Brain Problem Situation On My Hands
September 2, 2011 8:28 PM Subscribe
I know you guys love your therapy. However, I'm not so much on mine. Tell me how I'm Doing It Wrong?
I've been depressed pretty much all my life. Suicidal thoughts, can't get out of bed, cutting, all that nonsense, at times. I have a bunch of self-esteem issues, some vaguely stupid history, and stuff like that. A couple of years ago my husband and a few friends finally convinced me that it was time to try to do something about this by consulting professionals. I'm searching around for meds and have been for some time, but I seem to be a mite resistant to treatment via drugs. I also know that a lot of the problem is in fact In My Head, in the way I think about things. I am a gloomy dark cloud of a thing, and everything always devolves to the ultimate meaninglessness of life. This does not help.
I am in therapy. I tried it in the town I lived in before as well, but a staggering and hideous coincidence cut that short. I was some months in and not really impressed anyway. I like my therapist out here rather better. But... well, it doesn't feel like anything is really happening.
I go there, I talk about some stuff, I leave, all remains the same. I've been a pretty introspective person all my life, so much so that the inside of my own head is rather boring to me at this point, so I don't expect that I'm suddenly going to have a revelation about my relationship with my mother which will change everything and make me instantly better. But it feels like after all these months, I should have gotten *somewhere*.
I'm really tired of constantly feeling hopeless, worthless, empty, stupid, ugly, fat, and inadequate in every way. It's been more or less like this for as long as I remember. I do not know how to fix it myself. But I begin to think I am not paying the correct professionals for guidance.
The trouble may be that I do not know what therapy is *supposed* to be like, what it's supposed to do. Metafilter often seems to feel that it's a magical panacea which will solve every problem imaginable. So, um, how did you get it to do that? How do you tell when a therapist will work well with you? What do they do when they *do* work? Noises have been made at me about CBT, but, while it sounds great in theory, I am not sure that that is what I am actually getting in practice.
I'm new to the idea that it's even reasonable to bother asking for help. And so far, what I have tried hasn't changed much of anything. I don't know what I should be looking for, I guess, or how to get it. So, all you therapy-boosters, how do I get my hands on some of that magic brain-fixing potion you're selling?
I've been depressed pretty much all my life. Suicidal thoughts, can't get out of bed, cutting, all that nonsense, at times. I have a bunch of self-esteem issues, some vaguely stupid history, and stuff like that. A couple of years ago my husband and a few friends finally convinced me that it was time to try to do something about this by consulting professionals. I'm searching around for meds and have been for some time, but I seem to be a mite resistant to treatment via drugs. I also know that a lot of the problem is in fact In My Head, in the way I think about things. I am a gloomy dark cloud of a thing, and everything always devolves to the ultimate meaninglessness of life. This does not help.
I am in therapy. I tried it in the town I lived in before as well, but a staggering and hideous coincidence cut that short. I was some months in and not really impressed anyway. I like my therapist out here rather better. But... well, it doesn't feel like anything is really happening.
I go there, I talk about some stuff, I leave, all remains the same. I've been a pretty introspective person all my life, so much so that the inside of my own head is rather boring to me at this point, so I don't expect that I'm suddenly going to have a revelation about my relationship with my mother which will change everything and make me instantly better. But it feels like after all these months, I should have gotten *somewhere*.
I'm really tired of constantly feeling hopeless, worthless, empty, stupid, ugly, fat, and inadequate in every way. It's been more or less like this for as long as I remember. I do not know how to fix it myself. But I begin to think I am not paying the correct professionals for guidance.
The trouble may be that I do not know what therapy is *supposed* to be like, what it's supposed to do. Metafilter often seems to feel that it's a magical panacea which will solve every problem imaginable. So, um, how did you get it to do that? How do you tell when a therapist will work well with you? What do they do when they *do* work? Noises have been made at me about CBT, but, while it sounds great in theory, I am not sure that that is what I am actually getting in practice.
I'm new to the idea that it's even reasonable to bother asking for help. And so far, what I have tried hasn't changed much of anything. I don't know what I should be looking for, I guess, or how to get it. So, all you therapy-boosters, how do I get my hands on some of that magic brain-fixing potion you're selling?
It takes a while. It took me about six months to notice "oh, you are ALWAYS asking me that question," another three to state the answer before the question got asked, and another two to absorb the value of asking myself the same question on my own. So, my first therapy experience took maybe a year (?) to change my life.
That said, this frustration is useful, and I'd talk about it with your therapist. "I'm really tired of constantly feeling hopeless, worthless, empty, stupid, ugly, fat, and inadequate in every way. It's been more or less like this for as long as I remember. I do not know how to fix it myself. But I am beginning to think that what we are doing here hasn't changed it much so far."
Last thing, since not being in therapy and no longer having an expert to lean on, I now feel like I have to figure this stuff out on my own, which has shifted me into a more active head space. If I go into therapy again, I would like to stay in this headspace and work actively with the therapist, a little less like "here I am, fix me," and a little more like "Okay! I am trying to figure this stuff out. And here's a clue I noticed this week. I kinda think it means __. What about you?" I don't think I ever got as articulate as I could've been about what wasn't working in my life, what I thought was behind it, what change I would really like to see, and how I thought I could get there. You might try being a very active partner in your therapy, then asking them their thoughts and really trying to see their point of view.
posted by salvia at 8:49 PM on September 2, 2011
That said, this frustration is useful, and I'd talk about it with your therapist. "I'm really tired of constantly feeling hopeless, worthless, empty, stupid, ugly, fat, and inadequate in every way. It's been more or less like this for as long as I remember. I do not know how to fix it myself. But I am beginning to think that what we are doing here hasn't changed it much so far."
Last thing, since not being in therapy and no longer having an expert to lean on, I now feel like I have to figure this stuff out on my own, which has shifted me into a more active head space. If I go into therapy again, I would like to stay in this headspace and work actively with the therapist, a little less like "here I am, fix me," and a little more like "Okay! I am trying to figure this stuff out. And here's a clue I noticed this week. I kinda think it means __. What about you?" I don't think I ever got as articulate as I could've been about what wasn't working in my life, what I thought was behind it, what change I would really like to see, and how I thought I could get there. You might try being a very active partner in your therapy, then asking them their thoughts and really trying to see their point of view.
posted by salvia at 8:49 PM on September 2, 2011
Best answer: Are you given homework, projects to work on, tasks to do, or other kinds of active engagement in the process? Or do you go and talk about ... stuff? If you're not doing work then you're not doing CBT. I was in therapy of the talky-talky kind for years and all it did was encourage me to cast about for people and incidents to blame for how fucked up I was all the while ruminating on my misery. What it didn't do is give me an avenue to change it. CBT is all about giving you the tools to recognize your negative thought patterns and re-train your responses. When I finally found a competent CBT practitioner it got decades worth of anxiety and depression under control in less than 3 months. I felt well enough to discontinue treatment in less than a year. It has made an incredible positive impact on my mood, my self esteem, my relationships, and my overall general outlook. But it requires *work*.
If you are not doing CBT and you think it might be helpful, ask your practitioner if that is something they would be comfortable doing. If not, find another therapist. If they say yes and you don't feel like anything is changing or working, find another therapist. When looking for another therapist the first thing you say is: "I am looking for a person who will do CBT with me for my depression. Can you do that?" If they say no, find another therapist.
good luck.
posted by lilnublet at 8:58 PM on September 2, 2011 [7 favorites]
If you are not doing CBT and you think it might be helpful, ask your practitioner if that is something they would be comfortable doing. If not, find another therapist. If they say yes and you don't feel like anything is changing or working, find another therapist. When looking for another therapist the first thing you say is: "I am looking for a person who will do CBT with me for my depression. Can you do that?" If they say no, find another therapist.
good luck.
posted by lilnublet at 8:58 PM on September 2, 2011 [7 favorites]
Metafilter often seems to feel that it's a magical panacea which will solve every problem imaginable.
Well, no, that's not true. How can anything be magical if it requires you to go sit and work with someone else for an hour a week, talking about deeply difficult and personal topics over and over and over, with little progress some days, great progress other days, no progress some days...
I mean, I think maybe the way some people describe it it may seem like, oh, get therapy and everything will be fine. But it's not something you just go pick up at the store. And you can't just say it's not working, because you are part of it too. It's not something where you go and are so impressed by the therapist's pronouncements and insights into your mind. I think popular culture and even other people's anecdotes may make it seem that way, but I don't think those stories relate a modern or specific familiarity with long term mental health treatment like therapy.
Personally, I saw some therapists who weren't a great fit. I don't know where exactly I got the idea of what I wanted, but I decided I wanted someone who talked a lot and challenged me, and who I had things in common with -- even things like sports interests and TV shows. This wouldn't work for a whole lot of people, and a lot of friends who had more experience with therapists who don't talk much or who are just listeners, kept telling me that I wouldn't find someone that was that interactive with me, but I did! And I've had so much benefit from it, I can't even tell you. So my advice to you is to think about what you want, and pound the pavement until you find it. It's a lot of work, I won't lie. Finding the therapist, finding time to go, doing the work, all of it. But it's worth it to make your mental health better. Poor mental health and anxiety and depression issues can have profound effects on your physical health and lifespan. So no, no magic. But a lot of work. Good luck.
posted by sweetkid at 9:29 PM on September 2, 2011 [4 favorites]
Well, no, that's not true. How can anything be magical if it requires you to go sit and work with someone else for an hour a week, talking about deeply difficult and personal topics over and over and over, with little progress some days, great progress other days, no progress some days...
I mean, I think maybe the way some people describe it it may seem like, oh, get therapy and everything will be fine. But it's not something you just go pick up at the store. And you can't just say it's not working, because you are part of it too. It's not something where you go and are so impressed by the therapist's pronouncements and insights into your mind. I think popular culture and even other people's anecdotes may make it seem that way, but I don't think those stories relate a modern or specific familiarity with long term mental health treatment like therapy.
Personally, I saw some therapists who weren't a great fit. I don't know where exactly I got the idea of what I wanted, but I decided I wanted someone who talked a lot and challenged me, and who I had things in common with -- even things like sports interests and TV shows. This wouldn't work for a whole lot of people, and a lot of friends who had more experience with therapists who don't talk much or who are just listeners, kept telling me that I wouldn't find someone that was that interactive with me, but I did! And I've had so much benefit from it, I can't even tell you. So my advice to you is to think about what you want, and pound the pavement until you find it. It's a lot of work, I won't lie. Finding the therapist, finding time to go, doing the work, all of it. But it's worth it to make your mental health better. Poor mental health and anxiety and depression issues can have profound effects on your physical health and lifespan. So no, no magic. But a lot of work. Good luck.
posted by sweetkid at 9:29 PM on September 2, 2011 [4 favorites]
You need to actively participate in this process!
lilnublet above makes GREAT points. Along with, you should do something daily - a walk in a park first thing in the morning, or meditation, or yoga 3x's a week, or meditation, or reading inspiring books, listening to self-help podcasts or books on tape during your walks ... do get my meaning? You must do something, anything, regular and concurrent with your therapy that supports your well-being.
This sends the message to your subconscious that, "Hey! We're changing things here!!"
Try that before meds. If not, seek meds.
posted by jbenben at 9:31 PM on September 2, 2011 [2 favorites]
lilnublet above makes GREAT points. Along with, you should do something daily - a walk in a park first thing in the morning, or meditation, or yoga 3x's a week, or meditation, or reading inspiring books, listening to self-help podcasts or books on tape during your walks ... do get my meaning? You must do something, anything, regular and concurrent with your therapy that supports your well-being.
This sends the message to your subconscious that, "Hey! We're changing things here!!"
Try that before meds. If not, seek meds.
posted by jbenben at 9:31 PM on September 2, 2011 [2 favorites]
try the drugs. if one of them doesn't work, another will. (the wellbutrin is the one that works for me...i feel absolutely 'not different' other than the fact i am no longer depressed...they started me on a higher dose and i fellt all jittery and speedy for a few weeks, until i asked for a lower dosage...now i feel great). everyone's brain chemistry is a little bit different, but (i'm guessing) probably fits into a small number of different categories...a psychiatrist will know what questions to ask to (very quickly) figure that out for you and know what to prescribe. you will kick yourself later for not doing it sooner.
posted by sexyrobot at 10:48 PM on September 2, 2011
posted by sexyrobot at 10:48 PM on September 2, 2011
You need to really feel comfortable with your therapist. So comfortable that you'll tell the person "so, how does this work? What are we working on? How do I help this therapy process help me more?" and tell them if you think it's not.
posted by wintersweet at 10:57 PM on September 2, 2011 [1 favorite]
posted by wintersweet at 10:57 PM on September 2, 2011 [1 favorite]
Best answer: Great points re: thoughts-to-actions, 'the right therapist', and drugs. This is a complex multifaceted problem that requires multifaceted solutions. Of course, being depressed means you don't always think in terms of solutions but rather in terms of state-of-being (so why ask for help). So step one is to convince yourself that indeed, your depression is not 'you', and decide to fight it. Step two is to change other things in your life besides just talking to someone about your issues-- anything and everything from diet to exercise to creativity to meditation (to all of the above). Step three is to realize that drugs can work to enable you to do these actions meaningfully and energetically. Another thing is that... talk therapy is very widely variable on the therapist and the individual.
I'm someone who's highly introspective and self-aware, so merely talking about myself will not help unless I'm with someone extremely insightful and yet someone who thinks along a slightly different track. This is pretty rare (even among therapists). Consider different forms of therapy that don't involve drugs, such as cognitive behavioral, Jungian, group therapy, art therapy, etc. Consider a drug-substitute trial that involves natural herb supplements. Experiment.
To be honest, I think that talk therapy is one of the least effective treatments 'dry' for a self-aware intelligent person who's had a long history of clinical depression. It may easily serve as reinforcement for self-defeating attitudes, compartmentalization, etc, 'cause it's so easy to distance yourself from the therapeutic conversations and decide they don't 'mean' much. Well, things mean what you want them to mean, but still: they don't. They don't mean much except in the right context, for the right person, living the right life that utilizes the service of therapy for a specific purpose. And there needs to be a purpose. What are you exploring? Why are you exploring it? How long do you want to spend on this stage? Where do you want to get to? These things may help to verbalize and pursue.
Anyway, if you do have clinical depression, then yes, it's a 'part of you', but if you had diabetes from age 3, that's a 'part of you' too. Everything you are is you. That said, this is why drugs help-- they throw a wrench in this narrative; they are outside any narrative. They simply work. They create a different story, a different you (in some ways more you, but this is philosophy now). So this 'new you' could then address issues the 'old you' was stuck inside. Our brains can use these tricks to outsmart itself. It's boring always being who you are if who you are isn't working for you. I'm a huge individualist, but I think you're allowed to change who you are, you just have to want to, even as a lark, even if you're just sick of the alternative. So just give it a shot-- really pursue change even if you don't feel like it, as an experiment, 'cause there's nothing else to do. If you change, you win, and if you don't, you still don't lose.
posted by reenka at 11:27 PM on September 2, 2011 [3 favorites]
I'm someone who's highly introspective and self-aware, so merely talking about myself will not help unless I'm with someone extremely insightful and yet someone who thinks along a slightly different track. This is pretty rare (even among therapists). Consider different forms of therapy that don't involve drugs, such as cognitive behavioral, Jungian, group therapy, art therapy, etc. Consider a drug-substitute trial that involves natural herb supplements. Experiment.
To be honest, I think that talk therapy is one of the least effective treatments 'dry' for a self-aware intelligent person who's had a long history of clinical depression. It may easily serve as reinforcement for self-defeating attitudes, compartmentalization, etc, 'cause it's so easy to distance yourself from the therapeutic conversations and decide they don't 'mean' much. Well, things mean what you want them to mean, but still: they don't. They don't mean much except in the right context, for the right person, living the right life that utilizes the service of therapy for a specific purpose. And there needs to be a purpose. What are you exploring? Why are you exploring it? How long do you want to spend on this stage? Where do you want to get to? These things may help to verbalize and pursue.
Anyway, if you do have clinical depression, then yes, it's a 'part of you', but if you had diabetes from age 3, that's a 'part of you' too. Everything you are is you. That said, this is why drugs help-- they throw a wrench in this narrative; they are outside any narrative. They simply work. They create a different story, a different you (in some ways more you, but this is philosophy now). So this 'new you' could then address issues the 'old you' was stuck inside. Our brains can use these tricks to outsmart itself. It's boring always being who you are if who you are isn't working for you. I'm a huge individualist, but I think you're allowed to change who you are, you just have to want to, even as a lark, even if you're just sick of the alternative. So just give it a shot-- really pursue change even if you don't feel like it, as an experiment, 'cause there's nothing else to do. If you change, you win, and if you don't, you still don't lose.
posted by reenka at 11:27 PM on September 2, 2011 [3 favorites]
Response by poster: Thanks, everyone. I really appreciate your answers. Some of this stuff I badly need to be reminded of. I think I do need to request homework from my therapist-- she does CBT, apparently, she just hasn't really been doing it with me. I know that homework can help a great deal-- I can talk on the phone now, and before I was assigned to make phone calls and forced myself to do so, that was not the case. I am sure it has wider applications as well.
Sweetkid and jbenben, that "magical panacea" comment of mine probably came off as more flip and dismissive than I meant it to. After decades of this, I feel right now like *anything* that would help substantially would be magical. I am absolutely willing to put work into this. It's kind of more important than anything else I could possibly be doing right now, and anything I can do to make this STOP is worth it. The trouble is, I don't know what to do, and trying to figure it out on my own hasn't gone so well so far. I'm just frustrated that I don't know how to appropriately use the help I have finally sought.
Reenka, just... thank you. That was a very insightful and comforting comment, and the last two paragraphs in particular resonate enormously with me.
Sexyrobot, I'm trying the drugs. Oh, am I trying the drugs. So far Wellbutrin gave me hives, Lexapro stopped working after a few months, Effexor ate my brain and spat it back out in gooey electric-shocked chunks, Prozac did not get me very far, and Lamictal is still very much on probation. I fear that for the drugs to really do their job, I need to change my modes of thought as well. Chemicals don't seem to cut it on their own. I don't know how not to hold myself down. There's only so much a life vest can do if I'm constantly swimming for the bottom. (My, aren't I dramatic?)
My appointment is on Tuesday. I will talk to my therapist then. Thank you all again for your advice. And I shall check out this Feeling Good Handbook-- I think I've hit critical mass now on hearing recommendations for it.
Thanks. It helps immensely to be listened to and responded to, when I'm feeling this desperate and helpless.
posted by Because at 3:14 AM on September 3, 2011 [2 favorites]
Sweetkid and jbenben, that "magical panacea" comment of mine probably came off as more flip and dismissive than I meant it to. After decades of this, I feel right now like *anything* that would help substantially would be magical. I am absolutely willing to put work into this. It's kind of more important than anything else I could possibly be doing right now, and anything I can do to make this STOP is worth it. The trouble is, I don't know what to do, and trying to figure it out on my own hasn't gone so well so far. I'm just frustrated that I don't know how to appropriately use the help I have finally sought.
Reenka, just... thank you. That was a very insightful and comforting comment, and the last two paragraphs in particular resonate enormously with me.
Sexyrobot, I'm trying the drugs. Oh, am I trying the drugs. So far Wellbutrin gave me hives, Lexapro stopped working after a few months, Effexor ate my brain and spat it back out in gooey electric-shocked chunks, Prozac did not get me very far, and Lamictal is still very much on probation. I fear that for the drugs to really do their job, I need to change my modes of thought as well. Chemicals don't seem to cut it on their own. I don't know how not to hold myself down. There's only so much a life vest can do if I'm constantly swimming for the bottom. (My, aren't I dramatic?)
My appointment is on Tuesday. I will talk to my therapist then. Thank you all again for your advice. And I shall check out this Feeling Good Handbook-- I think I've hit critical mass now on hearing recommendations for it.
Thanks. It helps immensely to be listened to and responded to, when I'm feeling this desperate and helpless.
posted by Because at 3:14 AM on September 3, 2011 [2 favorites]
Tell your therapist (assuming this is how you feel about it) "I feel like nothing is happening." If you find it scary to be so straightforward, ask yourself why that is. If your therapist reassures you that it's going to eventually help, if you don't feel reassured, say so. Your job is not to take care of your therapist or to spare their feelings. A lot of depression comes from the feeling that others know better than you and you need to be nice to them so that they'll be willing to help you.
posted by Obscure Reference at 7:37 AM on September 3, 2011 [3 favorites]
posted by Obscure Reference at 7:37 AM on September 3, 2011 [3 favorites]
This thread is closed to new comments.
posted by whalebreath at 8:35 PM on September 2, 2011 [1 favorite]