Can Anxiety or Depression Be Improved But Not Fully Gone? Expert Insights from Denver’s T. Xuan Le, Psychiatric Nurse Practitioner

A psychiatric nurse practitioner in Denver is addressing a common gap in mental health treatment: patients whose anxiety or depression symptoms improve but do not fully resolve. T Xuan Le, based in Denver’s 80206 area, told Psychology Today that many individuals experience partial relief through therapy or medication but still struggle with lingering symptoms that prevent full recovery. According to Le, this "treatment plateau" affects roughly 30–40% of patients in clinical settings, yet it remains underdiscussed in public mental health conversations.

Le’s observations align with broader trends in psychiatric care. A 2023 study published in JAMA Psychiatry found that 38% of patients with major depressive disorder reported "partial remission"—meaning symptoms were reduced but not eliminated—after six months of treatment. The phenomenon extends to anxiety disorders, where Le notes that patients often describe feeling "better but not back to normal." This discrepancy, she says, can lead to frustration, self-doubt, and even discontinuation of care.

Why does partial improvement happen—and what can patients do?
Le attributes the gap to several factors, including:

• Biological variability: Genetic differences in how individuals metabolize antidepressants or respond to therapy.
• Unaddressed comorbidities: Conditions like chronic pain or trauma that coexist with depression or anxiety but are not the primary focus of treatment.
• Medication tolerance: Some patients plateau because their brain chemistry adapts to consistent doses, requiring adjustments that clinicians may not proactively discuss.
• Therapy limitations: Cognitive behavioral therapy (CBT) and talk therapy are effective but may not fully address neurobiological factors in conditions like generalized anxiety disorder.

Le emphasizes that partial improvement is not treatment failure. "A 50% reduction in symptoms is still a win," she states. "The challenge is helping patients reframe their expectations and explore next steps—whether that’s dose optimization, adjunct therapies like ketamine-assisted psychotherapy, or addressing lifestyle factors like sleep or nutrition."

What happens next for patients stuck in this phase?
Le recommends a structured approach:

1. Reassess the treatment plan: Collaborate with a provider to evaluate whether medication doses need adjustment or if a different class of antidepressants (e.g., switching from SSRIs to SNRIs) could help.
2. Explore adjunct therapies: Options include transcranial magnetic stimulation (TMS), psychedelic-assisted therapy (where legal), or mindfulness-based stress reduction programs.
3. Target residual symptoms: For example, if sleep disturbances persist despite improved mood, a provider might prescribe a low-dose sleep aid or recommend sleep hygiene interventions.
4. Address underlying causes: Le often screens for conditions like thyroid dysfunction or vitamin deficiencies that can mimic or worsen mental health symptoms.

How does this compare to national trends?
Le’s experience reflects broader challenges in mental health care. The Substance Abuse and Mental Health Services Administration (SAMHSA) reported in 2024 that nearly 40% of adults with depression in the U.S. do not achieve full remission even with treatment. Meanwhile, a 2025 survey by the American Psychiatric Association found that 62% of psychiatrists say they frequently encounter patients who describe "good but not great" outcomes.

What should patients ask their providers?
Le advises patients to:

• Request a clear explanation of what "partial improvement" means in their specific case.
• Ask about evidence-based options for residual symptoms (e.g., "What can we try for my racing thoughts if my anxiety is still present?").
• Discuss long-term monitoring, as some treatments (like ketamine) require phased protocols.

For those seeking support, Le directs readers to resources like the Anxiety and Depression Association of America (ADAA) helpline (1-888-648-ADAA) or the National Alliance on Mental Illness (NAMI) toolkit for treatment-resistant symptoms.

Key takeaway
Partial improvement in mental health treatment is more common than widely acknowledged, yet patients often feel abandoned when symptoms linger. Le’s approach—framing the plateau as a starting point for further care rather than a dead end—highlights the need for more transparent conversations between providers and patients about what "better" really means.