Treatment-resistant depression: "I relapse systematically at the same time every year."

Hello, and thank you so much for agreeing to share your story with Carenity.

First of all, could you tell us a little about yourself?

I’m Marie, 37 years old, an architect for almost 15 years, and the mother of an 8-year-old girl. I’m passionate about writing and music, and I write and compose my own songs.

You experienced postpartum depression after the birth of your daughter. How did the illness first show up in your life? When did you realize something was wrong, and what were the symptoms?

To begin with, my delivery was very difficult and ended in an emergency C-section, which kept me from enjoying the first moments with my daughter because I spent several hours in the recovery room. Then, my stay in the maternity ward was painful, because I was unable to sleep even though I was completely exhausted. I think I was in a state of hypervigilance with my daughter, which kept me awake day and night. On top of that, I was in pain from my scar, which immobilized me and kept me from taking care of my baby. Then, once I got home, my symptoms only got worse. I wasn’t sleeping at all, and I was having tetany attacks (severe anxiety with muscle spasms). At the time, I didn’t realize they were panic attacks, and that my journey was only beginning.

I first went to a general practitioner, who suggested that I had postpartum depression. He prescribed antidepressants and sleeping pills and assured me I’d quickly get better, saying things like: “You’re not the only one, it heals very well,” before sending me on my way. At the time, I didn’t know that antidepressants take several weeks before they start working, and despite the sleeping pills, I still wasn’t sleeping. I quickly stopped the treatment because I felt even more tired while taking it.

A few weeks later, during a severe anxiety crisis, my husband called an urgent care doctor. I was given a Valium injection, told there was nothing more they could do, and advised to see both a psychiatrist and a psychologist to get through it.

After that, the psychiatrist recommended a stay in a psychiatric clinic so I could rest and find a suitable treatment. I spent two months in the clinic, where I finally understood that I had an illness and that to recover I needed both psychological support and medication.

Before my depression, I had never had anxiety attacks, nor had I ever seen a psychiatrist. Until that first depressive episode, I thought of the mental health world as something for “the weak” or “the crazy.” I never would have imagined going through depression myself. That’s why it took several weeks before anyone could put words to my symptoms.

After that, you went through 7 major depressive episodes. Could you tell us about them?

Depression can affect anyone: rich or poor, young or old, men or women. It’s invisible and silent, unlike a wound, burn, or fracture where treatment is obvious, and that’s what makes it so dangerous. It is insidious, it doesn’t give warning signs, and it isn’t routinely screened for like cancer, but it must be identified and treated in time to prevent serious consequences such as suicide. Finding effective treatment can also be really difficult. Yet, it is so often misunderstood, ignored, judged, and even trivialized by some practitioners.

Recovery often takes time, and without proper care, relapses are common. Over time, depression can drag on and become a series of recurring episodes with symptom-free intervals. That’s when it turns into chronic depressive disorder.

Eight years ago, after a month spent hiding in bed and two months in a psychiatric clinic, I finally regained my strength and got my life back. But depression had only just begun, because since that first episode, I’ve had seasonal depression every winter. I relapse systematically at the same time every year, and each episode lasts around 6 months, followed by a 6-month break before the next wave. Each depression is different, and each one is stronger than the last.

I recently learned that I have what’s called “chronic” and “treatment-resistant” depression. This means that, even after trying many different medications, I don’t respond to them. By definition, treatment-resistant depression is a depressive episode that continues despite at least two properly administered antidepressant treatments, or one that doesn’t improve enough under their effects. I’m part of the 30% of patients who don’t respond to antidepressants.

What kind of treatment are you on right now, and how is it working for you?

Because of the number and severity of my depressive episodes, I have very close medical follow-up. I see a psychiatrist twice a week, a psychologist once a week, and my GP once a month. I’ve been on medication for 8 years now and have tried many drugs (antidepressants, anxiolytics, antipsychotics, sleeping pills). My current treatment is heavy, but it still needs to be adjusted, because it doesn’t stop the yearly recurrence.

For 8 years, my psychiatrist has constantly adapted my treatment depending on my “state of mind,” but he doesn’t seem to know how to stabilize me.

Recently, after mentioning the diagnosis of “treatment-resistant depression,” he brought up new treatment options: Esketamine and electroconvulsive therapy (ECT). These are considered when other treatments fail.

According to patient reports and hundreds of small studies, ketamine, an anesthetic available by prescription, can be effective for severe depression and suicidal thoughts.

ECT, meanwhile, is a technique for treating severe depression or profound melancholy that has shown very good results. The principle is to pass an alternating current between two electrodes placed on either side of the skull.

After years of medical wandering and trying dozens of drugs without success, I’m relieved to know that there are still other options to explore. But time moves slowly in the mental health world. Weeks can pass where nothing happens, and suffering takes up all the space.

Could you tell us more about the times you have been hospitalized?

In eight years, I’ve had three long stays in psychiatric clinics, spread out over several years. The first was after my postpartum depression.

During this first admission — voluntary — I discovered the hidden world of madness behind the high walls of the clinic. On arrival, I had to open my suitcase and hand over my hairdryer, razor, and tweezers. My room smelled of hot plastic and antiseptic. I felt like a criminal going to prison, stripped of my belongings, my freedom, and my dignity. And yet my illness required kindness and compassion, gentleness and hugs. Even injured arms can still open and offer tenderness. Instead of being reassured by the human warmth of the staff, I was left alone in an empty room, as if I’d been put in a corner, shut away.

I remember asking the nurse: “And what do I do now?” I expected a commando-style plan with lots of activities, workshops, and support groups. I imagined many things would be set up to tackle the problem head-on and make it disappear. But psychiatry doesn’t work like that. Time is slow, and for hours nothing happens. The nurse replied: “Now, you take time to rest.” Days passed, all the same.

For two months, the only events in my days were meals and the quick visit from my psychiatrist each morning. That world on “pause” offered nothing but stillness: my room was cleaned, my sheets changed, my meals served; every gesture meticulously repeated, again and again.

In that world, everyday life stops while the real world keeps turning, but without us. For weeks, I had no right to go out or receive visitors. The break from the outside world had to be total. I had to refocus on myself without being distracted by outside voices that had kept me from doing so until then.

What impact has depression had on your personal and professional life? Do you talk about it with those around you? Do they support you?

My daily life is often very hard, and I suffer a lot. I struggle to keep a job, to take care of my daughter, and to cope with routines. I have no savings because I’ve often been unemployed. At 37, I live in a 25 m² apartment, I’m separated from my daughter’s father, I don’t have a car or investments… Recently, I took out a loan to buy my tiny apartment, and while the banker went through my “financial situation,” he remarked: “Given your age and income, I’m surprised you don’t have more savings!”

Where will I be in six months? Will I be happy? Will I have a job? Will I be lost in yet another depression? Will I be alive? Or dead? These questions have been running through my head for years, because my depression has taught me just how crushing uncertainty can be. Overnight, joy and hope can give way to melancholy and madness. The ground disappears, and I feel unsafe everywhere. I am exposed, raw, and no one can save me.

Depression has cost me many friends, my job, and even certain family members. Yet depression is not contagious, and beyond medication and therapy, what I desperately needed was to be heard and supported by my loved ones. It’s already very painful to be unhappy, but feelings of shame and guilt only intensify when the world rejects you.

What are your plans for the future?

For now, I’m holding on to the hope that new treatments will help me get out of this chronic, treatment-resistant illness.

Later, I plan to create an association to educate about depression (in schools, workplaces, for individuals) through talks, testimonies, and conferences, so that it’s commonly recognized as a real illness and not “a bad mood” or “a weakness of character.” I’d also like to create a place of welcome, listening, and refuge for people with depression and their loved ones.

What advice would you give to Carenity members also living with depression?

To all those who are suffering in silence, learn to forgive yourselves and stop feeling ashamed of:

• Your mistakes: You’re living through a moment of extreme vulnerability, and you blame yourself for not always doing what you think would have been right under normal circumstances. But it’s not your fault, it’s the depression or the pain speaking and acting for you. Mistakes are part of life. Don’t beat yourself up. You’re doing the best you can.
• Being in “survival mode:” This allows you to shut down all “non-essential” functions. You can’t focus on yourself or others. Your body and mind are telling you: “WARNING! You urgently need to stop and take care of yourself.” You’re not well, and you absolutely need to care for yourself before you can care for others again.
• Not making the right decisions: You have the right to make mistakes. We’re all human, not robots. If you’re depressed, concentration and clear thinking become very difficult. It’s not your fault.
• Losing your temper, sometimes often: No, we’re not robots, we all lose control sometimes. Especially when you’re suffering and no longer have control over your body or mind. You are enduring your illness, it’s not your fault.
• Resenting others: Of course it’s not their fault. But when you’re not well, it’s normal to go through phases of anger where you look for someone to blame. With the help of loved ones and trained professionals, you’ll learn to let go of that pain and anger.

We, who are suffering from depression, must never forget to be gentle with ourselves and not hesitate to ask for help. Even though this illness is invisible, it is real, it is incredibly violent, and we must fight with all our strength to overcome it.

A big thanks to Marie for trusting us with her story.

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Take care!