My Depression Feels Like an Uphill Battle

Depression. The Big Sad. The mood thief that robs you of joy, energy and sometimes hope. It’s more than just feeling down in the dumps or having a rough week—it’s an unwelcome houseguest that can overstay its welcome. Depression can last years or it can be situational and fade away when a person’s circumstances change. It can also return in the future, which is why getting help early is key.

A Quick Refresher

The American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) classifies depression into several types, including:

Major depressive disorder (MDD) is the heavy-hitting and most severe form of depression. Symptoms can include feeling sad, low or even hopeless for most days for at least two weeks, along with other symptoms like sleep disruption, loss of interest in activities, fatigue or a change in appetite. 

Persistent depressive disorder (PDD): Also known as dysthymia, this is a mild or moderate depression that lasts for at least two years. Imagine depression, but turned down a notch. It’s less intense than MDD but more enduring, often making life feel like a gray, overcast day.

Disruptive Mood Dysregulation Disorder (DMDD): Think of DMDD as chronic irritability turned up to eleven, often seen in children and teens. It goes beyond the typical mood swings and involves intense outbursts that can leave everyone feeling frazzled.

Premenstrual Dysphoric Disorder (PMDD): PMDD is like PMS on a rollercoaster with extra loops—mood changes, irritability and physical symptoms can feel overwhelming in the days leading up to your period.

Depressive Disorder Due to Another Medical Condition: Sometimes depression isn’t just about emotions—it can be a side effect of a medical condition like thyroid disease or stroke.

How Long Does Depression Typically Last?

Because every person is unique, their depression is also entirely individual. For some, depression is triggered by something situational or specific like substance abuse or medical problems. And for others, depression can arise out of nowhere or come in unexpected waves or episodes.

Depression can last any length of time. And symptoms can vary in intensity from person to person. If left untreated, severe depression can last six to nine months on average, but again, everyone’s experience is different. What we know for sure is that chronic conditions, like dysthymia, can stretch on for years.

What If My Depression Won’t Budge?

If you’re doing (and have done) all the things—therapy, medication, lifestyle changes—and your depression sticks around, you could be dealing with something called treatment-resistant depression (TRD). TRD is a type of MDD that can can persist even after taking multiple antidepressants and trying different treatments.

For those who have not responded adequately, there are alternative treatments, such as:

Transcranial Magnetic Stimulation (TMS)

Think of TMS as the brain’s version of WiFi troubleshooting. This non-invasive treatment uses magnetic pulses to “wake up” underperforming parts of your brain. No anesthesia, no downtime and for many people it works when nothing else has. Approximately 50-60 percent of people with stubborn depression who’ve failed to receive benefit from medications and therapy experience a clinically meaningful response with TMS.

Electroconvulsive Therapy (ECT)

ECT gets a bad rep (thanks to movies like One Flew Over the Cuckoo’s Nest), but it’s one of the most effective treatments for severe depression. Administered under anesthesia, ECT essentially reboots your brain’s electrical activity, with many patients reporting dramatic improvements in their symptoms. For the skeptics out there, read JAMA’s editorial which calls ECT vastly improved yet greatly underused.

Ketamine Therapy

Ketamine, traditionally an anesthetic, has emerged as a groundbreaking treatment for treatment-resistant depression (TRD). Unlike conventional antidepressants, which can take weeks or months to work, ketamine offers rapid relief, often within hours, by targeting the brain's glutamate system to enhance neuroplasticity. This unique mechanism helps break entrenched depressive patterns, making it particularly effective for individuals unresponsive to standard treatments. Administered in controlled, low doses under medical supervision, ketamine is transforming mental health care for those with severe, persistent depression.

When Should I Get Help?

Getting help early for depression makes a big difference. The sooner you start treatment, the easier your symptoms will be to manage and the better your chances of feeling like yourself again. As an ER crisis worker, I often saw how waiting can make things harder—symptoms can grow and feel overwhelming, sometimes leading to thoughts of suicide.

We get it, there are many reasons why people don’t seek help, including money, time and even stigma. Reaching out for help is not a sign of weakness—it's a big step toward feeling better and preventing depression from taking a greater toll on your emotional and physical health. We're here to listen and guide you through this process, no matter where you are on your journey.