STAR*D presents us with a "glass half full" problem. It's absolutely true that the majority of people will recover from depression with suitable treatment, but that leaves us with a minority who won't.

I'm not sure how to communicate those facts effectively to a wide audience. It is absolutely imperative that people with depression seek treatment and keep trying even if the first or second or fifth treatment fails, otherwise we're condemning people to unnecessary suffering; conversely, a lot of people with treatment-resistant depression are doubly stigmatised because of unreasonable expectations about the efficacy of treatment.

I do think it's useful for treatment-resistant patients to shift their focus away from recovery and towards symptomatic management - it's easy to get disheartened because you're not in remission, but a treatment that takes you from 10/10 depressed to 8/10 depressed is still useful. Eking out small reductions in symptoms and small improvements in functioning can be tedious and frustrating, but it's better than resigning yourself to interminable misery.