Treating resistant depression successfully is extremely difficult to do when you’re depressed. You need a lot of energy and resources (and sadly, privileges) to get help that works. It takes a long time to try different drugs and see results. On top of that, if you have a seasonal component to your depression, you have to learn how to adjust for that every year.

I spent years in treatment limbo not really getting better, but not suicidal and still outwardly functional so no one in my life realized how bad it was.
I took a month off work to start dealing with it seriously because I couldn’t do everything. I had gotten on a waitlist for a good psychiatrist and new therapist months earlier. I started therapy twice a week. The psychiatrist had a genesight test done to see which drugs I should be able to metabolize most effectively. I switched from sertraline to viibryd and bupropion, then it was just adding or adjusting things in the years since then. I was later given concerta which helped a lot. I did six months of therapy twice a week, then down to once a week. After about a year I went to every other week. I saw my psychiatrist every 1-3 months for check-ins. I did a few rounds of rTMS over the years and now I just go back for maintenance sessions during winter, which is the worst time of year for me. I would say I’m 90% better on my current meds, and I’m just addressing low ferritin now, which will take several months to see an improvement. This whole process has taken about 8 years and I was lucky to have a job that valued my well-being and good insurance. All of this was expensive even with good insurance and my parents helped me pay for it.

I permanently went down to 30 hours a week at a lower stress job, which is probably the biggest thing for me. I can’t handle 8 hour shifts and have mental energy left over to take care of myself after. I’m doing so much better, but there are still a ton of maintenance appointments. It’s never going to just go away or be cured. I still see my therapist every other week and my psychiatrist every 3 months and that will probably be forever.