First, I want to invite you to check out Shawn Coss and his artwork. The featured picture is his adaptation of Major Depressive Disorder. When I first saw it, I loved it so much that I bought a large print and put it in a frame. It’s so fucking accurate with how this feels that I took it to a session to show a previous counselor, it helped me work through my fear of diving deep and I bawled my eyes out, blubbering words the whole time. With that one, I’d been going to him for a year and a half or better, not really getting anywhere. It was a hell of a breakthrough for me. Unfortunately, at the end of my emotional dump, he dismissed me entirely. I don’t even remember WHAT he said, only the emotional impact it had on me – which was utter shock and offense. Suffice it to say, I never went back.

For today’s post, I’m going to put in the “educational” Google AI Overview stuff because I’m feeling all the BLEH. Yesterday, I woke up with much the same. I did NOT want to get out of bed, deal with cats, or leave the house for my Yoga/Trauma therapy. I tried to cancel via text, but didn’t get a response and had to force myself (mentally kicking and screaming) to get dressed and leave in time. However, it’s actually good that it happened this way. Even though I get in these heavy ass moods, going to therapy (of any kind) truly does help. By the end, I was in a better mood.

All the same, it’s another day where I don’t want to do jack shit. I just started the 20mg’s of Trintellix this past Tuesday and have to give myself time for my body to adjust to it, but… if things don’t improve by the time I speak with the psychiatrist again… I wonder if this dosage is too much? I don’t have the knowledge (yet?) about why my body/brain hate and reject medications so often, but the hunt continues.

So here we go… I’ll be adding (notes) after things for personalization, I guess.

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Treatment-resistant depression (TRD) is a subtype of major depressive disorder (MDD) where symptoms of depression do not improve with at least two different antidepressant treatments of adequate dosage and duration. It’s characterized by persistent symptoms, often including a low or depressed mood, anhedonia (loss of interest or pleasure), feelings of guilt or worthlessness, fatigue, difficulty concentrating, and changes in appetite or sleep. 

Here’s a more detailed explanation:

Key characteristics of TRD:

• Failure to respond to treatment: The core feature of TRD is the lack of significant improvement in depressive symptoms after trying at least two different antidepressant medications or other treatments like psychotherapy. (Since I began taking meds back in Arkansas with Ms. Amy as my administrator, I’ve gone through SEVERAL rounds of this, and more of the same since moving to Colorado)
• Adequate dosage and duration: To be considered TRD, the prior treatments should have been administered at an adequate dose and for a sufficient duration (often considered 4-6 weeks at the full dosage). (Ok, seems like a repeat of the last one, but Ms. Amy did determine my “regular” MDD was TRMDD before I moved)
• Persistence of symptoms: TRD is marked by the continued presence of depressive symptoms, indicating a resistance to standard treatments. (Pretty self-explanatory and definitely accurate to my situation)

Factors that may contribute to TRD:

• Comorbid conditions: Other mental health conditions like anxiety disorders or substance abuse can complicate treatment and contribute to resistance. (I was diagnosed with Anxiety when I first started seeing Dr. Phil. I’m fairly certain I have Inattentive ADHD as well. I was recently diagnosed with (c)PTSD. And Anhedonia comes with MDD.)
• Inadequate treatment adherence: Not taking medications as prescribed or discontinuing treatment too early can hinder effectiveness. (I can say with 100% conviction that I have adhered strictly to whatever medications were prescribed. For whatever fucked up reason, this is the one thing I’ve always been able to commit wholly to.)
• Individual biological factors: Some individuals may have biological predispositions that make them less responsive to certain treatments. (Ya think?! Omg, everyone is different and sometimes things don’t work the same from one person to the next?! Shock and awe. But seriously, whatever might be “wrong” with my biology, nobody has figured it out. Can’t say Arkansas did any sort of work in that department unless I demanded things. I haven’t been in Colorado and established long enough for that with current doctors.)
• Psychological factors: Negative thought patterns, lack of motivation, or difficulty engaging in therapy can also play a role. (FFS… lol. Depression and Anxiety alone can cause this shit, so no duh. I’ve always participated in therapy to the best of my ability, sometimes beyond, because I WANT to get better.)

Treatment approaches for TRD:

• Medication adjustments: Switching to a different class of antidepressants or combining medications can be effective. (Done this many times)
• Psychotherapy: Cognitive behavioral therapy (CBT) or other therapies can help individuals develop coping strategies and address underlying psychological issues. (Started a little of this with Dr. Phil, but it fizzled out and idk why. Currently in IFS/EMDR, which I believe is helping so far.)
• Brain stimulation therapies: Repetitive transcranial magnetic stimulation (rTMS) or electroconvulsive therapy (ECT) can be effective in some cases when other treatments fail. (Now here’s one I have NOT tried. Can’t say I want to, of course, it seems pretty scary to be messing with brain wave shit, but that’s merely my ignorant fear talking. If this ever comes up as something to try, I’ll do my research.)
• Other treatments: Ketamine or other medications may be considered in specific situations. (For one of my previous surgeries, I was given Ketamine as part of my anesthesia. My mood improved for an entire month before tapering off to my “normal.” If Medicaid paid for this, I’d do it in a heartbeat.)

In essence, TRD is a more complex and challenging form of depression that requires a more tailored and multifaceted approach to treatment. (Yeah, well… since I’m the only one that’s doing what I need to do to get more tailored treatment, and I can only do so much… that’s where we stand.)

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If you’d like to know the major catalyst that caused a lifetime of trauma, setting me up for where I am now, feel free to read about The Plague, if you haven’t already. I also have 2 drafts saved, one for each ex that’s added to the traumas I’ve endured, titled “Gravity” (my son’s father) and “The Dementor” (the last ex), which I will eventually write at length about and post (it’s difficult to get motivated to tell those stories). Other entries involve more explanations on the other mental health things and traumas I have suffered from, like: Cats & Anhedonia, My Brain on Trauma, The Good/Bad/Ugly, and Sacrifices.

Overall, I’ve covered quite a bit about myself, physically and mentally. I’ve been through way too much in my life and, as a result, here I am today. I’ll do Dr. Phil a proud and end this on as positive of a note as I can, though…

During Yoga/Trauma therapy yesterday, I pointed out that – BECAUSE of all the things I’ve gone through (especially The Plague and his influence) – I am pretty proud of who I am as a person right now. I’m not perfect, I don’t think I’m “better” than others, but I LIKE who I am. I’ve taken a solid shitty example of a sub-par human and held myself up to standards that exceed who he has been and still is. I became the best mom I could be to my son. I’ve tried my damnedest to help my loved ones (especially romantic interests) navigate life in healthier ways and inspire them to grow. I have a lot of love, kindness, empathy, understanding, compassion, and so many other good qualities inside me – which I do my utmost to share with others. I could definitely work more on giving those things to myself, of course, but that takes a lot more time and effort… I’m working on it.

And just so you know, saying all that doesn’t come with 100% confidence. I doubt myself a LOT, especially with raising my son and when I encounter someone that takes me for granted (like The Dementor did). I still have a long way to go, but I’m trying. And? The next couple of days are going to be pretty rough, me thinks. The Boyfriend has a boundary task to complete and he’s waiting until the very last possible minute to do it. It’s causing me significant stress having to wait for him to choose to do it or… not. And the results of choosing NOT to will impact my life in a way that I’m not sure I’m ready to face. So yeah… shit is up in the air right now.

So much for ending on a positive note, lol