Treatment-resistant depression is depression that has failed to respond to at least two previous antidepressant treatments. In order for depression to be considered treatment-resistant, you have to have tried at least two antidepressant treatments for a period of six weeks each, without achieving at least a 50% improvement in your symptoms.

Treatment-resistant depression is common; about 50-60% of patients don’t respond to their first or second antidepressant treatments.

Treatment-resistant depression also refers to the reality that for many people with depression, full recovery is elusive. While standard treatment may help to a degree, full return to normal function is less likely for those with treatment-resistant depression.

Estimates indicate 80% of patients with treatment-resistant depression experience a relapse of symptoms within a year of remission. Those who have treatment-resistant depression over the course of a decade are likely to recover to full function only about 40% of the time.

Treatment Resistant Depression Options

In recent years, promising new treatments have emerged for treatment-resistant depression, including ketamine therapies and esketamine. Esketamine is a nasal spray version of ketamine used in conjunction with a more traditional antidepressant medication.

Psilocybin (the active ingredient in magic mushrooms) also shows a great deal of promise for treating treatment-resistant depression. Early studies suggest that two to three sessions of psilocybin-assisted therapy seem to cause full, lasting remission of treatment-resistant depression in a large percentage of patients.