When depression continues despite medication and psychological therapy, it can feel as though the options are running out. At Deakin Private Hospital in Canberra, we understand how difficult this can be. Our psychiatrists provide a staged and individualised approach to treatment-resistant depression, exploring treatment options based on your needs, previous treatments and recovery goals. Where clinically appropriate, this may include advanced treatments such as Esketamine, alongside psychiatric and therapeutic support.
In short: At Deakin Private Hospital, treatment-resistant depression is approached individually. If previous medication and psychological treatments have not provided sufficient improvement, our psychiatrists can assess whether options, including rTMS or Esketamine, may be appropriate for you.
When standard depression treatment is not enough For some people, depression can continue even after trying antidepressant medication and psychological therapy. This is often referred to as treatment-resistant depression (TRD). At Deakin Private Hospital, treatment is not one size fits all. Our psychiatrists work with each person to understand their symptoms, previous treatments and individual goals before recommending the next step. This may include reviewing existing treatments, psychological therapy, rTMS or, for eligible patients, advanced treatment options such as Esketamine Depression treatment at Deakin Private Hospital.
Rather than treating advanced therapies as a first resort, our psychiatrists work through a staged approach so each patient tries the treatment most likely to help at the right point in their care.
Esketamine is a nasal spray therapy approved in Australia specifically for treatment-resistant depression. It is used alongside an oral antidepressant, rather than on its own, and is administered under direct medical supervision in a monitored clinical setting, since patients are observed for a period after each dose. Your psychiatrist will talk you through what this looks like in practice and whether it is an appropriate option for your circumstances.
| Option | Core focus | Often considered when |
| Medication and psychological therapy | First-line treatment addressing symptoms through antidepressants and structured therapy | At the start of a depression treatment plan, or when a new episode is identified |
| rTMS | Non-invasive magnetic stimulation targeting mood-regulating brain areas, delivered over a four-week course | Depression has not responded adequately to medication and therapy alone |
| Esketamine and other advanced therapies | Medically supervised treatment administered alongside an oral antidepressant in a monitored clinical setting | Earlier steps, including rTMS where appropriate, have not delivered lasting relief |
Advanced therapies are considered for people who have tried standard depression treatment, including at least one other evidence-based option, without lasting improvement. Whether this is the right next step for you depends on your history, current symptoms and overall health, which is why a comprehensive psychiatric assessment always comes first.
Your pathway begins with a referral to a psychiatrist with admitting rights at Deakin Private Hospital. Following assessment, your psychiatrist will discuss which options are appropriate, including whether rTMS or advanced therapies such as esketamine fit your treatment history. If advanced therapy is recommended, administration takes place in a monitored setting with your treating team present, and your progress is reviewed regularly as part of your broader care plan.
Advanced therapies for depression are delivered under close psychiatric supervision, with monitoring throughout every session. Your psychiatrist will explain the specific effects to watch for and how these are managed at Deakin Private Hospital before treatment begins, so you know what to expect and who to contact with questions along the way.
What if rTMS has not worked for me?
Your psychiatrist can discuss whether advanced therapies such as esketamine are an appropriate next step based on your treatment history and current symptoms.
Is esketamine the same as ketamine used outside a medical setting?
No. Esketamine is a specific, TGA-approved medical treatment administered in a monitored clinical setting under psychiatric supervision, which is different from unsupervised or recreational use of related substances.
How do I find out if I am eligible?
Speak with your GP about a referral to a psychiatrist at Deakin Private Hospital, who can assess your history and discuss whether advanced therapies are appropriate for you.
Will I need to be admitted to hospital?
This depends on your individual treatment plan. Some patients receive advanced therapies as part of an inpatient admission, while others may be managed on an outpatient basis; your psychiatrist will discuss what applies to you.
If depression has not lifted despite treatment, it is worth raising advanced therapy options with your GP or psychiatrist. To ask about a referral or learn more about the depression treatment pathway at Deakin Private Hospital, contact our Admissions Team on 1800 961 391 or by email at dkn.admissions@imh.com.au.
