Depression affects more than 21 million Americans each year, but treating it remains a challenge.
“Each person’s experience is shaped by a mix of biological, psychological, and environmental factors, meaning a treatment that works well for one individual may not be effective for another,” says Russ Voltin, MD, a psychiatrist in Charleston, West Virginia, and medical consultant for Brainsway.
About 60% of people with depression need more than one treatment to start feeling better. If you have what’s called treatment-resistant depression (TRD), even taking two medications for at least six weeks might not provide relief.
“This can be especially discouraging, often intensifying feelings of isolation or hopelessness and creating a cycle that makes it harder…to seek help,” Voltin says.
Below, three people who’ve made it to the other side of depression share their stories in the hopes that it will help you, too.
“Mental health recovery doesn’t mean your mental health is perfect all the time.”
Sierra Grandy, 31, has successfully kept her depression in remission for seven years, but it took multiple treatments to get to this point.
Grandy’s mental health struggles began at age 11, when she called 911 to get help for suicidal thoughts. During a 72-hour psychiatric hold, she was diagnosed with depression and anxiety.
For a while, medication and therapy helped. But another crisis situation never seemed far away.
“I’d end up in the emergency room, I’d end up in a different hospital, and they’d be like, ‘Well, let’s try something else,’ so I’d go on a different medication, and I’d get a different therapist,” Grandy says. “It just kept escalating.”
By her 18th birthday, Grandy had tried over a dozen different depression medications that either stopped working after a while or caused side effects such as weight gain that made her feel worse. Over the years, she tried intensive inpatient and outpatient treatments, various types of therapies, support groups, electroconvulsive therapy, and transcranial magnetic stimulation (TMS).
Then, in 2019, Grandy’s mother read about a fast-acting antidepressant as a new treatment for depression. After talking with her psychiatrist, Grandy started a month of infusions of the antidepressant.
“It’s not like my depression went away,” Grandy says. “My depression was like a cave, and…my only goal was to survive in that cave. And then I started these treatments and having my needs met and getting more support…and I got to choose, ‘Am I going to do the work to get out of the cave?’”
Today, Grandy continues to get the infusions every 10-12 weeks under a psychiatrist’s supervision. She takes medication for ADHD and anxiety, which helps keep her mood stable. Therapy, particularly dialectic behavioral therapy (DBT), has also been a touchstone for her. “It’s skill-based, so it teaches a variety of different skills, including mindfulness, distress tolerance, and communication skills,” Grandy says.
Often, when we talk about mental health recovery, “we don’t define what we mean, so people assume that your mental health is perfect all the time,“ Grandy says. “That’s absolutely not the case.”
She can sometimes still feel her symptoms, but she now has the tools and support to help her stay well.
“I can still see that cave, but I’m not in [it] anymore,” Grandy says. And if she does return, “I always have an escape route.”
“Try as many approaches as you can.”
In the summer of 2019, Joshua Beharry, 39, became increasingly anxious about his final year of college and what would come next. As classes began that fall, “I started having more frequent and darker thoughts,” he says.
By the time Beharry saw his family doctor, he was severely depressed, scoring 20-something out of 27 on the PHQ-9, a common depression screening tool. He began taking an antidepressant. But, he says, “I was pretty devastated to learn it could take weeks to fully kick in. At that point, each day felt like a marathon.”
Beharry began seeing a psychiatrist who offered a mix of cognitive behavioral therapy (CBT) and general talk therapy. Then, he tried a CBT support group, which felt more overwhelming than helpful.
“My mood kept improving slightly, then going back down, so it was hard to know if I was actually improving,” he says. “I’d feel a bit better one day, then hit a new low the next.”
Once the antidepressant had time to take effect, Beharry’s energy finally started to improve. This helped him start eating more and sleeping better and having the energy to just go for a walk.
His treatment kept evolving from there. Beharry began taking a second antidepressant, practicing mindfulness, committing to learning CBT skills to challenge his negative thought patterns, and joining a different peer support group where he felt more comfortable opening up.
He credits his recovery to these treatments working together, “as well as time, experience, and just getting used to having highs and lows,” he says.
“The last piece of the puzzle wasn’t really a treatment per se but more me regaining a sense that all the work I was putting in could help me get better, that recovery was actually possible,” Beharry says. “For a long time, I was going through the motions and trying different strategies but…my inner monologue was so negative and dismissive of anything actually helping.”
Today, Beharry works for HeadsUpGuys, a nonprofit that encourages men to improve their mental health. When it comes to depression recovery, “talk therapy consistently comes up as one of the main things that helped, along with self-acceptance, reaching out to others, and medications, for some,” he says.
That squares with Beharry’s advice to others: “Try as many approaches as you can, focus on the basics like sleep, food, relationships, social connections, and physical activity, and give therapy a chance.”
“Alternative treatments have been life-saving for me.”
Gina Capobianco, 53, has lived with depression for 40 years. When she was first diagnosed in college, she was prescribed a popular antidepressant. It helped only a little.
“I don’t think I knew enough at that time about what I was going through to really know whether I was getting better or not,” Capobianco says. “And then, anxiety kicked in shortly after I was diagnosed, so that threw a wrench into things.”
After she graduated college and no longer had health insurance, Capobianco stopped her medication. She used alcohol to self-medicate instead. Then, in her late twenties, she started seeing a psychiatrist. For the next decade, Capbianco was regularly prescribed new medications or the doses of her existing medications were increased.
“Sometimes, [the psychiatrist] wouldn’t look up from her prescription pad,” she says. “It was like I was a walking medicine cabinet.”
And still, nothing helped lift Capobianco’s depression.
Her primary care provider, reviewing her medication list during a visit, finally raised an alarm. “She basically told me I was being overmedicated,” Capobianco says. “And she encouraged me to find a new psychiatrist.”
It took work for Capobianco to not only stop the medications but also to find her current psychiatrist, who diagnosed her with treatment-resistant depression and suggested TMS.
The noninvasive procedure, which uses magnetic pulses to activate brain regions that are linked to mood, was a commitment: 38 sessions, lasting about 45 minutes each. But between the second and third session, Capobianco began to feel her depression lift. “It was eye-opening that I could feel better,” she says.
The effects lasted six to seven months.
During a recent rough patch, Capobianco also found relief through an anesthetic, given as a nasal spray twice a week, for several weeks.
About being under the care of her previous psychiatrist, Capobianco says, “It was like I didn’t know that I had a right to insist on better treatment.” She says, “The one I’m with now listens, and I’m a part of every decision.”
Although medication works for a lot of people who live with depression, “there are some of us that it just doesn’t work,” Capobianco says. “Alternative treatments like TMS…have been life-changing for me.”
How to Get Help When You Feel Helpless
If a depression treatment doesn’t work for you, don’t give up. “It doesn’t mean that nothing will,” says Leana Oppenheim, DO, a neurologist and medical director at NeuCognition Centers. “Many individuals who feel stuck do go on to experience meaningful improvement, sometimes after multiple adjustments in their care.”
Feeling hopeless is the most well-known symptom of depression. But “it’s frequently a reflection of the condition itself, rather than an accurate prediction of the future,” Oppenheim says.
Show Sources
SOURCES:
Joshua Beharry, project manager, HeadsUpGuys, Vancouver, Canada.
Gina Capobianco, author of Traveling the Healing Journey: Finding the Light in Mental Illness, Southern California.
Sierra Grandy, speaker and advocate on neurodiversity, mental health recovery, and disability; founder, Questify Your Life; Minnesota representative and 2nd vice chair, NAMI Peer Leadership Council, Saint Paul, Minnesota.
Russ Voltin, MD, practicing psychiatrist and medical consultant, Brainsway, Charleston, West Virginia.
Ken Duckworth, MD, double board-certified psychiatrist and chief medical officer, National Alliance on Mental Illness, Arlington, Virginia.
Leana Oppenheim, DO, neurologist and medical director at NeuCognition Centers, Seminole, Florida.
Mental Health America: “Depression.”
National Alliance on Mental Illness (NAMI): “Treatment-Resistant Depression.”
