For me it's complex .

Starting with the fact I never sought out treatment, I was referred to a phT because I kept ending up in the hospital beatn up from my husband. PTSD with depression was my first diagnosis. The antidepressants either put me into a mixed state where I would try to kill myself which would land me IP and then be given more antidepressants and thus the circle would go. Then I would go off the meds because clearly they weren't helping. I'd either be stable for a bit or hypo manic in witch case I felt great and had no need to see anyone. If I had a T I stopped seeing them. After a while depression would hit and I'd seek out help and be given antidepressants again, though the cycle once more.

After they figured out I was Bipoar they added antipsychotics and mood stabilizers but continued the antidepressants.. Then I'd quit the medicine because it was really working and I'd think they were poisoning me. About 5 years ago I refused all antidepressants. Actually I refused all meds. The side effects I had, the doctors that refused to listen and told me the side effects were in my head. I had my fill of it all.

I had had some wonderful Ts but mostly I worked on the PTSD with them. Since most of them were also qualified to diagnose they would tell me I had bipolar too, which I refused to accept. Then this past year I was in terrible shape and sought out a Pdoc, I said no antidepressants. He listened, I was put only on a mood stabilizer and a antipsychotic. This was the first time I've done so well on meds.

I believe too things have changed a lot since my first experience with Pdocs about 30 years ago. The ones I have met in the last year listen much better and take side effects into consideration.

I don't think it's as easy as saying its treatment resistance as much as it is getting the wrong treatment. Over all the Ts helped me much more than the Pdocs. But I also needed the right meds, meaning no antidepressants.