The Difference Between 'Curing' and 'Managing' Depression

I had no idea some people have “curable” depression. After 20 years of symptoms, 15 years of medication and at least 30 major relapses later, I just never thought about it that way. But in fact, some people with depression can be treated effectively with medication and therapy, and eventually their depression will go away and never return. Mind-boggling to me. I wonder what that is like. I can only imagine it is something like taking a really long, complicated course of antibiotics for an infection. I have no idea — because for me, there is no “cure.”  Like an antibiotic resistant infection, it just keeps finding ways to bite back.

I got lucky. The first antidepressant I took was extremely helpful. But there was a problem: no other medication was even remotely similar. Most antidepressants generally affect the same neurotransmitters to different extents, and in different ways. I happened to respond to the one and only antidepressant that worked differently. 15 years later, it’s still mostly in a class of its own. What I didn’t know at the time was that my good reaction to one medication was going to be an equally bad reaction to all others. And as was inevitable, after about 15 years of on and off with a wide variety of medications, something would go terribly wrong.

I developed grand mal seizures, something that can be a side effect of the very antidepressant that had been so helpful for so many years. I could no longer take it. I was forced to stop. I was devastated. How was I going to live? In fact, I was certain I couldn’t. I was certain it would be impossible to be alive without that medication.

We tried pharmaceutical combinations left and right. I had occasional “OK” days, but they never lasted. I had side effects, too many to count. But mostly it came down to a realization: My depression will never be cured. Never. It can only be managed (well at times) but never cured. I am considered to have “refractory” or “treatment resistant” depression. It’s an understatement after 30-plus medication combinations over 15 years, but it’s true: my depression is very treatment resistant.

I will probably never be on the same combination of medications for more than 6 months to maybe a year. They will stop working, or the side effects will become too much. I have to accept that. Part of managing my depression is accepting that there is no cure. There will always be a darkness trying to force its way in to my every waking moment. I will always have thoughts of self-harm and suicide — and there is no shame in that. I survive those thoughts, and that takes strength.

No, my depression can’t be “cured.” Not by medication, diet, exercise or anything else. But it can be managed. I can work hard to keep it under control as best I can. But it will never be cured. And that’s OK. Because I’m a survivor. Every day, every moment, every breath, I’m fighting it. And I will not lose.