Treatment-resistant depression and the elephant in the room

Depression is a complex disorder associated with significant health, social, and economic burdens. Current treatments are not effective in producing remission in a large proportion of those diagnosed with this illness, resulting in a high prevalence of treatment-resistant depression (TRD), a form of depression associated with significant disease burden. A scoping review of the literature was conducted to identify the treatment paradigms currently being utilized to address TRD. The findings indicate that despite evidence of the biological, psychological, and social factors surrounding depression, our treatment approaches are detrimentally narrow, with little research addressing the psychological or social realms of the disorder. Additionally, systematic barriers to certain treatment approaches exist, limiting access to care and hindering optimal treatment outcomes. Efforts to expand the scope of research and advocate for structural changes that support well-being are necessary to reduce the substantial burdens associated with TRD and promote the health of our population.