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How to Keep Going When Mental Illness Treatment Doesn't Work

August 15, 2011 Natasha Tracy

What do you do when medication, therapy and other treatment of mental illness doesn't work? Why keep trying bipolar treatment? More at Breaking Bipolar blog.

Everyone who has been bipolar, or mentally ill in general, for longer than about a day-and-a-half has experienced failed treatments. We've all had medications that didn't work. Therapy that didn't help. Lifestyle changes that did nothing. And so on, and so forth. In fact, most of us experience months of treatment failure before we find treatment that works for our mental illness.

But after years of failure and trying everything you can think of and still being sick, how does one keep going? How do you keep going when mental illness treatment doesn't work?

Do You Regret Trying a Treatment?

People have asked me if I regret trying some of the treatments I have had, like VNS or ECT as they were painful and didn't work.

I can understand why people would think I'd regret it, but I don't. Because you can never tell if a treatment is going to work before you try it. Every treatment is a question mark and the only way to know whether you'll get better or not is to try. I don't regret trying. Because even failure is information to use moving forward.

I have not failed. I've just found 10,000 ways that won't work.

- Thomas A. Edison

Treatment Doesn't Work

I have experienced far more treatment failures than I have successes. I'm what you call treatment-resistant, also known as a doctor's nightmare. A doctor gives me pills, I get every side effect. I do therapy and I know what the therapist is going to say before they say it. I make other changes in my life to little or no effect.

Nothing works.

And when I say nothing, I mean 40+ medications and practically an infinite number of combinations. Intolerable side effects. Pain. Uselessness.

Seriously. Nothing.

Why Bother?

A friend of mine sometimes gets depressed. And he told me, he forces himself to go outside and do things anyway. When I asked him why, he said he knew staying inside wasn't going to make him feel better, but outside there was at least a tiny chance something would happen to make him less depressed.

Ah. Brilliant.

Continuing treatment is extremely simple: If I try something new, there is a chance I will get better; if everything stays the same, there is no chance.

Treatment, Even That You've Already Tried, Can Work

Today is not yesterday and today sure isn't three years ago. You're not the same. Your illness is not the same. You may not have seen a good response three years ago, but you might today. Or tomorrow. Or a month from now.

And the truth is there are always more treatments. Therapy, medication, ECT, VNS, rTMS, DBS and on, and on, and on. And any one of them can work. Really.

Because even a tiny chance of getting better is infinitely superior to no chance at all.

You can find Natasha Tracy on Facebook or GooglePlus or @Natasha_Tracy on Twitter.

APA Reference
Tracy, N. (2011, August 15). How to Keep Going When Mental Illness Treatment Doesn't Work, HealthyPlace. Retrieved on 2024, March 18 from https://www.healthyplace.com/blogs/breakingbipolar/2011/08/how-to-keep-going-when-mental-illness-treatment-doesnt-work



Author: Natasha Tracy

Natasha Tracy is a renowned speaker, award-winning advocate, and author of Lost Marbles: Insights into My Life with Depression & Bipolar. She's also the host of the podcast Snap Out of It! The Mental Illness in the Workplace Podcast.

Find Natasha Tracy on her blog, Bipolar BurbleTwitter, InstagramFacebook, and YouTube.

E
April, 5 2023 at 8:23 pm

I've been suffering from severe mental illness for the majority of my life and would describe it as absolute horror at this point. It's really upsetting that after having tried every treatment short of ect and well over a dozen pills along with a dozen or so different combos of all those pills without any improvement, I'm still expected to act like my other option is the irrational one and will be locked up in a psych ward if the wrong person thinks I intend to get out of this mess my way. I'm all for others making their own decisions and continuing treatment but why must I be tortured endlessly when it is my life and my welfare at stake and no one else's?

April, 7 2023 at 11:36 am

Hi E,
What I hear is that you're desperate. I understand that. I've been desperate many times. In fact, I've attempted suicide.
Do you know what happened after that? A different doctor suggested a different combination, and I improved dramatically.
I can't say what will happen to you, but what I'm saying is that you have as much of a chance to get better as I had.
You might want to consider a few things:
* Try a new psychiatrist. A new doctor may have new thoughts on your treatment.
* Try a new therapist. They, too, may be able to help you in a new way.
* Remember, new medication options are being approved every day. One of them may work for you.
* Have you tried rTMS? It's a neuromodulation treatment with fewer side effects than ECT. You can see here for more details: https://www.healthyplace.com/depression/depression-treatment/transcranial-magnetic-stimul…
* I'm not one to pressure a specific treatment on anyone, please keep in mind that ECT can be a miracle for some people, and when it comes down to death or trying ECT, death is not the answer. You can read about one person's experience here: https://www.healthyplace.com/depression/ect/my-ect-experience
Please don't give up when there are so many more options to try.
-- Natasha tracy

Fedup
November, 9 2021 at 4:23 am

I've been dealing with treatment resistant depression, ComplexPTSD and anxiety for over 30 years. I have little faith in mental health treatments. They work for many, but I'm not one. It has gotten to the point I fear hope because every treatment has failed or stops quickly. I don't leave my house, am a shell of a once happy human. Mental healthcare is a shot in the dark for some of us. I need structure, I need purpose, I need a reason. No medication or talk therapy has helped.
I want to run away, I have no friends, they don't understand mental illness, same with family. I've tried every possible treatment known and yet I am worse. Now in my mid 50's, unable to work and a failing memory from treatments.
I need a team of help and like minded folks to help me remember and to push and pull. I'm all alone even though married. My spouse doesn't understand nor does she want to.
She just wants me fixed. I have money, I have insurance, but still everything is fraught with how to make it more difficult to get care. I end up spending so much money out of pocket it is insane. I'm starting to think Shrinks are just poking in the dark and collecting a check. Heck many don't even take insurance, cash only.
The system is broken and so am I. All the treatments, torture, pain, suffering trying everything under the sun.
So what now? Seems us treatment resistant folks are just lost and on our own. Their has to be a better way.
This can't be just a life of suffering, with long term effects from all the meds.
I'm sick of waiting, hopingm trying, pushing. I want my life & I'm already mid 50's my physical health is affected now as well. Talking won't help, so now what.
Honestly Fed Up.

November, 10 2021 at 9:27 am

Hi Fedup,
I'm so sorry you're in that situation. I've been in the place where treatments don't work and I know how hard it is.
As you know, it's usually hard to treat complex PTSD. Have you tried EMDR? Some people find that very helpful for PTSD:
https://www.healthyplace.com/blogs/traumaptsdblog/2016/01/ptsd-treatment-what-is-emdr-and…
Also, you may be able to get in a trial for a psychedelic of some sort. They are showing real promise for those with PTSD.
https://www.medicalnewstoday.com/articles/psychedelic-therapy
I can't say whether either of those will work for you, but I can say they are worth looking into.
Also, I hope you are seeing a therapist who specializes in complex PTSD. It's a very specific illness and someone who specializes is your best bet.
I do also recommend that you look into online or in-person groups for people with complex PTSD. You'll likely feel less alone when you speak to people who intimately know where you are.
I hope something there helps. Please know that you're not alone.
- Natasha Tracy

Travis
April, 9 2021 at 4:52 am

At some point, the “professionals” need to finally face the hard truth that 2+2 will never add up to 5, the square peg will never fit into the round hole, etc. The definition of insanity is doing the same thing over and over again expecting a different result. Well, that’s what constantly piling failed treatments on top failed treatments is—insanity. None of us like seeing our loved ones anguishing with mental illnesses, but at what point do we finally put our own feelings aside and think about the individual doing the suffering? Many of you can retreat away from those individuals’ troubles when it becomes too much, but those poor souls struggling get no such luxury. Lucky for you, not so much to them. Does it ever dawn on you that maybe, just maybe, their lives are not yours to “save”? As kids, many of us are told that our lives are ours to make of whatever we dream, but that only seems to be the case when we want to be cowboys or astronauts. No, when someone is suffering from a debilitating mental illness that they can’t find any relief from after dozens of even hundreds of treatments don’t work, we opt instead to take that choice away and force them to do what *we* want with their life. Why? I mean, if your 5 year old daughter came to you and said she wanted to be a ballerina when she grew up, would you tell her, “No, you’re going to work a dead end customer service job where people will verbally abuse you all day, and learn to like it”? Of course not! At what point do we finally acknowledge that this person just might *never* get better? At what point do we acknowledge that maybe, just maybe, letting someone go, as undesirable to us as it may be, is just as compassionate as trying to help them? Maybe it *is* helping them? Yeah, some people say the mentally ill aren’t “in their right mind,” but who are we to say what the “right mind” actually is? What real evidence do you have to say you’re thinking clearly? Maybe a mentally ill person realizes something about life we just can’t comprehend? Maybe the modern societal norm that we should enjoy being alive is completely wrong and we’re the ones that are batcrap insane? No one that doesn’t suffer from one of these debilitating illnesses can truly know what it feels like, so who are we to tell those that do what they should think and do? Maybe instead of forcing upon them the treatment we think they need, we let them have the relief that they want even if it’s to die?
Sorry for the long post, but I feel this is a POV that should be considered even if it’s unpleasant for us.

April, 12 2021 at 1:12 pm

Hi Travis,
You certainly have a right to your opinion and point of view; but as one of those people who suffer from one of those debilitating illnesses, my point of view differs. I could list 1000 reasons why, but here are two:
One, we never know when a new treatment might work. Are the odds against someone who has been trying treatments for a long time? Probably. But that doesn't mean that a different treatment type such as ketamine infusions or electroconvulsive therapy or a new medication on the market won't be successful. I have a hard time "letting someone go" when I _know_ there is hope to be had.
Two, I have been in the place where I wanted to die and I have been in the place where I have tried and failed treatment after treatment. I, in fact, tried to die. But here, standing on the other side of that, I can honestly say, I was wrong. I wasn't the only one -- the doctors were wrong too -- but the point is, there is always a new avenue, you just have to find it, and I did. And now it's 11 years later. And it's not that it's been a glorious 11 years or anything, but it has been 11 years worth having, and that matters.
Yes, if you would like to consider the point of view of a very sick person who de facto isn't capable of making good choices (serious mental illness does that to your brain), that's certainly one option, but as I said, my view differs.
- Natasha Tracy

Travis
September, 6 2022 at 10:09 pm

You know physical illness can affect one's decision-making, too, right? So by that logic alone, we shouldn't consider the point of view of terminal cancer patients because their suffering prevents them from making "good" choices and thus we should keep them suffering on life support because some not-yet-developed cure could come along at any second now.

E
April, 5 2023 at 8:26 pm

Thank you so much for being compassionate as it hurts me so bad living in a world where very few people can understand the things you said. Just wanted to let you know I appreciate this comment so much taking up for people like me.

Kiera Gardner
December, 9 2017 at 4:13 pm

Thank you for sharing this. I have been in the "nothing works" journey for 26 years. I was able ttyl maintain some semblance of hope until about 2 months ago at which time even my hope failed. Since then I have felt something weird, a type of apathy that scares me. I've always have chronic suicidal ideation, but it's become such a casual thought process now. Without hope I feel more apt to self destruct than ever before. Your message made me feel less lonely. It was a breathe of fresh air and for that, I thank you.

Valerie Marx
April, 17 2017 at 12:18 pm

I'm also mental Resistant tried many meds feel good for a couple weeks then I'm flat on my back, nothing is helping, I'm Lonley for one house bound and couch bound for 3 yrs now, everyday I ask why, why can't I clean my house, cook food, leave the house? Been seeing a therapist or psychiatrist caseworkers your name for years nothings helped! I think if I had a friend slash care taker come with positive attitude may help I don't know but your employment definitely controls my depression, what do I do next ???

In reply to by Anonymous (not verified)

Natasha Tracy
April, 17 2017 at 7:28 pm

Hi Valerie,
I'm not sure what your last sentence means. Can you explain?
- Natasha Tracy

DepressedAllMyLife
October, 23 2016 at 10:09 am

I am a 63 yr old female, and can only remember one at in my life I wasn't depressed - the day my daughter was born. Other than that, my life has been continual, severe, unrelenting depression, despite a gazillion different medicinal treatments, therapies, hospitalizations, and even ECT. I have come to the conclusion that, for many of us "treatment-resistant" folks, it is preferable to accept that this is the way it is, instead of tossing our life savings down a black hole.

Barry Wilson
March, 23 2017 at 1:59 pm

While the article was published 5 years ago I have to say that at that time the author based on how I am able to feel and function, is doing great. She was able to actually write down an article about this subject and her relations to it. Then she was able to put it online. And get some intelligent responses plus mine. From where I am. That is the picture of good mental health. But I imagine that there is a person who is unable to write a comment although they would like to. All the best

Eve
March, 23 2016 at 3:38 am

I am at the end of my rope. The last medication gave me horrible side effects - a first for me, and something I don't need to happen again. I'm on a new med now and we resume the ECTs after I'm back from holidays with my SO.I haven't been this depressed in a very long time, and am seriously thinking about readmitting myself instead of going away, but that would let my partner down one more time. A lifetime of depression with the occasional bout of hypomania (not often enough to my liking, although the crash is not really worth it) is enough. I've had enough. Sometimes I think a rest home is the only way to go. Trying to live a life this way is brutal. Painful. And even more depressing when a new med poops out. We're probably going to move to bilateral ECTs now, given the limited effectiveness of the unilateral ones. There goes my memory and who knows what else. I know my psychiatrist would fix me if she could - she's been an unending source of support and compassion, for which I am truly grateful. But how much more can one person take? I know there's no magic fix, and I have tried so much over the years. But it's all disintegrating again and I can't keep pretending that things are all right. I'm tired, I cry all the time, and we're cranking the dosage of the newest med up as fast as is reasonable. I've come to consider my depression as me, not just an ailment because it IS who I am. It's unrelenting, it's interminable. I'm utterly fed up. I appreciate reading all these comments because it's awfully nice to see little rays of hope shining in the murk. Don't let me bring you down. It's probably just me. It's always just me. I'm so done. I can't find it in me to be hopeful any longer. Sorry for the downer post, but thanks for letting me share.

menotyou
October, 1 2014 at 1:59 pm

I've never read such utter crap in my life as I have on this page.
Hilarious was the part about the friend that can tell them self to go outside LMAO.
That's not mental illness thats plain old boredom.
Try not to post things as such and act like you know anything about what its like to suffer and not be able to EVER feel good for over 30 years.

Nancy McLernon
April, 30 2014 at 10:18 am

P.S. There is nothing painful about the treatment.There MAY be some short term memory loss but my memory was hampered by sever depression prior to E.c.T. there is no damage to neuro transmitter's. They grow back. They are reenergized after week's and month's of depression and lack of activity and stimulation. A doctor wrote his story about his receiving E.C.T. The Electric Man. haven't read it yet .too busy. :) That is a great thing! Peace and commitment to a life worth living.. Bless you,friends.

Nancy McLernon
April, 30 2014 at 10:10 am

I had experienced severe depression from the time i was assaulted, my dear friend died,my mother died and my husband nd I moved away from my close relatives. I went from depression,to isolating to wanting to hide till I felt better.Quit my job,impulsively instead of taking a medical leave. Began month's of medication that did not work returning to a medication that once worked and then did not..I felt I was in a cave... I believed that I would never get better... I took sleeping pill's hoping to sleep till I was better. I could not reason and felt other's would be better off without me if I could not function again or joke and tease. After three hospitalization's, I went into a great residential treatment center and therapeutic farm and horticulture setting.I had to get out of bed... I did receive E.C.T. and at that point of my existence, I did not care about what the future held for me if i had E.C.T. I wanted a life worth living again. Thankfully,it worked!! I had no strength to object or even question. I gave my trust over to the E.C.T. Team at an excellent University Hospital and I have no doubt it saved my will to live. It was frightening,however the support and educating i received from the team was so comforting .

glenn
December, 27 2012 at 2:41 pm

ive tried every therapy and medication too im seeing my gp tomorrow but its getting e down too.
a new medication is lined up but it didnt work last time and i am snookered and confused as to how i will get better. i have anxiety and ocd but head tension mainly

Mike H.
September, 21 2011 at 5:24 am

~N, I totally relate to your friend who forces himself to go outside. With me however, I take my trusty weed puller. It is a task that I can completely focus on and I can turn around and see some immediate results. Of course here in the Great Pacific Northwest, we have no shortage of weeds! But, if I am in a particularly difficult state of mind over a long period of time, I've told all of my neighbors not to be surprised at seeing me on my hands and knees in their front yards cutting a swath of dandelion destruction. They don't seem to mind.

MMC
September, 20 2011 at 8:48 am

My oversimplified understanding is that many time diagnosis is determined by what you actually respond to--so if you're bipolar you should respond to mood stabilizers but stay away from anti-depressants. So if someone is not responding to meds sometimes it is easier to change diagnosis than to wait for the next drug that is being put on the market. Especially if you are woman or person of color for which the classic symptoms might present differently.

ExcuseMoi
September, 9 2011 at 3:57 pm

I've been dealing (unsuccessfully) with depression and bipolar for many years. After surviving suicide attempts and finally getting a job with insurance and seeing a psychiatrist on a regular basis, just when I saw a light at the end of the tunnel, my psychiatrist hit me with the "you'll never be whole" thing. Gee. Thanks. Just what a depressed person needed to hear. Then my Aspergers son tried to kill his little brother--twice. Anyway, there is help out there, and I am proof of it. Yes, my current doctor just spent an hour trying to reason with me that I am psychotic, but not enough to commit me (already been down that road), and my eldest son hasn't killed anybody yet. Yes, there are many downs like having to quit my job, and devoting many hours to counseling, and everybody involved is taking medications, but it's worth it. I refuse to accept that I have a masters degree and can't find a workplace to "fit it". I remain optomistic that with continuted treatment, I won't off myself, my eldest won't kill off the family, and eventually we will all attain some type of success in our personal lives.

James
August, 17 2011 at 9:11 am

I've tried and had several medication failures. Some ended in hallucinations, while others triggered a severe mania. The worst failures I've found are the ones where instead of side effects, it just stops working. As depressing as those failures can be, I've always tried to remain realistic. Every time I've tried a new drug, I learn more about myself; what I'm willing to tolerate, what sort of symptoms I tend to get, any life style changes that have improved my stability regardless of the drug. I see each medication as a chance to learn a little more about myself, and that stays with me even after a failure.

madam bipolar
August, 16 2011 at 5:41 pm

Hi Natasha,
Thank you for telling your story. It certainly can be a long path towards getting the right medication and sometimes it can be a very lonely journey.
My lifesaver was lamictal. I hope you find yours soon.
MB xx

Natasha Tracy
August, 16 2011 at 8:46 am

BipolarBlogg and Natalie,
Thanks for the positive feedback. Glad I could help with perspective; it's a challenge for anyone.
- Natasha

Natasha Tracy
August, 16 2011 at 8:45 am

Hi Alistair,
Great comment.
"It is frustrating at times but patients need to know that if care providers had a magic solution they would not hide it."
Yeah. I've felt like they were "hiding it" before. Not because I really thought they were but because I couldn't get better and I was desperate and I knew that other people got better. It _seems_ like they're hiding it, but of course, they're doing the best they can. (Which I tell people all the time and yet people find it hard to believe.)
- Natasha

Alistair McHarg
August, 16 2011 at 7:11 am

So often we approach treatment with unrealistic expectations, especially when we are new to the game. Frequently we are coming from very painful and scary places - we look to treatment for salvation. We forget that treatment is more art than science, and that a cure is not a binary thing, like throwing a switch. The patients that do best are the ones that think of treatment as a process which requires a lot of trial of error, fine-tuning, and even experimenting. It is frustrating at times but patients need to know that if care providers had a magic solution they would not hide it. -- Those who crave certainty should remember that, while no treatment is infallible, what IS certain is that if they continue to do nothing, they will certainly continue to suffer.

Natalie Jeanne Champagne
August, 16 2011 at 7:02 am

Hi, Natasha:
Great post. I just want to say that I have been following you for a while on HealthyPlace.com and on your website. I appreciate your honesty on the topic and am glad to be part of the blogging team. Thank you for, as they say, keeping it real.
Natalie
@ http://www.healthyplace.com/blogs/recoveringfrommentalillness/

BipolarBlogger
August, 16 2011 at 6:45 am

Hi Natasha,
I started on a new treatment programme for my bipolar this spring with high hopes and a really positive recommendation from my psychiatrist. It didn't work. I got to a stage where I was feeling upset with myself for not responding as expected to the meds, which I know is crazy, but that's how it was. I'm changing meds now and have been on the new one a couple of weeks. I know I am going to be really disappointed if this one doesn't work either, but reading your post has helped me get a bit of a sense of perspective back, thanks!

Natasha Tracy
August, 16 2011 at 6:05 am

Hi Robin,
This is really, really common. When treatment doesn't work it feels like your fault - but it isn't your fault. Mental illness can be very difficult to treat and you just haven't found what you need yet.
It's natural to blame yourself, but please know, that's just the disease talking. It's not you.
I recommend discussing this in therapy because a therapist is always there to back you up and fight the nasty things your disease tells you.
- Natasha

robin
August, 16 2011 at 6:01 am

I have been struggling with the idea of being treatment resistant for a while now. I go back and forth between thinking i have an illness and its stubborn OR maybe, I don't and this is how I am- healthy but feeling shitty and this is how everyone feels and i just am weak?
I wonder about this- a lot. I wonder if its my job, not an illness, if its my relationship and not an illness, I even wonder if maybe i am just dehydrated!!!
Today, Im in treatment, but still feeling shitty and depressed and anxious. I wrestle everyday with it and someways- i feel like its not worth the effort.

mef123
August, 16 2011 at 2:54 am

I'm also treatment resistant and it's been over 3 years since I felt good. But I won't give up. I really like what you said gives me hope.
Michele

Natasha Tracy
August, 15 2011 at 6:11 pm

Darren,
I generally consider it an accurate assessment of the glass, but that's me.
- Natasha

Darren Joyce
August, 15 2011 at 5:27 pm

Now that's looking at the glass half-full, isn't it?

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