How can I manage my depression without no organization?
September 11, 2011 4:34 PM   Subscribe

How can I, as a supremely unorganized (and deaf) person, manage my depression so that I can finally finish my studies in time (deadline: early 2013)?

I've read some of the depression-related posts on MeFi and while they were very helpful, I feel like they're only helping in some aspects because ultimately, every situation is different.

A quick summary of my life with depression so far:

- first episode in 2005 (burn-out), diagnosed with F33.1 (Recurrent depressive disorder, current episode moderate) and have been wrangling with it since then
- first therapist was OK, could sign, but due to distance/cost I haven't been back to him
- second therapist couldn't sign but was knowledgeable about deaf culture, communication was via paper&pen, I felt very comfortable with her, but she ended the sessions after I didn't attend therapy without telling her in advance because she felt that it was just a 'fake' therapy and that I wasn't being really open
- asked her last year to take me on again, but she declined and said that she wouldn't because she felt that I was repeating patterns and she didn't want to be part of it anymore, she recommended other therapists that had experiences with deaf people and insisted that I really commit to therapy then
- but as I study psychology, I already know these people in a semi-professional capacity (meeting them at conventions/networking/etc.) and want to keep these two areas of my life - depression and job - separate
- hearing therapists wouldn't know about deaf culture, communication might be fraught with misunderstandings or I'd be forced to explain deaf culture etc. first and wasting time, and having sign language interpreters along might also be problematic because I know most of them through my studies and I don't want someone who has interpreted for me at university to see me at my worst, so to speak - also, I know from experience at uni that misinterpretations do happen, and in a therapeutic session, functioning and effortless communication is paramount (for me!)
- so I've been trying to 'make it on my own' since then with the help of some self-help books - yeah, and it worked wonderfully /sarcasm (probably due to my perfectionism & impatience)

I've also been often fatigued after I've been in social situations (working with people, being with friends or family) and need some time to 'come down', which worries me because if I'll be working in a professional capability later, I can't afford to be fatigued all the time.

I've also grown rather lethargic; due to the lax German university system (especially regarding diploma studies in the social sciences...), I've been pretty much neglecting my studies as you have only to do a paper/essay/exam for each seminar/lecture and that was it - sometimes only attendance was required, and I didn't do most required reading at all, so - still having to pass four diploma exams and write the diploma thesis - I feel like a giant fraud for somehow coasting by. When I study for exams, I do giant cramming sessions.

I've got to write some papers that are due like yesterday, and I should've started working on my diploma thesis at least early August, but seeing as I've got a huge perfectionist streak, I feel like I can't do anything well enough and why bother starting, then? Talk about major self-sabotaging... Also, seeing as I've got to finish by studies by early 2013 at the very latest because after then, there won't be any diploma psychology studies at my uni, there's quite some pressure.

When I'm feeling well, I don't have much social anxiety other than being painfully aware of the usual communication barriers which inevitably arise when I've got to communicate with hearing people. But in my bad phases, I feel like everyone is judging me and I hate it; I try to rationalize it but that doesn't always work.

Also, due to my lethargy/depression I've started to lie to family and friends because after the first some times I had an episode - I was always very open about being depressed to everyone - I thought that I was ok (although not good), but ok, that I could work with/through it, but after having several bad slumps, I feel like I'm a failure (and me a psych student! Life's little ironies...) and seeing as I've always been a fiercely independent person (going on vacation to Sweden and the UK twice all alone), I hate admitting weaknesses. It was already hard enough the first times. Anyway, because I've been lying/obfuscating to everyone who cares about me I've avoided social situations because then I'd have to lie more when answering what I was up to lately... and I really, really *hate* this, I hate the person I've become.

I've read Julie Fast's book and I've got a few good books about depression etc. so I *know* what I should do... but I just can't get myself to do the suggested/recommended things. Or I do them for a day, but then am so overwhelmed with all the steps/things/projects that I then should do (can be anything from learning to meditate, learning a new language, emailing professors, texting a friend, ironing clothes, reading another chapter on depression etc. etc.) that I shut down and just do nothing.

I know that I should list all things that I've got to do, like David Allen (I've read GTD multiple times, and I've also read a similar German version - Simplify your life) says, to get it all out of my mind, and I've done that several times, but in a way I'm afraid that it'll 'overtake' my life (because I can get really crazy/committed to things for a while and neglect others), so I abort it after some time or just don't commit enough. In short, I've got a huge problem with organizing my life. Whenever I try, things crop up and then my plans are fucked. I've worked with several organization sites (HabitForge, Remember The Milk, etc.), the latest was GQueues. But sooner or later I always drop these. Also, when I think of the impeding deadline of my studies (I *have* to finish!), I think that there's not enough time anyway to properly treat my depression (like implementing little steps each week or so), because I've got so/too much to do. Yeah, I give up easily and am too impatient. *sighs* And then I feel even worse when I really can't manage anything in a sane fashion...

Also, I'm a 'last-minute' addict, so to speak. I often wait until the last possible minute to get up/stop surfing/etc. to shower, dress and be off to uni. Or pack things for a weekend at friends just minutes before I've got to be off. Or wrap presents just hours before. I know that this is unhealthy, that I should be more organized, but... somehow, I can't stop doing it this way - because, so far, it has (mostly) worked for me in the short-term. Long-term, though, it has turned out to be a nightmare (see above) for my life. Argh!

I really would appreciate it if I could get some advice with my special circumstances in mind - even if I've read/heard (so to speak) it a thousand times, hopefully it'll stick now and I can act on it.
posted by sparrowspike to Health & Fitness (3 answers total)
Have you tried antidepressants? (Not St. Johns Wort.)
posted by Houstonian at 4:55 PM on September 11, 2011

Best answer: Medication, medication, medication!!! If you've tried in the past and it's failed, try again: over 80% of people can find a drug or combination that works for them without unmanageable side effects, but you need to keep trying to find it. If you're on meds, clearly, you're not on right ones, so get help to find them.

For anhedonia (pleasurelessness), dread, and low energy/motivation, at least for me, I can't talk or think my way out because if things that used to give me pleasure are no longer giving me pleasure, it's not because I'm choosing not to enjoy them, it's because i'm chemically not capable of feeling pleasure!!! Only drugs can fix that part of things, at least in my experience.

Second, the therapist who said you were "fake" is basically not a good therapist. You want cognitive behavioral therapy or interpersonal therapy, both proven to help with depression. You don't want therapy that's about "insight" or "opening up" because those are not proven to help and may in fact simply increase depressive rumination. Find someone empathetic and supportive who will help you when your motivation flags, not blame you and dump you.
posted by Maias at 5:11 PM on September 11, 2011

Response by poster: @Houstonian: Argh, I didn't mention that in my post - I've taken Cipralex before and it *did* help, and for a time I was feeling OK and thought I could deal with everything and dropped it - and some months later my boyfriend broke up with me... (2 years ago) Since then I haven't been back on the medication - yes, a mistake. But independence (from anyone/anything) has always been important to me... gah. Seems like there's no way around it.

@liketitanic: That's a pretty good summary of what I've rambled on and on up there. *nods* I've tried to find a therapist in the past, but seeing as there are only very few strewn across Germany who can sign (and *even* fewer who are deaf themselves), it doesn't look too good. With the second therapist, we did it paper&pen because I'm fluent in German and there wouldn't be any misunderstandings; this worked pretty well. I'll try to find another one, it seems like there's no way around it. The 'small wins' thing seems like something I could do, thanks - I do need structure.

@Maias: I did have good experiences with Cipralex, but didn't want to go back on it... issues with 'dependence', again. But it seems like that I really can't do without it - I tried for the last two years, but it hasn't gotten better at all (duh...). I'll try asking my doc tomorrow for a prescription. And yes, CBT is the best method for depression; I'll try to look for therapists who practice it, or at least do something similar. The second therapist did a mix of interpersonal therapy and NLP, which I did like, and she asked some excellent questions, but then she dropped me... ah, well.

@kanata: Yes, therapists that know sign language are ideal, it's just that - like I said in my post - I *know* most, if not all of them from meeting them through networking etc., and I would like to go to a therapist who doesn't know me in this capacity; I'd feel weird about it if I'd meet them again later or maybe even work with them as a colleague. So basically the only way is a hearing CBT(/something similar) therapist who doesn't mind doing it the paper&pen way. And as for interpreters - I pretty much know everyone, alas. There might be a handful that I don't know, but that's because I haven't hired them because they're not very good at interpreting. *wry grin*

As to therapy methods, I only know that something like psychoanalysis would just fuck me up more. I need something that can make me manage my life - CBT seems the best for it, but seeing as my second therapist did use other methods which I liked, I'm not too averse to other methods - as long as they're mostly practical-oriented and not too theoretical.

Thank you all for your comments and advice so far! It really helps to get everything off one's chest and having people reply with compassion.
posted by sparrowspike at 5:50 PM on September 11, 2011

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