Conditions We Treat · Treatment-Resistant Depression

Treatment-Resistant Depression in
Monticello, MN.

If antidepressants haven’t brought relief, you still have options. TRD is one of our core focuses — with advanced therapies designed for exactly this.

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Understanding TRD

Treatment-Resistant Depression in Monticello, MN

Treatment-resistant depression (TRD) is depression that hasn’t improved after one or more adequate trials of antidepressant medication. If that’s been your experience, it can feel discouraging — but it does not mean you can’t get better.

It often simply means the standard approach wasn’t the right fit for your brain. Advanced therapy like Neurostar® TMS works differently — and it helps many people who had lost hope.

Defined as depression that persists despite medication trials
A core focus of our clinic — not an afterthought
Often responds to advanced, non-medication therapies
Neurostar® TMS therapy, an advanced option for treatment-resistant depression
FDA-Cleared TMS
Built for TRD
Signs & Symptoms

Does This Sound Familiar?

TRD carries the weight of depression — plus the frustration of treatments that haven’t worked.

Multiple Medications Tried

You’ve tried one or more antidepressants without lasting relief.

Partial or No Response

Symptoms improved only slightly, or not at all.

Relapse

Depression returned even after a medication seemed to help.

Side Effects Without Benefit

Enduring medication side effects with little to show for it.

Persistent Low Mood

A heavy sadness or emptiness that just won’t lift.

Loss of Hope

A growing belief that nothing will ever help.

Fatigue & Low Energy

Exhaustion that makes daily life feel impossible.

Trouble Functioning

Difficulty keeping up with work, relationships, or self-care.

In crisis or thinking about self-harm? You deserve immediate support. Call or text 988 (the Suicide & Crisis Lifeline) any time, day or night. If you are in danger, call 911.

Roxanne DoBrava, Founder & Psychiatric Nurse Practitioner
Accepting Patients
Meet Your Provider

Roxanne DoBrava

Founder & Psychiatric Nurse Practitioner · APRN-CNP, PMHNP-BC

Roxanne DoBrava is a board-certified Psychiatric Mental Health Nurse Practitioner (PMHNP-BC) and the founder of Tranquil Minds Mental Health. Treatment-resistant depression is one of her core focuses — offering Neurostar® TMS and precision medication management to patients across Monticello, MN who haven’t found relief elsewhere.

“Treatment-resistant doesn’t mean hopeless. It means we haven’t found your answer yet — and I’m committed to finding it with you.”

APRN-CNP PMHNP-BC Treatment-Resistant Depression Neurostar® TMS Medication Management
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Why Treatment Falls Short

Reasons Depression
Resists Treatment

There are many reasons standard treatment doesn’t work — and understanding yours points the way forward.

01

Wrong Medication Fit

The specific drug or class simply wasn’t right for your biology.

02

Dosing or Duration

Too low a dose, or too little time for a medication to work.

03

Underlying Conditions

Undiagnosed anxiety, bipolarity, or other factors complicating treatment.

04

Biological Differences

Brain chemistry that responds better to non-medication approaches.

05

Genetic Factors

How your body metabolizes medication can affect the results.

06

Need for a New Approach

Sometimes relief requires a fundamentally different kind of therapy.

How We Help

Advanced Treatments
for TRD

When first-line options fall short, these therapies open new doors.

Drug-Free · FDA-Cleared

Neurostar® TMS

A non-invasive, drug-free therapy that uses gentle magnetic pulses to reactivate the brain circuits involved in mood. FDA-cleared and highly effective.

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Personalized Psychiatry

Medication Management

Precise, closely monitored prescribing tailored to your biology, history, and goals — thoughtful care, never guesswork.

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Whole-Person Care

Psychotherapy

Compassionate, evidence-based talk therapy in a safe, judgment-free space that helps you heal the whole person.

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Objective Testing

Cognitive Testing with Creyos

When treatment is hard to get right, Creyos lets us objectively monitor your cognition over time — helping us see what’s truly working.

Creyos (formerly Cambridge Brain Sciences) is a scientifically validated platform built on 30+ years of neuroscience — giving us real data, not guesswork, to guide your care.

Objective, data-driven results
Measures attention, memory & reasoning
Quick, engaging, self-administered tasks
Learn About Creyos Testing
Creyos cognitive assessment platform
What to Expect

Your Path to Feeling Better

From your very first call, you're met with warmth, expertise, and a plan made just for you.

01

Reach Out

A free, no-pressure consultation to hear your story and answer your questions.

02

Comprehensive Evaluation

A thorough assessment of your symptoms, history, and goals — the foundation of great care.

03

Personalized Plan

Together we choose the right combination of therapies for your unique needs.

04

Ongoing Support

We track your progress and adjust as you heal — you're never in this alone.

Common Questions

Questions Answered about Treatment in Monticello, MN

What counts as treatment-resistant depression?

Generally, depression that hasn’t improved after one or more adequate trials of antidepressant medication at the right dose and duration. If that describes you, advanced options may help.

I’ve tried everything. Is there really still hope?

Yes. Neurostar® TMS works through an entirely different mechanism than antidepressants, and it helps many people who hadn’t responded to anything else — often alongside a careful second look at your medication plan.

Is TMS covered by insurance for TRD?

Often, yes. Most major insurers cover TMS for treatment-resistant depression. We’ll help you verify your specific benefits.

How is TMS different from taking antidepressants?

Rather than altering brain chemistry system-wide like medication, Neurostar® TMS uses gentle magnetic pulses to directly stimulate the brain circuits involved in mood. It’s non-invasive, drug-free, and FDA-cleared for treatment-resistant depression.

How soon might I feel better?

Every person and treatment is different. Some options act rapidly while others build over weeks. We’ll set clear expectations for your specific plan and track your progress closely.

Accepting New Patients

Relief Is Closer Than You Think

Start with a free, confidential 15-minute consultation — let's find the path that works for you.

Book Free Consultation 612-429-8280
Your Next Step

Your Path Forward
Starts Here

Schedule your free 15-minute consultation to learn more about your treatment options. During this no-obligation consultation, we'll:

  • Listen to your unique experience
  • Explain how Neurostar® TMS might help your specific condition
  • Answer all your questions about treatment
  • Discuss practical matters like insurance and scheduling