This is the second of a four-part series on mental health disorders and how real people handle them. These people are your neighbors, brothers, sisters, children, parents, even your grandparents. You know them. They’re around you every day.
Well, not specifically these interviewees, no, but you get the idea. They are perfectly normal people facing big mental health challenges.
We will be looking at the following disorders and how these people have handled them.
- PTSD/Complex PTSD. Note that C-PTSD is not yet a diagnosis in the DSM-V but as with many disorders, it comes on a spectrum, such as Treatment-Resistant Depression.
- Treatment resistant depression. This is a case of Major Depressive Disorder that has been resistant to several drug therapies.
- Bipolar disorder. This is a case where a person has struggled with Bipolar for years and has learned to cope with it.
- Borderline Personality Disorder. This is a case of the much vilified BPD that has shown incredible growth with and without medication.
These interviews have only been edited to protect the identity of the person answering. Gender neutral terms only—and the singular ‘they’—have been used where appropriate. “Spouse” instead of wife or husband. This is to ensure their privacy so they’re free to go into detail on certain things.
I will never reveal my sources, so please do not ask me to do so. I hold confidentiality as sacrosanct and will carry their identities to my grave.
None of these people are or were my patients. I do not confirm or deny how I know them or where from I know them. On my Facebook author page, people were invited to be interviewed and some chose to take me up on my offer and advertisement in the hopes that it would help others.
Case #2 – Treatment Resistant Depression
When were you first diagnosed with Major Depressive Disorder? How was it initially treated?
I was first diagnosed in 2001 / 2002. The first treatment I received was Celexa. It didn’t work and I gained 50 lbs. I didn’t notice any changes except for the weight gain. No change in sleep patterns, no change in feelings. It just didn’t work. When I say it didn’t work, I mean it didn’t do anything. I just stopped taking it—I weaned off it by notching back the dose by half every two weeks.
I was first diagnosed in 2001 / 2002. The first treatment I received was Celexa. It didn’t work and I gained 50 lbs. I didn’t notice any changes except for the weight gain. No change in sleep patterns, no change in feelings. It just didn’t work. When I say it didn’t work, I mean it didn’t do anything. I just stopped taking it—I weaned off it by notching back the dose by half every two weeks.
The depression resolved on its own after that. I attributed it to situational depression. When the circumstances changed, I got better.
What was your worst episode of MDD?
The worst was [a few years ago]. It’s hard to remember what it was like, because a healthy brain doesn’t work the same as an ill brain. Since that episode, lost brain matter has been restored; ganglia and pathways that were gone have regrown.
The worst was [a few years ago]. It’s hard to remember what it was like, because a healthy brain doesn’t work the same as an ill brain. Since that episode, lost brain matter has been restored; ganglia and pathways that were gone have regrown.
I remember crying almost every day. I was constantly exhausted, no matter how much or little I slept. I hurt all over, muscles and joints, and I couldn’t concentrate. It felt like someone stuffed my head with cotton and I couldn’t think, couldn’t read — it was a brain fog so intense, it didn’t matter how much caffeine or Adderall was involved.
The hard part was being frustrated and angry, all the time, about everything. Things that never used to bother me might spark rage or tears—an angry customer on the phone, someone overlooking me because they were busy, innocuous comments—it didn’t matter.
By nature, I’m pretty laid back, optimistic, and happy-go-lucky, and not feeling that way, but not knowing why, made me angrier than ever. I lashed out at people I loved and tried to cling to strangers for some sense or value. In the same way that I can’t remember now exactly what it felt like to be depressed, when I was depressed I couldn’t remember what it felt like to be cheerful or positive. I knew that I felt wrong, but couldn’t recall what ‘right’ felt like.
Reading this over, it’s surprising how mild everything sounds. It sounds like something anyone could just shrug off as a bad day, or a bad week, or a bad month, but it wasn’t mild. Imagine it’s one of those days where you’re just irritable: maybe you’re tired, maybe you don’t feel great, maybe you got skipped for a promotion. Imagine that crummy day is a birthday candle, now imagine that same day but intensified, like a searchlight. That’s the difference between a bad day and MDD.
Those 11 months were the worst I’ve ever felt emotionally, and when you feel that bad for that long, it seems even longer than it actually is. Every day was a fight in desperation to feel better and helplessness that I didn’t, or couldn’t.
How was your family affected by your illness?
It was awful on my spouse and there isn’t a day that I don’t regret it now that I’m well again. The hard part was, at the time, I wasn’t perceiving reality correctly. While I was mistreating them, I perceived that somehow, I was being mistreated instead. I felt like they didn’t understand and I couldn’t express myself, as if they didn’t understand anything about me. I’d never felt like that before and it was so gradual, I didn’t realize anything had changed.
It was awful on my spouse and there isn’t a day that I don’t regret it now that I’m well again. The hard part was, at the time, I wasn’t perceiving reality correctly. While I was mistreating them, I perceived that somehow, I was being mistreated instead. I felt like they didn’t understand and I couldn’t express myself, as if they didn’t understand anything about me. I’d never felt like that before and it was so gradual, I didn’t realize anything had changed.
It’s painful to talk about now and just trying to write this is uncomfortable and embarrassing too, because I feel like such a scumbag about it in the aftermath, but at the time, I honestly didn’t know how bad I was and I felt helpless—the way it might feel to watch them rowing to safety while I was stuck on an island that I couldn’t leave. They were tough, though, and helped me step-by-step.
How did you seek help for your depression?
I’m not put off by medicine and I tried adjusting my doses and medications three times within the year. When none of [those medicines] worked, I tried again and my MD referred me to a psychiatrist who gave me Trintellix, and it finally helped.
I’m not put off by medicine and I tried adjusting my doses and medications three times within the year. When none of [those medicines] worked, I tried again and my MD referred me to a psychiatrist who gave me Trintellix, and it finally helped.
Don’t misunderstand. That’s a short explanation, and it puts way too much credit on me, because I didn’t do it alone. My spouse should receive a lot of the credit here. When I didn’t feel like I could do it, they brought me. When I couldn’t make an appointment, they made it for me. When I couldn’t understand what the doctors were telling me, they listened and helped. My MD had also suggested Trintellix, but wasn’t sure about giving it to me along with Wellbutrin, so he suggested the psychiatrist and deserves credit for that. My psychiatrist was wonderful and incredibly thorough, and deserves credit.
Like any illness, I sure as hell didn’t get over it without help.
What is life like on medication? How was it at first compared to how it is now?
Life is great on medication — as long as it’s one that works. Like I said, I have no issue with taking pills, as long as they do what they’re supposed to do. My brain was missing matter and there was a medicine that could help restore that missing matter, so why would I not take it?
Life is great on medication — as long as it’s one that works. Like I said, I have no issue with taking pills, as long as they do what they’re supposed to do. My brain was missing matter and there was a medicine that could help restore that missing matter, so why would I not take it?
I’ve had different pills work to different degrees over the past twenty years, and I’m always overjoyed to feel like myself again. It can be hard to start them at first, but I don’t mind because I know that’s part of the process. If I’m adjusting, it’s working, and if I need to spend a month adjusting after a year of feeling like crap, that doesn’t seem like a big price to pay.
What kind of action plans do you have for a medication check? What is your relapse plan?
I try hard to monitor my symptoms, and seem to be having unusual success with my Trintellix. With the help of loved ones, journaling, and Wysa AI app usage, I’m trying to keep tabs on the medicine’s effectiveness. It actually seems to continue improving, rather than seeing any plateau or decline, but if I notice any stressed changes over a period of 4 – 6 weeks, I’ll visit the doctor again for a check. Unfortunately, I’m gaining weight again, so may need a check for that.
My relapse plan is similar and entails visiting the prescribing psychiatrist for any revisions or adjustments to my medicines, and using the self-help aids I have in place. I am also trying to cultivate habits to help prevent relapse or lessen it, should it happen. These habits include exercise, meditation, reading philosophy, enjoying art, and planning daily and weekly activities better.
Points to Reflect Upon – For People with MDD/TRD
What ways can you reach out for support from others while in recovery from depression? Who are the personal and professional contacts you have available to you who can offer support?
When medications stop working or do not help, what other treatments are available to restore your health? (Hint: there are many that a quick Google search can provide.)