Treatment-resistant or Resisting treatment?

This is turning out to be an adjunct to yesterday’s post. My brain is not cooperating with my attitude, or vise versa, I’m not quite sure which. While doing research on treatment-resistant depression, I’ve found the following information.

From Mayo Clinic

…with treatment-resistant depression, standard treatments aren’t enough. They may not help much at all, or your symptoms may improve, only to keep coming back.

Their suggestions include:

  • Stop drinking or using drugs – check
  • Manage stress – really? Good luck with that one.
  • Sleep well – as soon as I stop laughing at this suggestion, maybe I’ll take a nap.
  • Get regular exercise – OK, I barely have the energy to do everyday tasks and you think I’m going to get off my ass and go into the basement to get on the elliptical?

Wait…is that an attitude problem, or is it actual depression? OK, OK, let’s move on to the next website (which was WebMD, so maybe I’ll try the one after that-sorry WebMD people, I have a small problem with your website but I won’t get into that here).

This is from PsychCentral

These individuals may have treatment-resistant depression or refractory depression. While there’s some debate over the precise definition, treatment-resistant depression is typically thought of as failing to achieve remission after two treatments or two antidepressants, according to George Papakostas, M.D., director of Treatment-Resistant Depression Studies in the Department of Psychiatry at Massachusetts General Hospital.


A variety of genetic, neuroimaging and electrophysiological studies have investigated the underlying causes of treatment-resistant depression. And researchers know one thing for sure: Refractory depression is not the result of one brain region or neurotransmitter system.

Once again, lifestyle changes are suggested. A couple of the other suggestions, which I forgot to mention earlier, are not open to me. I’ve had ECT, which is not something I care to repeat. Another suggestion is Transcranial magnetic stimulation (rTMS), for which I did have a consult. That particular endeavor ended up quite disastrously (the definition of TMS can be found in the same link as the article).

The solutions all seem to be exacerbated by the fact that no mental health professional can seem to agree upon an actual diagnosis. Don’t get me wrong, I love my MH team, but come on, I really don’t want to get back on the medication merry-go-round again.

And here I go back to the bottom line, and my reason for the title of this post. Am I resisting treatment for some odd reason? As I mentioned in this past post, is it just too comfortable to be depressed? It’s certainly not fun for me nor my family. So like I said yesterday, I need to reread my positive posts, put on my big girl panties, and change my attitude…right? That will work, won’t it? I’m starting DBT in a couple weeks, and maybe I can find the energy to get my rear-end downstairs to the elliptical (c’mon, Sheri, how difficult can that be? You don’t even have to leave the house.). As for the ever elusive sleep, well that’s never been an easy one for me. I don’t like zombie drugs like Seroquel or Depakote, so I try to rely on one Klonopin just to shut up my brain.

Like I’ve said ad nauseum, there are so many non-traditional therapies I need to revisit. There are a multitude of options, but I feel like I’m blindly wandering around with my hands outstretched, trying not to fall in to the mire. Anybody got a spare rope?

blindfolded woman

10 thoughts on “Treatment-resistant or Resisting treatment?

  1. I don’t know if this is a relevant comment — as usual, I am reading a blog backwards. In another comment (in a previous post) I wrote of the difficulty I have of accepting my mental health issues, including life-long depression.
    There are people (I do a lot of research too) who are resistant to antidepressant medications. If there is a small cohort of those who don’t react like the general population, then I’m in it!
    And, reading backwards, I don’t know if you’ve discussed that much. Resistants need to take an antids longer than others to judge efficacy. Resistants don’t get the same “punch” as regular folks if the antid does kick in. And, most likely the positive of that medication doesn’t last past 6 to 8 months.
    Usually, it’s assumed that the resistant isn’t taking the medication as prescribed, has behaviour that counters/is contrary to the medication (like your check list), and so on. No matter how closely I follow the regime, use add-ons, and mood stabilizers, medicating my depression away just ain’t gonna happen. That much I’m learning to accept.
    I do tend to leave very long comments that could be posts by themselves!
    And I do apologize for reading backwards, it skews my understanding of you, and probably makes my comments even more incoherent. 😉

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    • Your comment is very coherent, no apology necessary. I may not have addressed the issue previously (how bad is that…can’t remember my own posts!). I try to augment my meds with alternative therapies, like meditation and mindfulness, and I never expect a pill to be a cure-all. It would be nice though, just pop a happy pill daily for the rest of our lives. I have not done research on unipolar depression, and while I’d never say bipolar depression is worse, I often wonder if it’s more difficult to treat because of the need to find the right balance. Now, I’m going backwards – your comment is quite, relevant. And it appears a long comment (which I love) begets a long reply.

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  2. The medical definition of “Treatment resistant depression” strikes me as about as arbitary as “surviving cancer” which is defined as still being alive five years after treatment. Die of cancer in year six and it doesn’t count. Doesn’t fit with my definition of the word survival.

    Sounds to me like “well if two lots of drugs don’t fix it then there must be something wrong with you!” Uh, yeah.

    Anyway the thought of of the Big Girl Panties cure brightened my otherwise miserable day. Wouldn’t work for me – I’d end up being divorced I reckon.

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    • Ha! No I don’t think that saying would work for you. It seems to me all things “medical” about mental illness is arbitrary. My psych once told me how frustrating it is to not be able to just give me a blood test and then prescribe the proper antidote. This has been going on for a very long time, but I generally have much longer respites between bouts (now I’ll think of waiting for the bell between bouts in a fight).

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  3. I think sometimes, looking back at my own life, it is a resistance to accept something deeper or especially, depression itself. When I fully accepted depression, treatment, and sometimes theinsanity of it… things began to lift from me in new ways. But that is my personal experience with it at times.

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      • I knew a lady who suffered severe depression for over ten years, to the point of making the decision to have electro-convulsive therapy. After our conversation I simply asked her, ‘Have you ever just accepted the depression?’ She thought about it and said no. Things changed for her after that, the depression was much more manageble and alot of healing was allowed. Thing about depression is, it can suck us into believing that the symptoms and situations within clinical depression is a part of ourselves somehow rather than what we are struggling with. And others will do that too, relate our symptoms to who we are or our ‘attitude’. It is just not true. So in some ways, it is accepting what it can do, what it does to our emotions or thinking sometimes. But accepting ourselves in the depression is a wonderful release of its hold.

        In your post you said, that it was not fun for you or your family so you have to re-read positive posts. It just reminded me of how much I had put into trying to ‘change’ it because it was uncomfortable and discouraging and sometimes hard to feel accepted by others in it. Then I accepted it, and myself in it, and the help… what a difference it made for me.

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      • I’ve been thinking about this since your first comment, and I just can’t seem to understand the concept. It seems to be something I can almost grasp, but I’m fearful that if I actually accept that I am severely depressed it will swallow me whole, and I’ll stop fighting (which equals suicide to me). This has been a lifetime struggle, with numerous diagnoses, medications, and therapies. I’m so used to the fight after all the years (I’m 57), that acceptance seems to equate with giving up, not embracing (if that’s the correct word for what you’re suggesting).

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