improves.
Every patient at Siler Brain Clinics receives Digital Cognitive Testing alongside their mood assessment. We track cognitive function as part of every evaluation and treatment plan, because mood and cognition are inseparable — and both deserve to be treated.
The Depression Protocol
Designed for treatment-resistant cases.
A structured 12-week program: comprehensive evaluation, TMS (standard or accelerated) if indicated, psychotherapy paired with each phase, medication review and management, and a re-measure on the back end. $14,500–$22,500 depending on which medical interventions are indicated.
Common questions
Depression & mood — common questions
What is treatment-resistant depression?
Treatment-resistant depression (TRD) is generally defined as depression that has not responded adequately to at least two antidepressant treatments taken at the correct dose for a sufficient duration. It is more common than most people realize, and it requires a different clinical approach — one that begins with understanding what is happening in the brain, not simply trying the next medication.
How is the Depression Protocol different from standard therapy or medication?
The Depression Protocol is integrated, physician-led, and measurement-driven. Rather than treating symptoms with a single tool, it combines qEEG brain mapping, Digital Cognitive Testing, TMS if indicated, psychiatry, and psychotherapy — all coordinated by one team from the same chart. Every treatment decision follows from your actual findings, not from a generic protocol.
Do I need to stop my current medications or treatment to start?
No. Our protocol is designed to work alongside your existing care. If changes to your current treatment are clinically appropriate, your physician will discuss those with you as part of your evaluation — nothing changes without your knowledge and consent.
Does depression affect thinking, not just mood?
Yes — significantly. Depression frequently impairs concentration, memory, processing speed, and decision-making. These cognitive symptoms are real, measurable, and often persist even when mood symptoms improve. We assess and treat cognitive function alongside mood at every stage of care.
How do I know if I am a good fit for the Depression Protocol?
The Depression Protocol is designed for adults who have experienced major depressive disorder and have not achieved adequate relief from standard treatments. The best first step is a Brain Tour — a 60-minute clinical consult at $150 that gives us a real-time picture of your brain and lets us talk through whether this approach is right for you.
What if I am in crisis right now?
If you are experiencing a mental health crisis, please call or text 988 (Suicide and Crisis Lifeline) or go to your nearest emergency room immediately. Siler Brain Clinics services are not a substitute for emergency mental health care.
A real workup is the first step.
Book a Brain Tour — $150, 60 minutes on-site. You'll see your brain, talk to a clinician, and leave with a clear next step.