Depression steals your energy, distorts your thoughts, and makes even simple tasks feel impossible. When you’ve tried multiple antidepressants without relief, it’s easy to lose hope. At Mend The Mind, we specialize in helping those living with treatment-resistant depression using ketamine therapy and comprehensive psychiatric care that can provide relief when standard treatments have failed.
Our approach combines rapid-acting ketamine therapy with medication management and psychotherapy options, addressing both the neurobiological and psychological dimensions of depression. Research shows 52-55% of patients with treatment-resistant depression respond to ketamine therapy, with improvement often visible within hours to days rather than the weeks to months required by traditional antidepressants.
Treatment-resistant depression (TRD) affects nearly one-third of people being treated for depression. You’ve followed your treatment plan, tried multiple medications, attended therapy consistently—yet the darkness persists. Your symptoms may improve slightly then return, or you may experience no meaningful relief at all.
This isn’t a personal failure. Depression is a complex neurobiological condition, and some cases require treatments that work through different mechanisms than traditional antidepressants. Research shows ketamine therapy offers new hope for people with TRD, with response rates of 52-55% in patients who haven’t responded to multiple other treatments.
Traditional antidepressants target serotonin, dopamine, and norepinephrine systems. They typically take 4-12 weeks to show benefits, and they don’t work for everyone. When you’ve already waited months for multiple medications to take effect without success, that timeline becomes unbearable.
Treatment-resistant depression often involves dysregulation in the glutamate system—the brain’s primary excitatory neurotransmitter network. Ketamine works through this different pathway, which is why it can provide rapid relief even when other approaches haven’t helped. Recent research demonstrates that ketamine is as effective as electroconvulsive therapy for non-psychotic TRD, with response rates exceeding 55% and improvement often visible within hours to days rather than weeks.
The impact extends beyond mood. TRD affects your relationships, work performance, physical health, and ability to find meaning in daily life. Many people with treatment-resistant depression also experience suicidal thoughts, which adds urgent medical concern to an already devastating condition.
Our approach to treatment-resistant depression combines rapid-acting ketamine therapy with comprehensive psychiatric care. We offer multiple treatment pathways because depression affects each person differently.
IV Ketamine Infusions provide the fastest and most reliable relief. Research shows 52% of patients achieve remission after just three infusions over 11 days, with another 15% showing significant improvement. The initial series consists of six infusions over 2-3 weeks, delivered in a medically supervised setting. Many patients notice improvement within hours of their first infusion. Effects typically last days to weeks, which is why we develop individualized maintenance protocols to sustain your progress.
Ketamine Troches offer convenient at-home maintenance therapy after you’ve completed your initial IV series and achieved stability. These sublingual tablets help maintain the neuroplastic changes created during IV treatment, extending the time between booster infusions and supporting long-term recovery.
Medication Management ensures your overall psychiatric care is optimized. Our provider conducts comprehensive evaluation of your medication history, makes evidence-based adjustments to your current regimen, and coordinates with your other providers. Many patients benefit from combining ketamine therapy with appropriate antidepressant medications, particularly during maintenance phases.
Ketamine Assisted Psychotherapy combines the neuroplastic effects of ketamine with structured therapeutic processing. The medicine creates temporary windows of enhanced neuroplasticity when your brain is more receptive to forming new patterns. Working with a therapist during these windows can help you address underlying trauma, shift negative thought patterns, and develop healthier coping strategies that persist after the medicine’s acute effects fade.
Somatic Psychedelic Facilitation addresses the body-based symptoms of depression—the fatigue, tension, disconnection from physical sensation, and dysregulated nervous system patterns that keep you stuck. A trained facilitator helps you work with breath, movement, and somatic awareness during ketamine sessions to release stored stress and rebuild the mind-body connection that depression disrupts.
Throughout your treatment, you’re monitored by a psychiatric provider who is also board-certified in anesthesia. This dual training ensures both optimal therapeutic outcomes and the highest safety standards during your care.
Most patients begin with an initial consultation to assess whether ketamine therapy is appropriate for your specific situation. We review your psychiatric history, current medications, previous treatments you’ve tried, and overall health status. If ketamine is a good fit, we develop an individualized treatment plan.
For IV ketamine, the standard initial protocol involves six infusions over 2-3 weeks. Each infusion lasts 40-60 minutes, during which you’ll experience altered perception, dissociation, and deep relaxation. These effects are temporary and resolve within 1-2 hours. Most patients notice improvement in mood within hours to days of their first infusion, though maximum benefit typically builds across the full series.
After completing your initial series, we work with you to determine the best maintenance approach. Some patients transition to ketamine troches for ongoing support. Others return for periodic booster infusions—monthly at first, then gradually spacing treatments further apart as stability improves. We adjust your protocol based on your individual response and symptom patterns.
Response to ketamine therapy for depression is typically sustained with ongoing maintenance. Research shows the therapeutic effects don’t significantly decline with repeated treatments, and even highly treatment-resistant cases can achieve meaningful improvement.
Ketamine therapy for depression is most appropriate for adults with moderate to severe major depressive disorder who haven’t responded adequately to at least two other antidepressant medications. You’re a candidate if you’ve tried multiple treatment approaches without sustained relief, if your depression significantly impacts daily functioning, or if you’re experiencing suicidal thoughts alongside your depression.
This treatment is particularly valuable if you’re facing urgent need for symptom relief. While traditional antidepressants require weeks to months to work, ketamine can provide improvement within hours to days. This rapid onset makes it especially important for people experiencing active suicidal ideation or severe functional impairment.
You should have realistic expectations. Ketamine therapy works remarkably well for many people with treatment-resistant depression, but it’s not effective for everyone. It provides rapid symptom relief but requires ongoing maintenance. The treatment works best as part of a comprehensive care plan that may include psychotherapy, lifestyle modifications, and optimized medication management.
Access to specialized psychiatric care is limited in rural areas. Many people with treatment-resistant depression face long wait times for appointments, limited provider availability, and few options beyond standard antidepressant medications. Mend The Mind brings advanced ketamine therapy to Livingston, serving both local residents and patients from nearby Bozeman and Big Sky.
We understand the challenges of managing depression in rural communities—the isolation, limited resources, and stigma that can make reaching out for help even harder. Our practice provides judgment-free, evidence-based care that treats you with the dignity and respect you deserve.
[1] Anand, A., et al. (2023). “Ketamine versus Electroconvulsive Therapy for Nonpsychotic Treatment-Resistant Major Depression.” New England Journal of Medicine, 389, 1577-1588.
https://www.nejm.org/doi/full/10.1056/NEJMoa2302399
[2] Parikh, S., et al. (2024). “Ketamine’s promise for severe depression grows, but major questions remain.” Michigan Medicine Health Lab.
https://www.michiganmedicine.org/health-lab/ketamines-promise-severe-depression-grows-major-questions-remain
Conditions Treated
1201 U.S. Highway 10 W, Unit A4, Livingston 59047
Mend The Mind is a psychiatric practice in Livingston, Montana, specializing in ketamine therapy and comprehensive mental health services for adults. With anesthesia expertise ensuring the highest safety standards, we bring evidence-based treatment to rural Montana communities.