Clinicians often speak in abbreviations and jargon, and it may seem like everyone else in the room already understands it. If you have tried more than one treatment for depression, you have likely encountered terms that no one paused to define. This guide goes over the vocabulary that typically arises when treatment has not yet succeeded, which lets you keep up with what is being said and request an explanation whenever something is unclear.
Words about trying a medicine
A trial is a stretch of taking a medicine at a set dose for long enough that a clinician can judge whether it helped. Trials are not all alike. Clinicians often describe a trial as adequate when the dose was high enough and it was taken long enough, and inadequate when the dose was too low or the medicine was stopped early. Ask what counts as adequate for the medicine you took, because that judgment shapes what gets tried next.
Switching means discontinuing one drug and beginning another in its place. Augmenting means continuing your present drug while introducing a second one intended to operate alongside it. Some clinicians apply combining more broadly to include both approaches, so it is worth checking which meaning they intend. Your doctor might also use optimizing, which refers to changing the dose of a medication you already take before making any other alteration.
Side effects have their own vocabulary too. A clinician might talk about tolerability, which simply describes how well you can live with a medicine from day to day. Mention what bothered you even if it seemed minor, since that information affects which options make sense for you.
Words about treatments that are not pills
Transcranial magnetic stimulation, usually shortened to TMS, delivers magnetic pulses to a specific area of the scalp. It is given across a course of repeated visits, and each visit tends to be brief. Ask how the sessions are scheduled and how long each one runs, because the calendar is often the part that weighs most on everyday life.
Esketamine, marketed as Spravato, comes as a nasal spray that is administered at a medical facility in accordance with a REMS program, a federal safety initiative establishing requirements for how the drug is distributed and where patients may use it. Ketamine is a closely related compound that clinics sometimes administer as an infusion. The terms cannot be used as substitutes for one another, so verify which of the two a provider means. Inquire whether the application is FDA-approved for your circumstances or prescribed off-label, and who would be monitoring your dosing.
Psychotherapy, or talk therapy, is a structured series of conversations with a trained therapist. You may hear clinicians call a method evidence-based, which means it has been studied in research. That is a useful signal, but it does not tell you how any single person will respond.
Words about what comes after
Remission describes a period when symptoms have eased a great deal. Response describes meaningful improvement that may still leave some symptoms in place. A clinician may use both words in the same visit, so it helps to ask which one they mean when they say you are doing better.
Relapse describes the reappearance of illness after a period of improvement. Maintenance describes keeping treatment going after recovery so that progress is preserved. These concepts become important when deciding whether to end a drug or a series of sessions, and they should be discussed before any adjustment takes place.
Turning vocabulary into better questions
Knowing a word is only useful if it changes what you ask. Before your next appointment, pick two or three terms from this list that you heard in your last visit but did not fully follow. Write them down in your own words, then ask your clinician to explain each one as it applies to you. A question like "When you say that trial was inadequate, what dose were you measuring against?" will usually get a more specific answer than a general request for more information.
It can also help to ask the clinician to define any term they use that you do not recognize, even if it seems obvious to them. Many people feel awkward doing this, yet clinicians generally expect it. Language that is clear on both sides makes it easier to agree on a next step and to notice when something is not working.
A glossary cannot replace a conversation with the clinician who knows your history. Think of this list as a starting point. Your own records, your past medicines, and your goals for daily life are what shape the choice, and your clinician is the person best placed to weigh them together with you.