By Madison Avenue TMS & Psychiatry - Published on September 10, 2025

Last updated on September 10, 2025

Depression remains one of the leading causes of disability worldwide, and in the United States, we are seeing a troubling rise in suicide rates. 

In 2023, over 49,000 people in the U.S. took their lives. And for every life lost, there are untold numbers of suicide attempts, emergency visits for self-harm, and individuals struggling with suicidal thoughts.

In New York City alone, an estimated 732,000 people experienced major depressive disorder (MDD) or severe depression in 2023. Behind these numbers are real people – family members, friends, colleagues – facing a potentially life-threatening mental health condition. 

When Traditional Treatments Aren’t Enough

For most people diagnosed with depression, the first course of treatment is usually prescribed oral antidepressants combined with therapy. But these medications take weeks to start working, and for about one-third of people, they aren’t effective. This is known as treatment-resistant depression (TRD).

When someone is living with TRD or experiencing suicidal thoughts, getting timely care is crucial. Waiting for medication to “kick in” can seem impossible when depressive symptoms are unbearable. 

To address this gap in care, there are treatment options specifically designed for TRD, including Spravato. 

A Different Approach: What Is Spravato?

Spravato (esketamine) is an FDA-approved nasal spray for adults with TRD or MDD with suicidal thoughts or behaviors.

Some patients feel a noticeable difference within hours or days, as opposed to weeks with oral antidepressants. While Spravato is not an instant cure, it has been shown to offer rapid relief for those in deep depression, creating a critical bridge to safety, stability and long-term care.

Read more about Spravato for TRD here. 

Who Is a Candidate for Spravato?

You or your loved one might be a candidate for Spravato if:

• Two or more oral antidepressants haven’t worked 
• Depressive symptoms persist despite current treatment 
• There is a diagnosis of treatment-resistant depression
• Suicidal thoughts are present
  

If you’re unsure whether these apply, talking to a mental health professional is the best next step. 

What to Expect if You Begin Spravato

Spravato is administered in a clinical setting under medical supervision for safety and support. In each session:

• Your care team will guide you step by step through the self-administration process
• You will complete treatment in a comfortable, monitored environment
• You will be under observation for two hours after treatment

To gain a better understanding of what is involved with Spravato treatment, read our blog What To Expect At Your First Spravato Appointment or view this Spravato-patient brochure. 

The Importance of Self-Care and Support

Self care

Practicing daily self-care and coping skills are also important when it comes to maintaining mental health. In our blog, 10 Mental Health Resources Every New Yorker Should Know, we offer a list of things New York City residents can take advantage of to boost their mental health.   

Offering Support

It can be hard to know how to best support someone with depression. But the most important things you can do are:

• Listen without judgment
• Encourage / help them to seek professional help
• Stay connected and check in often

For more on this, read our blog How to Support Someone Struggling With Mental Health.

If you or someone you love is thinking about suicide:

• Call 988 – the Suicide and Crisis Lifeline (24/7)
  
• If in immediate danger, call 911 or go to the ER

Dedicated NYC mental health resources

• Mental Health Guides – The Mayor’s Office of Community Mental Health offers an array of services, starting with a downloadable guide available in several different languages that can help connect residents. 
• NYC 988 – The city offers free and confidential crisis counseling and support for mental health or substance abuse 24 hours a day, seven days a week via phone, text message or online chat.
• NYC Health + Hospitals – The largest municipal health system in the nation offers resources for free or low-cost mental health and substance-use services, including the 24-hour 800-NYC-WELL hotline and NYC Care, an access program for uninsured and immigrant patients.
• National Association on Mental Illness – The organization, known informally as NAMI, offers resources including a hotline, links to local chapters and support groups, educational resources including podcasts and videos, and more.
• SAMHSA – The Substance Abuse and Mental Health Services Administration, part of the U.S. Department of Health and Human Services, offers a tool to search for providers from anywhere in the U.S., national helplines, and information about treatment payment options, among other things.

You’re Not Alone – Help from Madison Avenue TMS & Psychiatry 

Depression can make you feel trapped. But depressive feelings and thoughts are symptoms, not the truth. No one has to carry their depression alone. Today, there are more treatment options than ever before, including Spravato and TMS, that offer hope. 

If you’re living with depression in New York City, our team at Madison Avenue TMS & Psychiatry is here for you. We offer Spravato, TMS therapy and medication management at our location in mid-town Manhattan. Call us at 212-731-2033 to schedule a consultation today. 

Madison Avenue TMS & Psychiatry