Why does depression persist without treatment? Let's talk about social causes (Treatment-Resistant Depression)

Do you or someone you know have depression? Maybe you've seen a doctor, taken medication, and followed the advice, but you feel like your condition isn't getting better. Do you sometimes feel better, but then feel like you're going back to your old self? We call this "treatment-resistant depression." But don't be afraid to hear this name. This doesn't mean that you can never be cured. Sometimes the cause of this condition can be deeper issues in our lives and society that we don't think about. Let's talk about that today.

Why do some people continue to have depression?

Simply put, depression is a condition caused by chemical changes in the brain. It can be successfully treated with medications prescribed by a doctor (antidepressants) and counseling/therapy. However, sometimes these treatments do not completely control the disease.

If we look at ourselves in Sri Lanka, we can identify several key factors affecting this situation.

Social stigma and shame

This is one of the biggest challenges in our country. When people say mental illness, most people think "crazy."

• Hiding the illness: Many people are embarrassed or afraid to admit that they have depression and talk about it. Many people suffer from this because of concerns like, "What will the neighbors think?" or "Will my friends at work ostracize me if they find out?"
• Pressure from family: Sometimes family members themselves don't understand this. They say things like, "That's just something I'm imagining," "Think about it a little harder," and "Go to a temple or a mosque," but they don't want to admit that this is a disease that requires medical treatment.
• Stopping treatment: Because of this shame, some people stop treatment midway, even if they see a doctor or start taking medication, for fear that someone will find out. Stopping the medication when they feel a little better, saying "that's enough," only leads to a relapse.

With this kind of social pressure, it becomes a big challenge to get proper, consistent treatment. It is a major reason for the prolongation of depression.

Economic and practical issues

Mental health treatment can sometimes be a financial burden. Think about the cost of traveling from the village to the city to see a psychiatrist, the cost of medication, and the loss of time off work. With all of this, it can be very difficult for some people to continue receiving treatment.

Although there is free treatment in government hospitals, there are practical problems such as the crowd there and not enough time to talk freely with a doctor. Because of this, some people give up on seeking treatment.

The relationship between you and the doctor

This is also a very important point. Do you feel that your doctor understands you? Do you have an environment where you can talk openly about your problems, feelings, and fears without any shame?

Sometimes, when we can't build a good relationship with a doctor, we become uninterested in treatment. We don't follow what the doctor says. We may even stop treatment, thinking, "He doesn't understand me."

So what do we do?

When you look at all these things, you probably understand that depression is not a disease that can be cured by taking medicine. It is complex. There are many social and economic factors that affect it.

1. Accept and talk: First, accept that this is an illness. Don't be ashamed. Talk about it with a trusted friend or family member. Keeping it bottled up inside will only make things worse.

2. Be honest with your doctor: Talk to your doctor about everything. Are there any side effects from the medication? Is it difficult to afford the cost of treatment? Tell him about the social pressures you are facing. Once you know all this, your doctor can create the treatment plan that best suits you.

3. Be patient: Depression takes time to heal. Don't expect overnight results. Be sure to continue taking your medication for as long as your doctor tells you. Don't stop taking your medication as soon as you feel a little better.

4. Ask for help: It's hard to go through this journey alone. Ask for support from family and friends. If necessary, seek the help of a counselor. It will be a great source of strength for you.

It's not your fault that depression persists. There are many external factors that can contribute to it. The most important thing is to identify those obstacles, work to overcome them, and never give up hope and continue to seek the right medical treatment.