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Cost: Member: $52.50 | Student: $22.50 | Non-member: $97.50

Abstract:  Approximately 23% of U.S. adults experienced mental illness in 2024. That statistic is expected to continue to rise, making depression and its related comorbidities an increasingly common condition presenting to primary care and integrative physicians. Of adults with depression, 55% are considered “treatment-resistant”- i.e. unresponsive to standard of care therapies - implying a major gap in our ability to understand and treat depression. To date, many practitioners address depression as form of dysregulation in other organ systems. But what do we do when depression is the primary concern? This presentation will cover the diagnostic criteria for “difficult to treat depression” (formerly “treatment-resistant depression"). We’ll then cover differing mechanistic theories of depression, including the drivers of anhedonia- a major cause of distress among DTD patients. Lastly, we’ll cover both novel FDA-approved pharmacologic and naturopathic treatment options that - in combination - can greatly improve the quality of life for patients with depression, with some case examples for demonstration.

Presenter Bio:  Dr. Constance Ohlinger is the clinic director of the Whole Systems Healthcare (WSHC) Portland clinic, and the site director for the WSHC residency program. She is also an active member on the executive board of the Institute for Natural Medicine (INM) Residency Consortium. She is passionate about advancing the naturopathic profession through teaching and mentorship.

Dr. Ohlinger completed her ND degree and residency at the National University of Natural Medicine (NUNM) in 2018, going on to practice naturopathic primary care with a focus in integrative mental health. Through collaboration with her colleagues, WSHC became one of the first naturopathic practices in the nation to become a certified Spravato (Esketamine) approved site in 2019. Since that time, she has completed additional training in Ketamine Therapy through the ASKP3, with an ongoing personal vision to expand access to mental healthcare for under served populations.
This presentation is worth 1.5 Category 1 CE credits, including 0.5 Pharmacology credit, for Washington-licensed NDs.
(Originally presented May 1-3. 2026, at WANP's 2026 annual conference.)