This study is testing if adding a type of therapy called *Cognitive Behavioral Therapy* (CBT) after taking a medicine called *esketamine* helps people with *Major Depression* and *Suicidal Ideation* (MDSI) feel better for longer. Cognitive Behavioral Therapy is a talking therapy that helps people change their thoughts and actions to improve their feelings. Esketamine is a medicine that can help with depression symptoms quickly.

The study will compare two groups: one will receive CBT with a computer's help, and the other will continue with their regular treatment (TAU). The goal is to see if CBT helps reduce suicidal thoughts more than just esketamine alone. The study hopes to enroll 100 people, both in and out of the hospital.

• The study is for people aged 18-65 with major depression and suicidal thoughts.
• Participants must follow the study rules, including using birth control if sexually active.
• Exclusions include certain brain disorders, substance use issues, and prior esketamine treatments that didn't work.