When My Psychiatrist Said the Words 'Treatment Resistant Depression'

The building that houses my psychiatrist’s office is sleek; all glass and metal with silver tinted windows. The lobby is equally glossy, dotted with oversized, modern art pieces and a young crowd of North Easterners sipping coffee and hurrying to who knows where.

After riding the elevator to the third floor, I am met by a receptionist who gives me a cursory, “Hello,” quickly followed by, “That will be $200 please.”

I take a seat in the waiting room. Everything is the same as when I was there last except the covers of the glossy, parenting magazines that litter the small coffee table. I can barely look at the deliriously happy mothers smiling out at me. All are dressed in some variation of white skinny jeans, a striped boat neck sweater and impossibly cute flats.

Once, I was one of those mothers. But since my children were babies, much has changed. In the last three years, I have been hit by a crushing combination of anxiety and depression that has left me a shell of who I once was. I have the urge to scream at these sparkling moms on the magazine covers. I want to implore them to live every day to the fullest because one never knows when things will suddenly fall apart, and your magazine-cover-life will come crashing down around you.

“Andrea?” I look up to see my psychiatrist standing in front of me.

“Come on back,” she says.

I get up from my chair in the waiting room and follow her down what feels like a two-mile hallway to her office. We don’t speak, and I keep a polite distance behind her. When we finally reach her office, she motions for me to sit down and closes the door. She then asks me to update her on how I have been feeling since we last met.

I describe the debilitating depression/anxiety that has me curled up in bed for hours, sometimes days, at a time. I admit to her that I am scared to eat anything for fear that it might contain flour or gluten or dairy or pesticides or sugar or some other ingredient that will exacerbate my mental illness. I tell her about the constant fatigue, the hopelessness, how the thought of making a cup of tea feels overwhelming, that my kids aren’t getting enough of my time and attention because I am constantly caught up in a fog of confusion and forgetfulness and emotional pain. And how guilty I feel about it.

She listens patiently. She is a decent person and a good doctor and has always offered me options and optimism in the face of my growing hopelessness over my mental health. Which is why her next words hit me like a kick in the stomach.

“At this point,” she says softly, “I think you need to see someone who specializes in treatment resistant depression.”

Her words bring on a roar in my ears, my heart speeds up and I fall into what feels like an ever-narrowing black tunnel. I can’t think, only feel. Terror, anger, despair.

Hearing that I have treatment resistant depression (TRD) shouldn’t, however, have come as much of a surprise. Since being struck down three years ago with a combination of anxiety and depression, I have been on a largely futile journey to find a cure. Like so many others with seemingly intractable depression/anxiety, I have repeatedly ridden the medication merry-go-round, trying dozens upon dozens of medications in a dizzying array of different combinations and dosages. I have spent time in a psychiatric ward, tried inpatient and intensive outpatient therapy as well as psychodynamic, trauma-centered, EMDR and cognitive behavioral modalities.

I even tried ECT. But after undergoing 20 rounds of electroconvulsive therapy I have very little to show for it besides significant memory loss.

And while I have often suspected that I had TRD, it was very different for me to hear it from a seasoned psychiatrist. I felt betrayed and utterly alone.

For three days after my appointment, I raged. I cried, I gulped for air. I slept and slept in the hope of waking up and finding that my psychiatrists’ diagnosis of TRD had been just a horrible nightmare. But no amount of sleep, tears, self-pity or bargaining with God was going to change the fact that there were few, if any, treatments left for me as someone with TRD.

So now I stand at a precipice. I can spend the rest of my life revisiting the same medications or getting more ECT in the hope that thing will be different. Or I can finally accept that I have a very serious and, at present, untreatable illness. This will require an act of courage that I could never fully muster when there was still hope that some other pill or procedure would swoop in and save me.

What must come next for me is a life-long journey of defining and creating a new me as someone with a serious, chronic health condition. The woman who had boundless energy, who worked out every day, who constantly volunteered at her children’s school, who kept the house spotless, who started her own business, who catered to the every need of her three children, is, most likely, a thing of the past.

In order to keep going, I need to find the something — anything — positive about TRD. Honestly, not much comes to mind except maybe:

1. I will no longer have to shell out copious amounts of money to see a psychiatrist every month.
2. I can put my present medications on automatic refill rather than having to repeatedly go to the drugstore with a new prescription that just isn’t going to work.
3. I no longer have to endure painful withdrawals as I ween off one medication while simultaneously enduring the excruciating side effects on a new one.

Granted, it is a pretty short list. But over time, I hope to find more things to add. In the meantime, I must remember that my mental illness may limit me, but it cannot define me. I still have a lot to give. I will need to keep pushing myself not to isolate, to withstand the daily burdens of loneliness, inferiority and shame. I will have to keep taking chances, putting myself out in the world, even when the depression and anxiety are screaming at me that I will fail.

Hopefully, with enough time and practice, I will carve out a different life.

A life where my goals will have to be less lofty than before the TRD.

A life where I can truly appreciate the fleeting shimmers of beauty, love and kindness that surround me.

A new life.

A life I never wanted or would wish upon anyone.

But a life, nonetheless.