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One Thing I've Found To Be True About Treatment-Resistant Depression


As mental health conditions such as major depressive disorder (MDD) have begun to shake their long-held stigma, people are also becoming increasingly aware of the spectrum on which many mental health conditions exist. MDD can look different for each person – but there is a specific subset that many people don’t understand, and that is treatment-resistant depression (TRD). Unfortunately, TRD is not simply a matter of going through more than one medication. Frustration builds when you begin to run through treatment after treatment, and combination after combination, year after year, only to find little or no success.

When I was first diagnosed with MDD in my late twenties nearly fifteen years ago, I never imagined it would be this hard and that I would still be searching for a solution.

I don’t know exactly when my psychiatrist decided my MDD deserved the label of “treatment resistant,” but when I saw it on a referral form, I realized he was right. I had been through every type of standard antidepressant on the market, at least once, and continued to search for a solution that worked for me.

Trying to find a medication that I responded to was very difficult. While I was relieved that there was a medical term for the struggle I was facing, part of me was disheartened. It was as if someone had validated me, but at the same time put me in the category of “just give up on her.”

Still, I continued to fight. I continued to try, everything. Every lifestyle change you could make, I tried. From low-carb diets to yoga to new sleep schedules. Every over-the-counter vitamin has made an appearance in my medicine cabinet. I was always willing to try something, even when I had very little hope of it helping. Every time a drug failed to work, it became a little more difficult to keep trying. I pushed, using whatever strength I could find, and kept giving medication after medication a chance. It’s difficult to describe the kind of hopelessness you feel when, time after time, you fail to get any “better.”

After officially deciding I was “treatment resistant,” my doctor and I began repeating medications in different combinations. At times I was on upwards of seven medications, as frequent as five times a day, using one medication to offset the side effects of another. I would set alarms on my phone and carry bottles of pills in my purse. It felt never-ending. There was so much to keep track of that at times I forgot to pay attention to if the medication was even helping.

So many nights were spent in tears, feeling like I must be the only person in the world who can’t just “get better.” The crushing feeling of isolation that comes with TRD is perhaps the most difficult part. The unshakable sense of being broken somehow.

But over the course of 14 years I have found one thing to be true above all else – I am absolutely not the only one.

I have endured three trips to a psychiatric hospital, and every time I met people just like me. People who struggled with the same things I did – and felt the same things I felt. We talked, we laughed, we cried, we bonded. So much so that I keep in close contact with several people I met there. We are each other’s lifelines, and we are happy to be able to support each other with unconditional love.

TRD is a very real problem for a number of people, and I happen to be one of them. It is not a reflection on my character, nor a personal failure of some sort. It is simply a medical condition. It’s not my fault. Frustrating as it may be at times, I didn’t do anything wrong. I didn’t bring this upon myself. I am not a bad person. It’s not a matter of willpower or positive thinking. I have a medical condition, and a doctor to help me manage it.

It’s not easy, but it’s not hopeless.

Finding a doctor who is willing to stand by your side through it all is of tremendous importance. On one occasion, I had to drag myself to my doctor’s office and hand him my cell phone. On the other end was my friend, who had to explain to my doctor that I was extremely depressed and couldn’t bring myself to even speak. My doctor was patient and understanding. He worked with me until I was able to talk to him a little. He took his time. Not once did I detect even a hint of judgment or frustration. It is vital that your doctor is willing to work with you in whatever condition you present yourself in. Because in the darkest time they may be the only thing you can reach out to.

Establishing a support system of people who are loyal to you no matter what is also invaluable. Friends who will hold you while you cry and not ask you to explain why you are crying. Friends who will play their guitar and sing for you because they know it always makes you smile. Friends who can see you at your worst moments, and only love you more. Those are your people – so hold tight to them, and lean on them when you need to.

When you are overwhelmed by the enormity of trying to manage TRD, it’s important not to forget how far you have come. You have to hold on to the good moments, no matter how brief. You have to search for things that work for you. Yes, it’s hard – but it’s not hopeless.

How many times you have shown up for therapy that you had no interest in being at? How many times you have woken up and put your feet on the floor and tried? Just tried. Because for as far as you have come already, you are capable of going so much farther. We are stronger than we think. We deserve tremendous credit every time we continue our search for a solution. Every time we push ourselves to just leave the house, or just make a phone call, or just get out of bed at all, it’s a victory. Those things may seem simple to the outside world, but with TRD they are monumental accomplishments.

Every step, every effort, everything deserves credit. We are still here, we are still fighting. We never give up. We are battle-hardened warriors. We are fighting for our lives. And it’s a fight we intend to win.