After living with psychiatric illnesses, including depression and PTSD, for many years and experiencing his first panic attacks when he was just a kindergartner, the patient in this study had been hospitalized numerous times. The authors write that he had endured “one protracted depressive episode without distinct periods of remission for 31 years.”

They describe his medical history as “remarkable” – he has tried at least 19 different medications and undergone electroconvulsive therapy (ECT) three times. While this treatment can be effective in some cases, in this patient it unfortunately left him with cognitive impairment.

Ultimately, the patient had experienced suicidal ideation and made attempts to take his own life. It’s thought that around a third of patients with major depressive disorder will progress to TRD, as in this case, and that is a strong risk factor for suicidality.