Here I Go Again...

 

WARNING: This blog includes descriptions of self-harming behaviors, please take that into consideration before you continue reading and especially if you choose to leave a comment.

Here’s an AI generated definition of treatment resistant depression:

Treatment-resistant depression (TRD) is the lack of response to at least two different, adequate antidepressant treatments for major depressive disorder, meaning the symptoms don't improve or only partially improve after taking the medications for sufficient time and dosage. While there isn't a universally agreed-upon official definition, the condition is identified by the failure to achieve adequate improvement with standard treatments and requires further investigation to find an effective course of action. 

I’ve had a major depressive disorder since I was roughly 22 years old. I’ve had treatment resistant depression since roughly 2006 when I had a 12-treatment course of ECT (electro-convulsive therapy), generally known as “shock therapy.” I had 2 weeks of ECT on a Monday-Wednesday-Friday schedule, then 2 weeks on a Tuesday-Thursday schedule, finally I had 2 weeks of weekly treatments on Wednesdays.

By the 5^th week Mark had to carry me from the car into our house after treatments because my head hurt literally beyond description, I was weak, I had unending vomiting on treatment days, and I could barely sip water and eat 6 saltine crackers throughout the course of the treatment days.

During the last 2 weeks of treatments, I attended the wedding of one of my best friends and I remember none of it. Thank God we have pictures so at least I could see the lovely bride and groom, their flowers, and my other friends in attendance.

In early October 2023 my depression symptoms were worsening. I spent weekly sessions with my psychiatrist trying an addition of another antidepressant, reported no improvement, that med was discontinued and another antidepressant was added, yet again I reported no improvement, and my symptoms were still worsening. Finally, I did some online research and found oral Ketamine treatment for treatment resistant depression. Costs were all out of pocket, I had to provide medical information, have an online interview with the prescriber for medical clearance, meet with a “guide”, and document my intentions pre-treatment and what I got “out of the medication session” to discuss with my guide.

I had a 6-treatment weekly course of 800mcg (I’m not sure how they measure the doses, it could be micrograms, milligrams, I don’t really know) but after week 4 I started feeling a shit ton less depressed and that continued for about 18 months. Which brings me to late summer/early fall 2025.

My shrink and I have gone back and forth over the years discussing if I may have bipolar disorder, which as of my last appointment with him on August 4, 2025, I’m not diagnosed with. I agree with that…there are times when my depression was so severe, I would have given anything for a smidge of hypomania, which never happened.

By mid-September this year I started feeling overwhelmed, anxious, and once again worsening depression. I believed I was an independent woman who ought to be able to manage my emotions without any help or support outside of my therapist and my shrink. I said nothing to anyone except for them about how I was spiraling down, down, down.

I couldn’t wait for my psychiatrist to tinker with my meds or take weekly doses of oral Ketamine through the previous online organization I had previously used and received significant relief. I needed help NOW.

On September 21^st I found a local provider of IV Ketamine, 6 total sessions on a Monday-Wednesday-Friday schedule for 2 weeks starting October 13^th. They use an app where I complete daily mood ratings, journal, have access to an online community, and PHQ-9 depression assessments.

This is my entry for Friday October 10^th:

I had a breakdown. I slammed my hands against the bathroom counter while sitting down in front of the shower and slammed my head against it a few times. Then I laid down on the bath mat and cried. I took the scissors and cut off my hair. No idea what I was doing, I just kept cutting and cutting until 80 percent of it was gone. I can’t look in a mirror to see my ugly face and what I’m sure is my ugly hair. I am useless, I am a burden. I can’t stand myself.

I had my first IV Ketamine session on Monday, October 13^th. As of today (10/23/25) I’ve had 5 sessions. I was originally scheduled for 6 sessions, but after talking with my provider she recommended 8 sessions, so my last medication session is now Wednesday, October 29^th. My anticipated return to work date on a part time schedule is Tuesday, November 4^th. I’m receiving short term disability, 60% of my regular salary, which is enough to get us through.

My “mood trend” scores have gone from 3 on a 1/10 scale on 10/05/25 to 7/10 on 10/23/25 which is a clinically significant increase in mood. I have another week and a half before this part of my medication journey concludes. We’ll see where I go from here.