When It Feels Like Having Treatment-Resistant Depression Is Your Fault

Let’s talk about treatment-resistant depression for a second, OK?

Treatment-resistant depression (TRD) is a diagnosis given to a group of people who have major depressive disorder (MDD) but don’t adequately respond to typical treatments (such as medications and psychotherapy). TRD is actively being researched so doctors can understand more; however, right now it is said that someone can have TRD after completely trying two or more antidepressants without a positive response.

I have treatment-resistant depression. It’s taken me a while to accept the fact that I might live with depression for a very long time, and that it is not my fault. It’s so very easy for me to fall into the trap of thinking it’s my fault I don’t respond to treatments. Many medication concoctions I’ve tried don’t have any impact at all, and some have had intolerable side effects. Psychotherapy has been a slow process, and I’ve had to see countless different therapists and professionals over the past few years.

I have to accept a lot of realities in my current treatment regimen. I have to accept that I’ve tried over ten medications and might have to continue this trial and error for a while. I have to accept that I need severe interventions every so often. I have to accept that people around me mean well and want to help, even though they sometimes give the quick hopeful answer to all my problems. I have to accept that my body doesn’t respond to treatments as easily as some other people.

I still struggle and think TRD is my fault. Why do some people’s bodies respond to treatment, and mine just doesn’t? Am I not trying hard enough? Even while wrestling with these questions, knowing I have TRD is validating. When I cycle through another medication change, I can remind myself that it’s an illness I have. Sometimes my body doesn’t respond to medications no matter how much effort I put into my recovery, but my efforts are still very real.

I know people try their best at supporting someone with severe or treatment-resistant depression. However, please don’t only say it will get better. It might not.

I understand the sentiment when people say this phrase, but it can be heard in the wrong way and seen as invalidating. I understand that, to many people, living in hopelessness is scary, but that simple phrase doesn’t cure deep depression or hopelessness. Stop throwing your quick fix of a phrase and try simply sitting with us and reminding us it’s not our fault.

I know life does have ups and downs. No one is down 100 percent of the time and I do appreciate when my mood is in a better place, but depression is different than sadness. It’s different than crying from a difficult situation. It’s deeper and darker than that. And with TRD, it feels never-ending.

TRD is sitting at countless doctor appointments with yet another person worried that you have suicidal thoughts. It’s not OK to feel suicidal, but this is my normal. Please accept me.

TRD is appreciating the multiple therapy appointments a week, but worrying that this exhaustion of appointments will follow me for the rest of my life. Will my therapists get sick of me?

TRD is worrying I’m going to be a burden when someone asks me how I’m doing, and I’m still depressed. I just want them to know I’m trying. This isn’t my fault.

TRD isn’t widely talked about and honestly, there isn’t much information about it. I worry people think I’m not being grateful enough or positive, and that’s why I’m still depressed. However, the reality is that I’m still depressed because my body and brain don’t respond quickly or adequately to typical treatments. It takes a lot of time to try new treatments, and then find out they don’t work.

Maybe I will find a treatment that works after more research is completed. Maybe I won’t. Please have compassion with me. Please don’t tell me it gets better. Maybe it got better for you, but not everyone’s journey is the same.

I know this isn’t an easy battle for anyone, whether you are the person living with treatment-resistant depression or the supporter of someone who does. I’m glad to be a part of the mental health community, and to be a voice to this subset of depression.

Follow this journey on the author’s blog.