\u201cMy grad school had free therapy. If it didn\u2019t, I would have failed,\u201d N Dhar, 25, said about living with treatment-resistant depression. And she isn\u2019t exaggerating. Even brushing her teeth felt impossible some days, so she swished mouthwash instead. Meals were replaced with bananas. Showers gave way to simply changing into clean clothes and slapping on strong deodorant. These weren\u2019t acts of laziness or self-pity; they were lifelines, micro-strategies for surviving when your brain insists it\u2019s over\u2026 again.<\/p>\n
In India, mental health challenges are often dismissed as \u201cjust stress\u201d or \u201cbad days,\u201d with structured support remaining scarce or unaffordable. For Dhar, diagnosed with depression in 2019 after years of silent unravelling, treatment resistance was a brutal reality. \u201cI was always depressed\u2014even before I knew what depression was,\u201d she said, recalling vague childhood memories of unexplained sadness as early as third grade. \u201cIt was like being homesick for another world. But I was only seven. What other world could I even know?\u201d<\/p>\n
<\/p>\n
Dhar is part of a growing population in India grappling with<\/a><\/strong> treatment-resistant mental disorders (TRMD) \u2014a term that sounds clinical but carries a heavy human cost. For these individuals, healing isn\u2019t a straight line. It\u2019s a maze full of trial and error, high financial stakes, misunderstood pain, and a healthcare system often ill-equipped to help.<\/p>\n<\/p>\n Story continues below this ad<\/p>\n What does treatment resistance really mean?<\/p>\n According to Vikram Kirtikar, senior psychologist at Mpower The Centre, Mumbai<\/a>, \u201cA treatment-resistant mental disorder is defined as a mental health condition that does not respond to conventional forms of treatment, including medication and psychotherapy. The failure of two or more evidence-based treatments, despite proper adherence, often raises red flags.\u201d<\/p>\n This resistance can manifest in depression, anxiety, bipolar disorder, schizophrenia, and obsessive-compulsive disorder (OCD). Patients may undergo multiple pharmacological treatments and various therapy modalities like cognitive behavioural therapy (CBT) or interpersonal therapy (IPT) yet show little to no improvement.<\/p>\n Vishnu Priya J, a consulting psychologist and CEO of Aathma The Healing in Trivandrum, said, \u201cIt\u2019s not just about treatment failure\u2014it\u2019s about the psychological toll of constantly feeling like you\u2019re fighting an uphill battle. I had a patient, Chithra (name changed), who underwent therapy and medications for years without progress. Her deep anxiety and depression, despite best practices, exemplify treatment resistance.\u201d<\/p>\n The lived experience: Stigma, isolation, and disruption<\/p>\n \u201cLife with treatment-resistant depression is just charmless,\u201d Dhar said. \u201cSometimes, I don\u2019t even have the imagination to have dreams.\u201d For her, the diagnosis offers a strange form of validation: \u201cBefore, people dismissed my sadness. Now, with the paper, it\u2019s as if my sadness is authenticated.\u201d Yet validation is not the same as support.<\/p>\n Story continues below this ad<\/p>\n Accessibility remains a major hurdle\u2014therapy costs are high, availability of medications is inconsistent, and stigma persists even at the chemist\u2019s counter. \u201cIn places like Chennai<\/a> and Guwahati<\/a>, I couldn\u2019t access common selective serotonin reuptake inhibitors (SSRI), common antidepressants. Sometimes, the chemist even questioned if the meds were \u2018really\u2019 for me,\u201d she said.<\/p>\n For people like Dhar, the disorder disrupts every aspect of life. \u201cThe worst part wasn\u2019t the symptoms,\u201d she said, \u201cit was being told I should be getting better. When I didn\u2019t, people assumed I wasn\u2019t trying hard enough.\u201d Basic tasks become monumental struggles, social relationships suffer, and educational or career paths stall. The result is often profound isolation.<\/p>\n Priyamvada Tendulkar, a clinical psychologist, stressed the hidden weight of such conditions: \u201cFor treatment-resistant patients, it\u2019s not just about not feeling better\u2014it\u2019s about losing faith in the very systems meant to help them. It leads to self-doubt, shame, and disconnection from the world.\u201d<\/p>\n Kirtikar said, \u201cChronic mental health issues can alienate individuals from their communities and families. The stigma attached to \u2018not getting better\u2019 only worsens their isolation.<\/p>\n Story continues below this ad<\/p>\n Resistance is more than diagnostic challenges and medication<\/p>\n Treatment resistance is not solely about medications that don\u2019t work. Sometimes, TRMDs remain undiagnosed for years due to misdiagnosis or overlooked underlying medical issues\u2014such as thyroid disorders or vitamin deficiencies. \u201cRevisiting the diagnosis is crucial. A proper evaluation should include a thorough review of treatment history, ruling out comorbidities, and sometimes rethinking the diagnosis altogether,\u201d Kirtikar said.<\/p>\n Vishnu Priya said, \u201cWhen a patient shows no improvement after multiple treatments, we must reassess everything\u2014from the diagnosis to the delivery of treatment.\u201d<\/p>\n The concept of \u201cresistance\u201d itself is layered. It could arise from biological differences, trauma histories, genetic vulnerabilities, or even environmental factors such as ongoing stressors or lack of support systems. Yet this clinical framing, although useful, can feel soulless. \u201cWe must ask: resistant to what? A protocol? Or resistant to not being seen?\u201d Tendulkar said. For many, resistance is not about biological non-responsiveness alone; it\u2019s the result of years of misdiagnosis, unaddressed trauma, and a lack of truly compassionate care.<\/p>\n Take Dhar\u2019s case, for instance. Since her diagnosis in 2019, she has cycled through nearly every class of antidepressants\u2014SSRIs, Serotonin-norepinephrine reuptake inhibitors (SNRI), and atypicals like bupropion\u2014with no sustained relief. \u201cEach psychiatrist visit is no less than Rs 1,500 and every trial takes weeks. It does feel like you\u2019re blowing money and time. I wish I could ask for a refund,\u201d she said, half in jest.<\/p>\n Story continues below this ad<\/p>\n Tendulkar explained that after years of being mislabeled or under-supported, some clients not only lose faith in the treatments but also in the very possibility of healing. She recounts a client who ceased to speak in therapy after receiving seven mismatched diagnoses in five years. \u201cShe was labeled \u2018resistant,\u2019 but in truth, she suffered from complex post-traumatic stress disorder (PTSD). No one ever asked, \u2018What happened to you?\u2019\u201d<\/p>\n This disconnect between clinical labels and lived experience can inflict wounds deeper than the disorder itself. In India, where trauma literacy is still emerging\u2014even among professionals\u2014the risk of further harm is significant.<\/p>\n Treatment-resistant depression often strains relationships. When recovery stalls, loved ones may feel helpless. \u201cWhat breaks the loop isn\u2019t magic\u2014it\u2019s attunement and radical acceptance,\u201d said Tendulkar. She encourages presence of friends and family over prescriptions and celebrating small wins\u2014sleeping well, journaling, walking\u2014over chasing a cure.<\/p>\n For Dhar, that support looks like grace during ghosting periods, and an understanding of her irritability. But she\u2019s also trying to meet her loved ones halfway\u2014by improving her own communication and setting realistic expectations. She talks about the \u201cunsexy truths\u201d of self-care. \u201cYes, being depressed is not my choice, but it remains my problem. I want to take some agency to solve it, like a diabetic person managing their blood sugar. Ambitious, yes, I know,\u201d she said.<\/p>\n<\/p>\n Story continues below this ad<\/p>\n Despite the grim prognosis, there is hope. \u201cLiving with a treatment-resistant disorder doesn\u2019t mean living a joyless life. It means finding a new language for survival\u2014through community, creativity, or alternative practices like mindfulness, nature therapy, or body-based interventions,\u201d said Tendulkar.<\/p>\n The goal in treatment-resistant disorders may not be to eliminate symptoms. \u201cYou redefine recovery not as \u2018no pain\u2019 but as \u2018living with pain and still loving life\u2019,\u201d said Tendulkar. This reframing\u2014of befriending the self rather than fixing it\u2014is central to long-term healing.<\/p>\n Vishnu Priya echoed this sentiment: \u201cWe may not always achieve full remission, but we can aim for management, resilience, and meaning. The goal shifts from \u2018cure\u2019 to \u2018coping with dignity\u2019.\u201d<\/p>\n The road ahead<\/p>\n Tendulkar said, \u201cThe only way to serve someone in that dark place is to sit with them in it. To say: \u2018I see you. You\u2019re still worth fighting for\u2019.\u201d<\/p>\n Story continues below this ad<\/p>\n Treatment-resistant mental disorders are not an endpoint; they are detours\u2013\u2013painful, confusing, and lonely. They challenge us to reconsider what healing looks like. They call for a deeper commitment\u2014from families, clinicians, and systems\u2014to see people as more than diagnoses.<\/p>\n As India\u2019s mental health movement evolves, we owe it to voices like Dhar\u2019s to hold space for complexity. Because healing isn\u2019t always about becoming symptom-free. Sometimes, it\u2019s just about finding the will to try again tomorrow. Even in the shadows.<\/p>\n","protected":false},"excerpt":{"rendered":"\u201cMy grad school had free therapy. If it didn\u2019t, I would have failed,\u201d N Dhar, 25, said about…\n","protected":false},"author":2,"featured_media":13638,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4317],"tags":[9242,9251,9248,105,9238,9243,218,9247,9241,9236,9246,9240,9239,9250,9249,9237,9234,9235,16,15,9244,9245],"class_list":{"0":"post-13637","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-mental-health","8":"tag-access-to-therapy-india","9":"tag-chronic-mental-health-issues-india","10":"tag-depression-that-wont-go-away","11":"tag-health","12":"tag-indian-mental-health-system","13":"tag-living-with-chronic-mental-illness","14":"tag-mental-health","15":"tag-mental-health-recovery-stories-india","16":"tag-mental-health-stigma-india","17":"tag-mental-illness-treatment-india","18":"tag-priyamvada-tendulkar-psychologist","19":"tag-psychiatric-medication-failure","20":"tag-therapy-not-working","21":"tag-therapy-resistant-disorders","22":"tag-treatment-resistant-anxiety","23":"tag-treatment-resistant-depression","24":"tag-treatment-resistant-mental-disorders","25":"tag-trmd-in-india","26":"tag-uk","27":"tag-united-kingdom","28":"tag-vikram-kirtikar-psychologist","29":"tag-vishnu-priya-psychologist"},"share_on_mastodon":{"url":"","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/13637","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/comments?post=13637"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/posts\/13637\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media\/13638"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/media?parent=13637"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/categories?post=13637"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/uk\/wp-json\/wp\/v2\/tags?post=13637"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}![\"treatment](\"https:\/\/www.europesays.com\/uk\/wp-content\/uploads\/2025\/04\/treatment-resistant-mental-disorders-1.jpg\")
Often, a patient may undergo multiple pharmacological treatments and therapy modalities like CBT or IPT, but show minimal to no improvement. (Source: Freepik)<\/p>\n![\"therapy\"](\"https:\/\/www.europesays.com\/uk\/wp-content\/uploads\/2025\/04\/therapy-1.jpg\")
A treatment-resistant mental disorder is defined as a mental health condition that does not respond to conventional forms of treatment, including medication and psychotherapy (Source: Freepik)<\/p>\n![\"treatment](\"https:\/\/www.europesays.com\/uk\/wp-content\/uploads\/2025\/04\/treatment-resistant-mental-disorders2.jpg\")
Psychologists urge families and friends to offer presence, not prescriptions (Source: Freepik)
\nSupport beyond a \u2018cure\u2019<\/p>\n
![\"\"](\"https:\/\/www.europesays.com\/uk\/wp-content\/uploads\/2025\/04\/track_1x1.jpg\"){kind=spacer}
<\/p>\n