Dr. Augustus John Rush on treatment-resistant depression and new therapies

Dr. Augustus John Rush joined the Health Policy Podcast on Sept. 9, 2026, to discuss treatment-resistant depression, the need for more precise diagnosis and the role of neuromodulation therapies. He argued that TRD is a spectrum of disorders and said treatments such as TMS and VNS can be life-changing for patients who do not respond to standard medications.

Why it matters: - Treatment-resistant depression affects patients who do not improve with standard antidepressant care. - Better diagnosis and more personalized treatment could change outcomes for people who have exhausted first-line options. - Neuromodulation therapies may offer another path for patients with persistent symptoms.

What happened: - Dr. Augustus John Rush joined the Health Policy Podcast to discuss treatment-resistant depression and the evolving mental health treatment landscape. - The episode focused on diagnostic challenges, personalized treatment approaches and neuromodulation therapies. - The podcast episode was released on Sept. 9, 2026. - A full episode is available here.

The details: - Rush said treatment-resistant depression is not a single condition but a spectrum that requires tailored interventions. - Rush said accurate diagnosis is critical because many patients have been misdiagnosed and may not receive the right treatment. - Rush said that when he ran a depression clinic, many patients had not been properly diagnosed. - The discussion highlighted transcranial magnetic stimulation, or TMS, and vagus nerve stimulation, or VNS, as options for managing TRD. - Rush said these therapies can provide significant benefits for patients who have not responded to traditional medications. - Rush said, "If you get one of these patients better, it is life-changing." - Rush also said, "depression itself, even very treatment-resistant depression, eventually will... get better."

Between the lines: - Rush's framing suggests clinicians may need to move away from a one-size-fits-all view of depression. - The emphasis on misdiagnosis points to a broader challenge in mental health care: patients can spend time on ineffective treatment before reaching the right care plan. - His comments on neuromodulation reflect growing interest in non-drug interventions for difficult-to-treat depression.

What's next: - The discussion points to continued attention on better diagnostic tools and more individualized treatment pathways for TRD. - Interest in neuromodulation therapies may grow as clinicians look for options beyond standard medication regimens. - Rush's comments suggest future progress in depression care will depend on matching the right therapy to the right patient.