I think I'm really depressed , will therapy help?
July 11, 2014 7:49 PM   Subscribe

When dealing with depression, what has worked for you . . medications, etc? I don't want to rely too heavily on friends for this, because I have in the past, and they tend to want to avoid you if you tend to talk about it too much.

I'm a 38 year old female who has never married, am still single, and feel I am deficient in too many aspects of my life. . friends, career, education. I am in the process of deciding how to go about pursuing a bachelor's degree while working full time. I don't make friends easily, and the friends I do have. .they are busy with either family or their significant others. Thankfully, I still have a job, but let's face it, I need to pursue a degree if I have hopes of getting to be where I want financially. I gave up on dating several years ago, after a string of short term relationships . .and not wanting to deal with the headaches. (And the fact that I would get emails from men 20 years older (ugh!),even though my age preference was clearly posted. Quite often, I feel pretty hopeless, and it's starting to affect work (I've missed days from work because I was too depressed/ashamed of myself to drag myself out out of bed) and my physical well being. (I've gained weight because I was depressed to remain active, as I did before. Sometimes, I do contemplate just ending things, because I think that they really can't get any better. But then I think about my parents, and my younger brother (even though we're not that close), and that stops me, as I wouldn't want them to have to deal with that. I have attended meetup groups/events to try and make friends, or to simply get out of the house, but it's usually just resulted in me going to the event, and coming home. I hate feeling lonely/depressed/ashamed of myself, but am not sure how to deal with the feelings.
posted by jeepwrnglrwmn to Human Relations (17 answers total) 8 users marked this as a favorite
Will therapy help? YES.

The time is *now*. Like, right this very minute.

It's super scary... I asked a question awhile ago about starting therapy. I sat in the waiting room with sweating palms reading the responses over and over to calm myself. It was fine, it helped, things got better. Life is hard, and brains are weird... This is exactly what therapists are for.
posted by jrobin276 at 8:55 PM on July 11, 2014

Just as physical therapy can help you get stronger when a muscle group isn't working in a comfortable way, emotional therapy can help you better mentally process the challenges you face. Yes, it can feel overwhelming to find a doctor, but yes, medication helps; yes, therapy helps; no, you do not have to feel this way forever.

You are important. You are a good person. Your failings do not define you as unusually bad (really). You deserve to feel mostly-OK for most of the time, and you can get help to make that happen. Talking to your GP, and talking to a therapist, will help.
posted by samthemander at 9:00 PM on July 11, 2014 [1 favorite]

I let myself feel like that for far too long. Therapy helped, but cymbalta has been near-miraculous in elevating my mood. What you're feeling isn't normal; it's depression lying to you. Go see someone. It gets better.
posted by Johnny Wallflower at 9:13 PM on July 11, 2014

I'm kind of in the same situation as you, only 10 years older. I've struggled with depression throughout my life, mostly because I've rarely ever felt accepted by society. I spend much of my time alone. The only thing I've found that helps is regular exercise. I walk everyday, anywhere between 30-60 minutes, even when I really don't feel like it. Just getting out in the fresh air is helpful.

But I'd try any and all suggestions. See what works best for you. Good luck and I hope that you find something that works for you.
posted by jenh526 at 9:19 PM on July 11, 2014 [3 favorites]

Yes! Therapy will help with this. Meds may help too.

For me, it took a combination of therapy and an antidepressant, but I did get better. Well enough to stop therapy and go off the meds without relapsing. Beyond that, beyond just not being depressed, I developed real self esteem - I learned to really like and accept myself.

The hardest part for me was right at the beginning, where you are now. Deciding to get help, calling a therapist, going to that first appointment, saying out loud that I was depressed. It was hard, but it took a weight off my shoulders. Suddenly I had someone to sit and listen to me while I worked it all out.
posted by balacat at 9:23 PM on July 11, 2014

I'm at a very similar place in my life right now, and just wanted to say ugh, it sucks, and I'm sorry you're going through this.

I'm glad you have your family to think of and giving you a strong attachment to this life (I say this as someone who also has suicidal thoughts but who won't go through with it due to a couple of people in my life who I don't want to harm). I don't know if you're an animal person, but if you are then having a pet can also help be one of those things that keeps you from spending too long in suicidal ideation (plus they are awesome and it's great being able to take care of someone who is adorable, not-very-complicated and who loves you unconditionally).

As far as therapy. .. It can help. So can meds, for sure. Don't be too discouraged if you try a therapist or meds and it's not a good fit. I've had therapy that was a colossal waste of time and money. But if you keep trying you will find a therapist you click with and who can help you have insight into your patterns.

Also, the combination of sleep, exercise and good nutrition can help a lot.

Good luck to you.
posted by whistle pig at 9:52 PM on July 11, 2014

Therapy didn't (or at least hasn't) help me at all. Medication did, somewhat. Based on my personal experience (for what that's worth), I recommend giving medication a try to at least get into a state where you can make the other changes to your life that you want, or even to figure out exactly how you'd like your life to change. If you're having trouble just getting through the day, which it sounds like you are, you're probably not in a great state to make major changes or decisions (regardless of a therapist's help or attempts at help), so if I were you (and I basically was you, in a lot of ways, albeit even more of a mess), I would actually try to stabilize things -- like your ability to get to work and do the bare minimum of "taking care of your current life" stuff -- before upsetting the applecart again. And medication can be really useful for that. Whatever you do, try not to actively fuck up your life. I know you're not liking or appreciating it much right now, but don't sabotage it out of anger/sadness/fear/frustration/anxiety/etc. Try to take good care of it, because it's a resource you'll be able to build on in the future.

Do you have any physical issues that are making your life uncomfortable or difficult? What has made the biggest difference to me over the longer term is to get those physical issues addressed. My state of mind has gotten better as my physical health has gotten better. And by "addressed," I don't mean exercise or something that you do on your own (though exercise and all that is great, you don't sound like you're up for tackling that right now, and that's OK, too), I mean going to a doctor and actually getting help with anything that's giving you pain or discomfort or distress. Also, if you do have the energy, any way to make your life easier on yourself is probably a good idea -- if you're depriving yourself in some way, STOP DEPRIVING YOURSELF. Spoil yourself rotten. If you're holding yourself to high standards, STOP and just hold yourself to adequate standards. For right now, it's better that you just tick of boxes (and even ticking off one box in a day is FINE -- better than fine, really) than to sit there struggling to make the perfect tick-mark on one box and putting tons of pressure on yourself and just dissolving into an exhausted mess. Or maybe you don't do that, but I do that, and it has been SUCH A RELIEF and made such a difference in getting through a genuinely rough time to give myself a pass on the perfectionism, and I highly recommend it if you're in a similar spot.

Anyway, *ideally,* GPs and psychiatrists and therapists work together as a "team" to help you. In practice, they don't always communicate perfectly and it might be up to you to make sure that they're all on the same page and keeping up with where you are in terms of taking care of your life/health/etc. Personally, I went from an evaluation with a therapist to a psychiatrist, and then to therapists and psychiatrists concurrently (sounds like more work than it was -- the psychiatrist in my case was more the person who did documentation and prescriptions, and that was pretty much it, and I think that's generally the case in the US), and then brought in the GP and specialists for OTHER health issues and that's when real change started happening. My point is, you don't have to just pick one person to talk to. Whoever can give you a mental health evaluation (sometimes that's a therapist, sometimes that's a GP) and a referral for whoever you'd need to see beyond that, is probably the person you should see first. Also, when you're feeling up to it, do go in for a physical and get the GP involved if she's not involved by the psychiatrist or therapist already. Even if you have zero other medical or health problems aside from your mental state, if it's at all practicable, you don't want the person who is your go-to in terms of your physical health to be completely ignorant about a new symptom (like depression) you're showing or even about new medication or new treatment (like therapy). That can be straight up dangerous.

Also, it's not your fault if you're distressed by distressing things (like loneliness), and it's also not your fault if you have things in your life that are distressing. It doesn't mean you did anything wrong, shit happens and people get burdens to bear whether they "deserve" them or not. I mention that because you say you feel ashamed, and it doesn't sound to me like you have anything to be ashamed of at all.
posted by rue72 at 9:54 PM on July 11, 2014 [1 favorite]

I'll preface all this by saying I'm a similar age, feel similar things, and have attempted suicide more than once.

Yes, therapy will help. Medication may help too, depending on how serious your depression is. Get a therapist, and ensure they are part of your healthcare team including your PCP.

Other things:

- get your PCP to order a really extensive panel of blood tests. Look specifically for vitamin deficiencies and thyroid problems.

- get as much unfiltered sunshine every day as can be reasonably done. Lack of sunlight affects depression in ways that are, as far as I'm aware, not entirely understood yet.

- Exercise. It's hard to start, I totally understand. But when faced with the choice between an elevator or stairs, for example, walk up one flight or down two if that's as far as you're going. Get off transit a stop early and walk home the rest of the way. That sort of thing. Parlay that into more rigorous exercise as you're comfortable. Endorphins are nature's antidepressant. Exercise really helps.

- Conversely, meditate and/or practice mindfulness (honestly the difference between the two is a gnat's wing). There are a million resources about both online--I'd advise sticking to the mindfulness resources as they tend to contain less woo.

- If you drink or smoke pot a lot, cut down. I believe in Canada the recommendation of weekly alcohol intake is no more than 10-12 units (1 shot, 1 beer, 1 glass of wine = one unit) per week for women. I could be mistaken on the actual numbers, but cut down. If you smoke pot regularly, cut down to one reasonably sized joint per day, and/or make sure you take days off.

- Find a creative outlet to pour your feelings into. Nobody else ever has to see or hear what you do... slap paint on a canvas, write music, write a journal, play with clay, code something. Doesn't matter. Feel your emotions and let them out in a constructive way, for yourself.

- Give yourself permission to halfass things at home. Okay, so maybe your bathroom (for example) isn't Martha Stewart levels of perfection. So what? Give things a quick wipedown, use the toilet brush whenever you go pee. Don't let the perfect be the enemy of the good; doing small incremental things to help yourself feel better about your situation is much better than trying to climb a mountain of Big Things To Fix. Start small. Is your kitchen sink full of dishes (like mine)? Do a few. You have accomplished something. That is good. Let tomorrow worry about itself. Maybe your laundry pile is as large as mine. Do one load. Don't attack the whole thing at once, just do one. Appreciate and congratulate yourself for small victories--the recovery from depression is all about small victories that result in a great big victory.

- Maybe group things aren't for you. Maybe trying--entirely up to you--to (re)create an adult healthy relationship with your brother and/or parents would help. Self-isolation is a huge thing in depression, and it'll just make you feel more depressed. Trust me. There are, I guarantee, friends and family who love and adore you. It can be hard, oh god it can be hard, to accept that, to accept you're worth it. But you are worth it. Every human being is. You don't necessarily need to reach out, per se, but allowing connections to flourish, accepting that people believe you're worthwhile, is incredibly helpful.

- Get out of the house. This doesn't have to involve meetups or groups. Go to the library and read about something you enjoy. Go see a movie you want to see, alone (I personally love doing this on Cheap Tuesdays because it gives me alone time, but around other people, and consuming entertainment I like). Go to parks frequented by people with dogs; petting and playing with a dog is incredibly therapeutic.

- Don't set unreal goals. Set goals that are sane, rational, and realistic. And give yourself rewards that are proportional to those goals. Did all the laundry? That should earn you an hour of silly TV time, for example. Worked out today? Find your appropriate reward for that. And don't, I repeat don't, beat yourself up for missing a goal today because:

- One of the few things that AA gets unambiguously right is taking life a day at a time. If today was a bad day, go to sleep, wake up tomorrow, and try to make tomorrow incrementally better. It does not matter at all how big that increment is. Make the best of today that you can, and let tomorrow sort itself out.

The fact that you have already experienced suicidal ideation is a Big Red Flag to me that you need a professional to help you unpack your head. Here is a google search for crisis hotlines in your state. If you start feeling that ideation again, call them. Or MeMail me and I'll give you my cell number if you need to talk. I can't call or text the USA for free, but if you poke me we can figure out a way to talk, and a way to support you.

I saw a great image online recently, which I didn't bookmark, dammit. Basically it's saying that depression is like being behind enemy lines with only a knife to protect yourself and everyone nearby is out for your blood. Surviving this--alone!--means you are a strong person. You've already survived. You're already strong. Finding therapy (and maybe medication) is, to continue the metaphor, radioing in for a helicopter rescue. You're already doing the hard work of living day to day; a therapist is just there to help you add more coping tools to your mental toolkit.

If I could, and if it were welcome, I would give you a great big hug right now and tell you that it can get better. Because it can. You are a worthwhile human being, and that nasty voice in the back of your head (and in the back of mine) is lying to you. Try to remember that.

In some ways, admitting to another human being that you have terrible depression--perhaps even depression on a clinical/dx level--is like standing up at an AA meeting and saying "I'm Jane and I'm an alcoholic." It's really damn hard the first time. After that, it gets a lot easier.

I would wish you luck, but you don't need any. You've already recognized the problem, you're fighting it, and you're looking for resources. They're out there, and the google search I linked above will help you find more.

Life, and this is not something I would have said 12 months ago, is worth living.

And remember, please, the most important thing: you are not alone. So very many of us struggle with depression and think we're alone. We aren't. There are millions of people feeling the exact same way and trying to figure out how to fix it. There's strength in that. And AskMe, well, is full of people who are brimming with love and compassion and personal experience in this arena, and we are a tiny subset of the world's population. I can speak from experience when I say that attending group therapy and hearing other people say things that I could have said about myself is a life-affirming experience; knowing that you are not alone is an amazing help in getting better.

You're not alone. Things can get better. Don't listen to the lying demon in your head. Squash it--this takes a hell of a long time and I'm only a short way into that journey, but the rewards are reaped very very quickly--and understand, truly understand, that you are a person who is just as deserving of love and respect as anyone else you ever see on the street. It's hard, I know how hard it is, but stop, as often as you can, from listening to that lying voice.

You are not alone. There are resources, both professional and personal, that are out there for you to tap. You are strong, you have survived this long. Tap those resources. Ask for help. You will, perhaps by trial and error, find it.

And frankly, if your friends don't want to hear about and support you through your problems, are they really friends? A friend helps you move. A real friend helps you move bodies. The friends who won't listen are in the former category.

Again, I'd hug you if I could and if it were welcome. You can get past this. You are strong.
posted by feckless fecal fear mongering at 9:54 PM on July 11, 2014 [9 favorites]

How you feel now is not permanent. Things can and will get better. Talk therapy and medication can do amazing things. Please make an appointment as soon as possible with a therapist and a psychiatrist (or even your primary care physician if s/he can see you sooner). If you're having trouble selecting one, you can ask someone you like (eg your PCP) for a referral.

Feckless' list of things to try in addition to therapy/meds is great. Do what you can but don't feel like you have to do it all at once. For example, a few months of medication may make it easier to get out of the house, which may then make it easier to be active/exercise—little steps will reinforce your progress and make it possible to do more.
posted by JackBurden at 3:07 AM on July 12, 2014

For me, the path from depression to wellness has typically involved these things, in this order: therapy, medication, more therapy, working on myself, then working on my external circumstances. Each step makes the next one more likely to take.

In a little more detail: therapy's typically been my first step, and it doesn't work immediately, but it's always good to get outside perspective from a professional, and my therapists have been able to tell after a few sessions whether they think medication (or a change in medication if I'm already taking something) would likely help. Once the meds kick in, I can get more use out of the therapy. From there, I can start properly caring for myself: exercise, eating well, regular sleep, just kinda getting my shit together so I feel healthy in my own body and my own home. Improving my social life and my career are last: these are often the biggest challenges. Not only do they require perseverance, self-confidence, and positive thinking - all of which are so hard to come by with untreated depression - but they're also slower to progress and a little more luck-dependent. If you bomb a job interview or go out to meet people and fail to connect, you'll have a much easier time recovering if you're not stuck in self-destructive thought patterns and if you're well-rested and your home is in okay order.

It can take a while, but it works in the end. It will get better for you; you just have to take that first step.
posted by Metroid Baby at 7:39 AM on July 12, 2014 [1 favorite]

I get the sense from how you phrase this that one thing it might be useful to work on, via therapy or self-help, is determining how much of your frustration with your life is based on you not getting what you want/need and how much is based in what you think you SHOULD have. Example: I spent much of my life bummed out because I didn't have a lot of friends; I put in effort to make/ maintain friendships but people still came and went. I eventually realized that while I do need some friends, I don't actually care about having many. I was basing my self-worth on other people wanting to be around me even though I'm not personally interested in lots of socializing.

Just mentioning this because dating/ meeting people can become something that you feel deficient in not so much because you want a partner but because you feel like a loser because you don't.
posted by metasarah at 7:49 AM on July 12, 2014 [1 favorite]

So for me, medication has been so important. But therapy too. Therapy is hard. Like seriously hard. My psychiatrist is gently nudging me to get back in it. I'm having to take it in baby steps. First call the agency I was interested in and find out they don't take my insurance. Get discouraged and put it on the back burner. Look up people on Psychology Today who take my insurance and bookmark them. Go back and look at their specialties (I need someone who is experienced with trauma survivors). Make a new list. Call to get information. Back on the back burner. Now I need to schedule and appointment. Baby steps.

I also had blood work done by my psychiatrist (because useless GP). I'm seeing the pdoc every 2-3 weeks as we adjust meds.

Other things to look into include sleep apnea. I just had a sleep study done and am fully expecting an apnea diagnosis.

tl;dr Therapy useful but hard. Medications useful but sometimes challenging because of side effects (and stupid insurance companies trying to do a doctor's job). A good physical is necessary to rule out any underlying medical conditions.
posted by kathrynm at 8:36 AM on July 12, 2014 [1 favorite]

How you feel now is not permanent.

Yes, this. I could have written so much of your question a couple of years ago. Therapy and medications and life changes have gotten me past the rough patch. I'm still single and kidless and my career is unexciting, but I feel less defeated and more accepting / action-oriented (depending on the issue).

The other thing that leaps out at me is that you seem pretty isolated. I'm guessing you don't have close ties at the office, you say you don't feel close to your family, and your friends are busy with kids and careers. I'd say work on finding new friends who have more availability - we are social animals, and we all need some connection and caring. A good therapist can help with this in addition to other things. I had a therapist who helped me strategize the best ways to meet new people and then kept nudging me to keep at it, and it definitely helped.

Good luck to you.
posted by bunderful at 11:00 AM on July 12, 2014

Therapy can help a lot - a LOT!! - but finding the right therapist is a process. I saw various therapists earlier in life and didn't find them very useful. Thank God I kept trying and finally found a fabulous therapist who worked with me to move from a very low place emotionally to establishing, step by step, a very happy, balanced, thriving life experience. Therapy has been an important part of that process, but so has meditation and spirituality more generally.

All this to say -- when you try therapy, don't give up if the first (second or third) therapist is not a good fit. Keep trying!

Yes: change is possible.
Yes: therapy can help.
Yes: you can be happier.
posted by Gray Skies at 1:40 PM on July 12, 2014 [1 favorite]

What Gray Skies said.

One thing I WISH someone had told me back in the days when I was at my saddest was if therapy isn't working, go find another therapist. It took me years to find the right one, because I'd stop and start with people who weren't right, and I spent a long time thinking it couldn't work for me because I was somehow doing it wrong. But finding a therapist who is someone you like and work well together with is really hard. If you don't feel any hope or glimmer of something good by the third session - just keep trying. Keep trying until you hit it off with someone. If it's not working, IT'S NOT YOU. You just have to find the right therapist.
posted by scuza at 10:32 PM on July 12, 2014

Long-time depressed person here. THE only thing that significantly helps me is exercise--the more intense, the better (though even going for a walk helps). With regular intense exercise, I spend much of my time not depressed at all, and when I start getting depressed around the edges, it usually goes away with the next intense exercise session.

Prescription anti-depressants did work for me, but not as well as exercise, and they have side effects that I don't care to experience again. Nothing else (talk therapy, OTC meds like St. John's wort and Sam-E, journaling, the support and advice of friends and family) has ever lessened my depression in any meaningful way.

I know you say you stopped being active because you were depressed, but it could also be some of the opposite--you became more depressed because you stopped being active.

I'm not as big of a fan of therapy as many others on mefi, but even if you are going to go that route, creating some good chemicals in your brain via exercise could help you be more open to the possibility that everything isn't awful, and hence get more out of therapy.

There is tons of research on the anti-depressant effects of exercise (search on pubmed if you care to); it just doesn't get as much play in the popular media because no one makes money off of you going for a walk :-)
posted by mysterious_stranger at 3:59 AM on July 13, 2014

Response by poster: Thank you for all the replies.Sorry, haven't visited this thread in awhile, because my home laptop died, and I've actually spent the free time I have at work looking for a new one. Am typing this post from work (finally found a replacement for the one at home). I've started exercising again. . it's been about two weeks. Haven't yet been to a therapist yet, though. .
posted by jeepwrnglrwmn at 7:56 PM on August 4, 2014

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