I went for 13 years with unsuccessful treatment for what started as anxiety when my aerospace engineering career ended at the time aerospace engineering collapsed in California. At the same time that happened, we were hit by a huge earthquake that destroyed the freeway between where I lived & where I worked which added to my breakdown (one T offered the thought that PTSD was possibly part of the problem) but a year later it all turned into major depression recurrent with many suicide attempts.......9 years after that, there was a trauma that hit me in my life.

There wasn't a med that worked but the side effects were horrible. They actually had a difficult time with my Dx to start with because they thought that it was major overreacting to JUST a loss of my career. Guess they didn't think that women would place all their value in their career like men were known to do.

What I have since found out however was that my bad marriage that ended up being 33 years....the last 13 being the time after the loss of my career......but I realize now how trapped I felt.....& as soon after the trauma hit & I took my inheritance I was able to leave the marriage......my life started to clear up, the depression & even the anxiety lightened up even though the last issues with PTSD still haunt me.

Like Rose76 said:
& sometimes the conditions of your life you aren't even aware of that they are causing such a mess in your life. I knew that my marriage was bad....but I didn't realize how bad it was until I left & could look back at it & see the damage that it was doing in my life.

Even with the fighting that my pdoc & my psychologist knew about in the marriage.....they weren't putting 2 & 2 together either.

Sometimes we feel trapped in the situation with no way out & we just don't see how badly it's really destroying our lives.....but there isn't a med in the world or a treatment in the world or a distraction that will permanently CHANGE situations that need to be resolved for any treatment to really work.

After leaving my marriage (I moved 2100 miles away)....I got a psychologist who suggested the DBT group & I got involved with it.....amazing how much more clear things became when I was no longer trapped in the forest of that bad marriage.....all of a sudden so much became clear & treatment actually started to work & it was amazing the progress that was made in just a short time compared to all the time that was wasted before.

We NOW understand the whole picture......something even pdoc's & psychologists at UCLA's psych hospital weren't capable of doing.

I'm sure there are other reasons for treatment resistant depression....but I definitely know that situational depression no matter what DX it ends up with.....can truly be treatment resistant until the situation either changes or is resolved in some way.