Paralyzed Senior Contributor
I am not OKAY, and I am reaching out, also sharing information about treatment-resistant diagnoses.
Hi folks,
I was browsing my Instagram account this afternoon, and I’m glad I did because I learned something new about treatment-resistant diagnoses that I didn’t know before. I was diagnosed as treatment-resistant a few years ago.
Has anyone else been diagnosed as treatment-resistant?
I hope this information helps you, as it has truly helped me and given me a new perspective on my healing journey.
I relapsed nearly four weeks ago and have been struggling with a severe relapse since then. It seems likely that I will need to return to the hospital for another six weeks of intensive treatment for my substance abuse and mental health issues. I finished my intake assessment via telehealth this morning and am now waiting for the admission decision. This has probably been one of my most difficult relapses.
Last August, I began volunteering and quickly rose to the rank of Frontline Leader within a few months. This role boosted my resilience and confidence, reigniting my sense of purpose. I was almost daily at outreach sites, managing 3-4 shifts, and worked remotely from home on my days off. I have strong leadership skills and have always aimed to volunteer on the frontlines, using my personal experience to support others and create a positive impact. Over time, I started feeling emotionally and physically drained. I kept going because I was taking two weeks off in December for the Christmas holiday. The last week before my break was tough, but I managed to get through it and felt proud of myself.
On December 18, 2025, I drove to Sydney to celebrate Christmas with my family, planning to return home by January 4 at the latest, since I was scheduled to resume my volunteer role on the 5th.
The day before heading back to Sydney, I felt anxious and nervous about returning to my empty apartment and falling into my lonely routine. I didn’t want to leave my brother, who lives there, but I had no choice. I left early at 4 am and arrived home around 1:30pm. Deep down, I also knew I wasn’t ready to resume my volunteer role and felt I needed at least another week before going back.
About an hour before I arrived, I messaged my drug dealer to arrange a meet at my place. As soon as I entered my apartment, my first instinct was to get as high as possible, craving solitude and an escape from everything. I found every excuse to avoid the outside world, and three weeks later, the relapse continued, with noticeable effects both mentally and physically.
The years of substance abuse are starting to affect me, and I worry about my future if I don't stop. I will leave it at that, and below, as promised, I am providing information about treatment-resistant diageneses.
~ ~ ~ ~ ~ ~
You're Not
"Treatment Resistant."
You're being misunderstood.
AND THAT LABEL CAN DOREAL DAMAGE.
"Non-compliant" and "treatment resistant" are loaded labels.
They often get used when someone isn't improving in the way a service expects.
But they can:
- shame people
- make people feel hopeless
- reduce compassion from providers
- block access to better care
- hide what's actually happening
Sometimes "non-compliance" is actually communication.
It can mean:
- This treatment doesn't fit me
- I don't feel safe here
- My nervous system is overloaded
- You're treating symptoms, not causes
- I don't have the skills to cope yet
My brain is protecting me the only way it knows how
One-size-fits-all care fails complex people.
Many systems treat mental health like: diagnosis → standard program → expected results.
But real life looks like:
trauma history + environment + attachment + dissociation + survival responses + access to care.
If you ignore the full picture, treatment can become harmful.
We were labelled "non-compliant" in ED inpatient.
But the program:
- didn't treat trauma
- treated every eating disorder the same
- focused on stopping behaviours, not healing the reasons behind them
When you're forced to stop behaviours, but the pain underneath isn't treated. Your brain will try to survive however it can.
That isn't "being difficult."
That's unmet need.
Why people fall back into behaviours in these settings
Because behaviours often function as:
- emotional regulation
- dissociation management
- self-protection
- control when life feels unsafe
- communication when words aren't accessible
- a way to survive unbearable feelings
Taking away coping strategies without replacing them with safe support equals more distress, not recovery.
Then people get blamed for the predictable outcome.
Instead of the system asking:
"What are we missing?"
It becomes:
"See? They don't want help."
That can destroy hope.
"Treatment resistant" often means:
"We don't know what to do." But the label gets placed on the person, not the system.
If someone has tried:
- multiple medications
- multiple programs
- multiple therapists
- and nothing helped...
It doesn't automatically mean they "can't be helped." It may mean they haven't had the right help yet.
Misdiagnosis can make treatment look like it "failed."
Examples:
If someone has DID/OSDD but is treated only for:
- "mood swings"
- "BPD traits"
- "anxiety"
- "psychosis"
- "attention-seeking"
Then the plan might completely miss dissociation, parts, memory gaps, and trauma responses. And when it doesn't work, the person gets blamed.
Dissociation changes how therapy works. For systems, "non-compliance" can look like:
- missed appointments (but there were memory gaps)
- "lying" (but different parts hold different information)
- "not using skills" (but the part present doesn't have access to them)
- "inconsistent progress" (because different parts have different needs)
That isn't refusal.
That's how dissociation functions.
Trauma can make 'standard treatment' feel unsafe. Even helpful things can backfire when trauma isn't considered, like:
- exposure done too fast
- pushing details before stabilisation
- rigid food plans without emotional support
- group environments with constant triggers
- "tough love" approaches
If your body is in survival mode, it won't respond to therapy like a calm body will.
This isn't just DID. This happens across diagnoses. People get labelled
"treatment resistant" when they're actually dealing with:
- complex PTSD
- dissociation
- eating disorders rooted in trauma
- neurodivergence (autism/ADHD) being missed
- chronic pain or illness affecting mental health
- unsafe environments (still living with abusers / unstable housing)
unaddressed grief, shame, attachment wounds
Real healing often requires flexibility.
Not punishment. Not shame. Not threats.
Helpful care usually includes:
- trauma-informed approaches
- stabilisation before deep processing
- collaboration instead of control
- curiosity instead of judgement
- pacing that matches the nervous system
- understanding that survival strategies exist for a reason
We were told we were "non-compliant." We were told we were "treatment resistant."
But once we had the right support, we made progress we never thought was possible.
You are not broken.
You are not hopeless.
You may just need care that actually fits.
If you've been labelled "non-compliant", please hear this:
It doesn't mean you're failing.
It doesn't mean you can't recover.
- It might mean you were never given what you truly needed.
You deserve treatment that understands you.
I am grateful for the SANE community. Stay safe, take care and be kind to yourself.
This is Paralyzed signing off 🤗