Untreatable Depression?

By Kristina Randle, Ph.D., LCSW

Q. I never had a history of sickness or psychological disorder until my mid 20′s. Then as a result of symptoms and by process of elimination of other illness, I was diagnosed with depression. I have been seeing a psychiatrist and a therapist for the last six years each of whom I’m very fond of and think they are more than competent.

Since going to therapy two times per week and trying many different types of anti-depressants/anti-psychotics, I feel no better. In fact, I feel worse in many ways.

My question is about mental illness’s ability to adapt and become virtually untreatable. I realize mood disorders are not viruses but perhaps there is some similar process by which they build up a resistance to treatment and evolve into more complex problems. For example, it seemed like my depression was pretty straight forward when I was first diagnosed, but now my doctors and I have been noticing what seem to be splintering components of additional depression, mood, personality and anxiety disorders (i.e. schizotypal, schizoid, meloncholic depression, social phobia…)

I’m not overly caught up in finding the best “term” to describe my condition–I’m mostly concerned with how I feel and my behavior. The bottom line is that my symptoms seem worse and my behavior more self-destructive.

Please try to explain why I am not getting better? Is some depression simply untreatable? If so, isn’t it reasonable to wish cutting life short? Many learned people have come to this conclusion including Freud himself. Thanks for taking time to analyze and explore this question!

A. There could be many reasons why you are not getting better. It may be that your doctors and therapists are not as competent as you perceive them to be. From what you wrote, it seems that their treatment plan consists of trying to find the right medication to treat your condition. While medications can help treat depression and many other illnesses, medicine alone usually only provides partial symptom relief. Some people complain that the medicine does not work at all. Good treatment for depression usually involves talk therapy in addition to and sometimes in place of medication.

It could also be that your treatment team has yet to find a medication that works for you. It can often take a long time to find a medication that works effectively for the treatment of depression.

With regard to personality disorders, medicine is generally not an effective treatment. The treatment of personality disorders usually requires some form of talk therapy. There are even empirically proven and specialized treatments available for certain types of personality disorders. Broadly speaking, if you are only being treated for your personality disorders with medication, this might explain why you’re condition is not improving.

Other reasons that you’re not improving may be that you are not following the advice of your treatment team or you have been misdiagnosed. You also say that as of late you’ve been experiencing symptoms of other psychiatric disorders. If you are experiencing these other disorder-related symptoms then it is possible that these symptoms are interfering with the effectiveness of your depression treatment.

Without more information I can only speculate as to why you are not feeling better despite your clear devotion to treatment. I would need very detailed information and an in-depth personal history to provide you with a more informed answer.

Please know that overcoming depression takes time. It also requires your patience as well as competent mental health professionals. You said that you like the mental health professionals who you work with. This is a very good start. You should consider talk therapy if you have not incorporated this into your treatment. Be patient, keep trying and do what is necessary to get better even if that includes seeing a new doctor or therapist. I wish you luck.

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Last reviewed: By John M. Grohol, Psy.D. on 7 Jul 2008

APA Reference
Randle, K. (2008). Untreatable Depression?. Psych Central. Retrieved on July 22, 2014, from http://psychcentral.com/ask-the-therapist/2008/07/07/untreatable-depression/