A-Z Teen Health Glossary

Teen Treatment Resistance

Teen treatment resistance is an often overwhelming and frustrating issue. While treatments for a variety of mental health issues can do great work to alleviate mental health problems, bring relief to teens, and help them adapt to their condition, some teens do not respond to treatments the way most others do. For teens struggling with treatment resistance, regular or first line treatments do not work as intended, and do not show the normal, desired results.

For instance, teens with treatment resistant depression may not show much improvement after being prescribed an antidepressant. This can be frustrating and very defeating for a teen looking for the right answer to their problems. However, with a little patience and a thorough commitment, they can get the help they need. If a teen shows resistance to their first antidepressant, then they are treatment resistant – but that doesn’t mean all hope is lost.

What Does Teen Treatment Resistance Look Like?

  • Despite the term, a teen with treatment resistance is not necessarily resistant to all treatments. Most teens with treatment resistance do not respond well to a specific medication or a class of medications, but may find relief through other treatments.
  • Treatment resistance may be caused by a variety of factors, including hereditary ones.
  • A teen with treatment resistance will continue to show significant symptoms with no signs of improvement for weeks after beginning treatment. Some medication can take over a month before it truly begins to do work, making treatment resistance difficult to diagnose.
  • Treatment resistance exists in nearly all illnesses. If a person does not respond to the first line treatment for an illness – from a common cold to a viral infection – they are presenting with a treatment resistant medical condition.
  • Sometimes, a disorder or illness is not what it first seemed to be. Sometimes, treatment resistance is a sign of a potential misdiagnosis.

Signs of Treatment Resistance

Teen Treatment Resistance

Continued symptoms despite first line treatment

Teen Treatment Resistance

Failing to see improvement in symptoms even after giving treatment more time to work

Teen Treatment Resistance

Symptoms continue to worsen despite treatments being administered

What Causes Treatment Resistance?

Treatment resistance is not necessarily understood to have a cause like any other illness or disorder, because it isn’t an illness of its own.

Genetics - differences in physiology, neurobiology, and endocrinology as a result of genetic variation and differences in environments can cause certain medications to work for some people, and to fail for others.

Misdiagnosis - furthermore, error on the part of medical professionals, particularly for psychiatrists who may not always see eye-to-eye on certain diagnoses, may lead teens to be diagnosed with an illness they do not actually have. Primarily, cases of treatment resistant illness refer to treatment resistant depression, in which case a selective serotonin reuptake inhibitor does not function to relieve a patient’s depressive symptoms. In such cases, it’s possible that a teen either does not respond to the first set of meds but does respond to a different kind of SSRI, however it is also possible that their depression is not affected by increased levels of serotonin.

Wrong treatment - many mental health issues are very complex and not completely understood, which is why the first treatment is not always the right one.

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Teen Treatment Resistance


of patients seeking relief from depression did not find first line antidepressants effective


of patients do not find antidepressants effective whatsoever


people find antidepressants effective over 6-8 weeks

How Can I Help My Teen with Treatment Resistance?

Help them seek alternatives – aside from first line treatments, different medications, and therapies, there are also alternative treatments to help teens with anxiety issues, mood disorders, OCD, and a variety of different mental health issues seek and find relief. Upcoming and older treatments, such as transcranial magnetic stimulation and other forms of neuromodulation, have proven effective in the treatment of depression. It’s not as simple as just recommending alternatives at random, however – a medical opinion should still be asked, as there is danger in haphazardly trying several different treatment methods at once, especially when mixing medication and/or supplements.

Work with professionals to find a path forward – it helps to get a second opinion, and to work with a variety of specialists to help your teen find the best treatment option, if possible. Two pairs of trained eyes is better than one, and when it comes to treatment resistance, it often helps to ensure that the possible cause of the treatment resistance is not a missed detail, potential misdiagnosis, or other errors that could have been made while working to figure out where a teen’s symptoms first came from.

Continue to support your teen throughout treatment – showing your support for your child can be a tremendous help on a very difficult journey, especially because treatment resistance continues to pile onto an individual and make them feel like their circumstances are especially hopeless. Be patient, understanding, and try to maintain your sense of optimism. To continue helping your teen, it’s also important that you work on maintaining your own sanity. These can be very difficult times, and your teen will look towards you for guidance – if you begin to lose hope as well, they will have an even harder time considering a healthy and happy future for themselves.

What Type of Treatments Work?

Cases of treatment resistant illnesses and disorders do not have a magic answer, or a treatment that specifically works for anyone with a treatment-resistant issue. Instead, psychiatrists and therapists utilize uncommon treatments that are not used as widely as the first line treatments but have still shown efficacy in the treatment of a patient’s specific issue, especially after FDA approval.

For example, treatment resistant depression may be tackled with neuro modulation, while some patients with chronic pain experience small relief after the use of antidepressants. Your exact course of treatment will depend heavily on what your issue is, how you responded to first line medication, and whether there is a protocol in place at your psychiatrist’s clinic for dealing with patients exhibiting certain symptoms after a treatment was not shown to be effective.

Helping Teens with Treatment Resistance at Paradigm Malibu

When it comes to treatment resistant teens, there are several very important factors. It’s important to have as thorough an initial evaluation as possible to try and determine why the first prescribed treatment might not be working. Mental health issues are as pervasive as they are complex, which is why it is understandable that many teens and their loved ones are frustrated by the lack of relief presented by usual treatments. However, only through a patient and thorough course of action can a trained professional help a teen find the best way forward.

A Personalized Approach

Personalized teen resistance treatment can be extremely helpful for teens that are treatment resistant. First line treatment is meant to provide relief from certain symptoms in most cases, but a more thorough approach is needed to reach long-term progress.

At Paradigm, we design a treatment plan for every individual teen and give special attention to the possibility of treatment, as well as other important factors, like co-occurring disorders, alternative causes, and family history. Furthermore, when treating any teen, we’re relentless in our pursuit to find the most effective and successful combination of treatment approaches and medication possible, in order for the teen to succeed in their recovery and in their lives.

Time and Patience

It’s also important to note that we understand that seeking treatment can become very frustrating and discouraging if the first effort doesn’t work. However, it’s important to note that this does not necessarily deviate from the norm. Even among established effective methods for something like depression, more than half of all patients seeking relief from depressive symptoms have to try at least more than one brand of antidepressants to experience significant relief without side effects.

It’s normal for mental health treatment to take time and patience. This might mean trying a variety of medications and treatment approaches. So if the first attempt wasn’t as successful as you hoped, don’t worry – there are usually a wide variety of options to attempt.

I don't know who will see this, but I just thought I'd put it out into the world that Paradigm Malibu changed my life forever. Long story short, I had nothing but anger inside me when I got there, and putting the rest of the world to the side for a while and being present with people I grew to love helped me gain my sense of self back. I'm forever grateful for the people of Paradigm.

– Olivia H.

Frequently Asked Questions About Treatment Resistance

If my teen is treatment resistant, does that mean their disorder is more serious?

Treatment resistance does not necessarily reflect on the severity of the disorder. It’s not that your teen needs a treatment of sufficient strength, but instead, they need a treatment of sufficient efficacy. Because mental health issues often stem from such a vast variety of different reasons and factors, it’s a modern medical miracle that medication such as antidepressants are as widespread in their overall effectiveness as they are. Rather than implying that your teen has a more serious disorder, treatment resistance simply implies they require a different approach to achieve healing and recovery.

Is treatment resistance more common in some cases than others?

Yes, there are factors that contribute to whether treatment resistance develops or doesn’t develop, although how and why these factors matter isn’t fully understood. When treating depression, women and the elderly are more likely to struggle with treatment-resistant depression. Physical affliction is also more likely to cause someone to find medication less effective – if a teen struggles with chronic pain, thyroid issues (or other endocrinological illnesses), or certain disorders such as chronic fatigue or fibromyalgia, they are more likely to present with treatment resistant depression. This is arguably because it is much harder to treat a mental health issues while under a constant source of stress and pressure, such as severe and lasting pain.

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