The Secret to Living with Treatment-Resistant Depression
You’d never suspect this by listening to pharmaceutical ads, but only one-third of people with major depression get better after trying an antidepressant. The others go on to try different drugs, or combinations of medicine and psychotherapy, and usually seven in 10 achieve remission.
The other third?
They are labeled with the three most dreaded words in the mental health profession: treatment-resistant depression.
If clinical depression affects more than 15 million American adults and is predicted to be the second most common illness in the world by 2020, that’s a lot of people suffering with chronic symptoms. There are millions of people in this country who wish they had a terminal illness, an acceptable exit out of life … just getting by hour by hour.
I know this well, as I’ve struggled with treatment-resistant depression much of my life.
The last five years, in particular, I’ve been fighting death thoughts on a fairly consistent basis. I’ve tried over 20 different combinations of medicine (over 50 in the last nine years); been in therapy longer than my kids have been alive; participated in an eight-week mindfulness course at the hospital and started meditating every day; and made drastic changes to my diet — eliminating grains and dairy, sugar and caffeine.
I’ve also spent $5,000 on a functional or holistic doctor and another half of that on a cabinet full of vitamins and supplements. In the last six months, I’ve been poked with a needle and had more blood work done than a monkey with the Ebola virus, in a desperate attempt to find the underlying cause for my death wish.
The other day, when I opened a letter from Cigna, my insurance company, that said that none of the $5,032 outstanding laboratory fee would be covered by them because it “does not meet the plan’s definition for medical necessary care or treatment.” I panicked, threw a few things, and called an emergency family meeting that determined this: if I had the funds of Paris Hilton I could go on testing to nail the prospective reasons for my brain pain, but since I don’t, it was time to call off all future holistic experiments and investigations.
I was left with one scary question: What if I want to die every day for the rest of my life?
That’s when I picked up Toni Bernhard’s book inspiring and courageous book, How to Be Sick: A Buddhist-Inspired Guide for the Chronically Ill and Their Caregivers. Bernhard’s advice comes from 13 years of wrestling with an acute viral infection she caught on a flight to Paris, a chronic illness that forced her to retire from her faculty position at the School of Law at the University of California, Davis. People grab for this book when, after trying myriad treatments over the course of several years, they finally come to ask a question similar to mine: What if I always feel this way?
She gives them hope.
Not that they will find a fix somewhere down the line — there will be an end to their symptoms — but that it is possible to live a very full life in the midst of a debilitating illness.
She is proof.
In her book, she describes the four “dwelling places” of the enlightened mind that are helpful to know and to try to practice: “metta,” loving-kindness or wishing well to others and to ourselves; “karuna,” compassion or reaching out to those who are suffering, including ourselves; “mudita,” sympathetic joy or joy in the joy of others; and “upekkha,” equanimity or a mind that is at peace in all circumstances.
Bernhard’s discussion of equanimity was especially enlightening to me because so much of my suffering comes from my desire for certainty and predictability. When I pay a doctor $315 an hour, I’m expecting to leave her office less confused than when I entered. When I go through the trouble of shipping away my stool, saliva, urine, and blood samples, I am hoping, in return, for a nice chart indicating that my deficiency in X is what is causing me to Google “easiest ways to get cancer.”
Bernhard cultivates equanimity by saying, “If this medication helps, that will be great. If it doesn’t, no blame. It wasn’t what my body needed.” “If this doctor turns out to be responsive, that will be nice. If he or she doesn’t, that’s okay. Any given doctor is going to be how he or she is going to be. It’s not in my control.” As soon as she was able to let go a little, that motivated her to keep on letting go, until she experienced true freedom and serenity, even in the face of disappointment.
Somewhere in the process of reading her pages, I came to accept my illness for what it is: a sickness that has been with me since my earliest memories and one that will probably be a constant companion throughout my life. I was able to sit with the death thoughts, instead of running scared from them or obsessing about them to tears or having them make me feel like an inadequate and inferior human being. I was able to let go of my timetable and agenda for better health, my detailed wellness plan.
Ironically, the very moment I gave up on a cure, I experienced peace.
Originally posted on Sanity Break at Everyday Health.
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Borchard, T. (2018). The Secret to Living with Treatment-Resistant Depression. Psych Central. Retrieved on December 5, 2020, from https://psychcentral.com/blog/the-secret-to-living-with-treatment-resistant-depression/