The term is ominous and misleading. It suggests that you’ve gotten as far as you can go, that nothing more can be done for your suffering. If you didn’t know better, you’d think that you just arrived at the last stop of the treatment bus, even though you feel like you’re far from home.
The day I was diagnosed
Like most people I know with treatment-resistant depression (TRD), I was already running dangerously low on hope by the time a physician attached the words treatment-resistant to my depression.
I had struggled on and off with depression for decades, but when I was a young mom, I descended into the kind of dark night that felt like suffocation or drowning. My painful ruminations and crying spells interrupted my responsibilities as a wife, mother, and writer. I struggled to tie my shoes and eat a bowl of cereal, to hold my baby girl and craft a cogent sentence.
I visited practically every psychiatrist in Annapolis and I tried more than a dozen different medication combinations.
“You have treatment-resistant depression,” the fifth psychiatrist said to me matter-of-factly.
The words sent chills up and down my spine.
I went on to try a dozen more medications and two more doctors. Eighteen months into this current depressive episode and under the right care, I could begin to see light again.
Far from hopeless
Thirteen years later I have a much better understanding of treatment-resistant depression, often defined as multiple courses of antidepressants at acceptable doses over an adequate period of time. Although the term resistant conveys a sense of doom, the diagnosis does not in any way mean that you are a hopeless cause – just that your depression is “stickier” or more challenging to treat than the average Joe’s. The complexities of your illness demand a different approach.
The Goldilocks of depression
Until the day of my TRD diagnosis, I had relied predominantly on medications to relieve my symptoms of depression. Certain treatments were easy and kept me stable. There was no reflection though about why I was depressed – no attempt to connect symptoms to events or to understand relapses – nor was there any consideration of alternative therapies.
In my experience, I’ve found that a diagnosis of treatment-resistant depression motivates psychiatrists to be more aggressive in their approach. The diagnosis encourages us to think holistically and design wellness plans that incorporate a range of tools, such as psychotherapy, cognitive-behavioral strategies, mindfulness, stress reduction, and support.
Realizing that treating my depression involved a holistic approach, I suddenly approached my condition with a feverish curiosity, strolling the self-help aisle of the bookstore for ideas and experimenting with a variety of tools and resources. I tested them out, much like Goldilocks, until I found the ones that were “just right” for me at the time. Today I use a combination of therapies and strategies to manage my depression symptoms, including medication, art therapy, deep breathing, meditation, self-compassion exercises, and a diet regimen. The process of accepting my diagnosis involved a philosophical shift from trying to completely cure my depression to finding ways to live with and through it.
A community of support
Invaluable to navigating the meandering road of treatment-resistant depression has been connecting with a community of people that share my condition. Four years ago, I created two online communities for people with treatment-resistant depression and related mood disorders. The level of closeness formed online between persons with common stories is extraordinary. Knowing I’m not alone in my experience of treatment-resistant depression is immensely consoling, as is seeing members triumph over similar battles to mine. These members are mental health warriors, fighting side by side on the frontlines of this disease.
Every day members post nuggets of hope and insights that inspire. I am reminded that my symptoms of treatment-resistant depression aren’t permanent, that the word resistant has no bearing on my prognosis for healing and health, and that there is light in my experience of darkness.
A diagnosis of treatment-resistant depression is certainly not the last stop on the treatment bus. With a little creativity, effort, and support, it can be the beginning of a journey towards a better, healthier you.
Therese Borchard is partnering with Janssen Pharmaceuticals to share her story. She has been paid an honorarium for her time.