Anyone dealing with treatment-resistant/refractory depression? It’s been about two-and-a-half years since my initial diagnosis of depression - one of the happiest moments I’ve had in the past decade finally having someone tell me this - and I’m now on my second medication and on this second one, the second change in dosage. The second medication has been far more tolerable than the first and markedly more effective, but there is still not much overall change in mood. The upping of the dosage in the past week or so, however, has made me nauseous. The trade-off just doesn’t seem to be worth it since it’s barely helping anyway.

I tried talk therapy. It tried for about a month or two, and it was a big deal for me to talk one-on-one with someone and share stuff I’d never shared. As an introvert, it absolutely drained me, but I kept going to prove to both myself and others that I was attempting some self-help. I stopped going, however, when it became clear to me that we were talking about the same thing(s) every single time, and he was starting to push me far past anything I was ready for. I’d already pushed myself further than I’d ever gone in my life - specifically pushing myself to be more assertive, bolder and more adventerous in my social life than I’d ever gone - and thought I was doing well, but he wanted something more and far more structured/scheduled than I was willing to do. Nice older gentlemen, but I didn’t find the work meeting the goals I set. It turned way more into a life coach situation than someone who focused on the brain.

So, did I not try hard enough with the talk therapy? Is treating refractory depression really just realizing that you have to do the things “normal” people do on a “normal” schedule and still feel like shit? My big problem is that I’m really good at social interactions in short spurts. Like, I am good at “appearing” normal, hell, even “fun.” I’ll reach out and contact people and everything for short spurts. But the moment I relapse, it can last for months until I’m given some kind of inescapable reason to be social (wedding, holiday, etc.), which I dread literally up until the moment of the event. I’ve never talked about my depression with anyone but my sister, and then only kind of as an aside where she talked about her situational depression which isn’t the same thing. I feel like it’s obvious - yeah, so like when you call me at 7 in the evening and I’ve already been asleep for hours, but am up at 3 AM, you know what’s going on - and everyone knows but just doesn’t want to talk about it, and I understand because I don’t want to talk about it. It makes me feel like a bad person, though.

How does one deal with this? What brought on the diagnosis was the death of my brother, who was literally the only one who could work around me and understand me. I look back now ad it’s obvious to me that this was because he had the same thing I had or at least part of it, though it was never diagnosed. It’s crazy, because he was always seen as the complete opposite of me. Him not being here leaves me more isolated than I already was most of the time, though, I know also have more “bursts” of social interactions than I did, because I want to show everyone that I can be “normal” without him and I know he’d really like me not to stop my life for him. I actually think he’d be really proud of all of the work I’ve done on myself since he’s been gone. The problem is that literally no one has had any kind of encouraging words recognizing any of this. I never in a million years thought I’d be that person who needed validation like this, but I’ve found I’ve really been hurting for someone to acknowledge the work I’ve done on relationships. And then I realize that for everyone else, this (the work) is just “normal.” One of my parents dealt with grief by basically pretending that my brother didn’t exist or that his death didn’t hurt them, unless I bring it up to them. The other has basically turned into Queen Victoria in their grief, and I have to try and navigate this on top of everyday life without the one person who could really help me with this, who ironically is the one we are all grieving over. It’s the cruelest cosmic joke I’ve ever been a part of, that’s for sure.

Yeah, it’s frustrating, more or less. What has worked in your lives?