I'm Desperate - What to do when not seeing any progress in counseling?
July 9, 2015 3:27 AM   Subscribe

I have been dealing with depression for the past 5 years of my life. It got really bad 6 months ago, to the point where I feel immobilized and suffocated by it. I have seen counselors but am not making any progress. I know there have been numerous threads like this one but I am desperate now and don't know where else to go.

During the past 5 years, my coping mechanism was talking about my feelings to somebody I could confide in. I would immediately feel better. That is not the case anymore. I can honestly say I have the most supportive support system I could ever ask for but even after talking to them I no longer feel that sense of relief that I used to. I've told my parents, my best friend, my boyfriend, I've called NUMEROUS crisis hotlines, I've sought support from strangers on anonymous apps, and still nothing.

I started seeing the third counselor in my life after failed attempts with the two previous ones. I really really like her. But I still haven't followed any of her suggestions. I spend all day lying in bed. I'm not seeing her right now because she told me she felt bad that I was paying out of pocket and that she's pretty positive my type of insurance covers counseling. I still haven't made the call to my insurance company. It's been a week now. I don't know why but the thought of having to look for my health insurance information and then make a call seems so daunting to me, as ridiculous as it sounds.

I have considered medication and she gave me the number of a psychiatrist but have I made the call? No. I feel really stressed out right now over an event I have coming up on Saturday and that's making me even less productive than I usually am. I feel almost paralyzed. That's the best way I can describe it. So, I'm just desperate now. I would like suggestions for coping mechanisms in the meantime between today and Saturday. Also I just need hope? If anybody has felt this way and successfully overcame it, I want to hear what you did to help yourself.
posted by NowYouKnow to Human Relations (25 answers total) 17 users marked this as a favorite
 
Hey, I get it. That paralysis? That's the worst part of depression for me. For me, the paralysis comes from having "so many" things to do (true or not) and so many other things to do after I do those first things. The way out is to pick one, relatively simple, choice-free thing to do and do it, then consider it a success and try and give your self some credit and acknowledgement for "doing a thing in the face of depression". In your case, the thing to do is call that psychiatrist and make an appointment. The reason being that meds can absolutely change your life. It's true that they don't work for everyone, and sometimes it seems like they don't work for anyone, but that's because for the most part you only hear the horror stories, you don't hear about the many many people who just get put on some meds, and they work, and then they can go on with their life. After you call, post here that you have done it, and all of us reading this question who are fighting the same fight you are will congratulate the fuck out of you and it will feel great. So do it!
posted by Rock Steady at 3:43 AM on July 9, 2015 [14 favorites]


I may not be able to give you hope, but I can give you solidarity. My situation is a lot like yours.

You know what we want? We want to not feel like this. It's awful. It's not how we want to live. But we can't get the motivation or the energy or the desire to do anything about it. For one thing, we don't know what to do. For another, the idea of a better life is frankly exhausting. I'm barely coping with life and all I do is shuffle from bed to couch to bathroom and back. How am I going to get out of this pit?

And sometimes at the back of our minds, this just seems easier. Maybe we want this. Maybe it would be easier to just give up.

That is the depression talking though. You and I are not our depression. We are ravaged by it, we are incapacitated by it. But it is not us.

You have two things you need to do. Insurance and call the psych. Holy shit are they hard things.
Insurance: bad, scary, complicated, involves organisation, probably phone calls, ugh. Also, pertains to counselling which you are probably quite ambivalent about. Depression doesn't want you to get counselling. So it's going to make it hard hard hard for you to stick with it.
Psych: same deal. It's hard and complicated and it's making you think about a positive future and that's just not something you can do right now.

That's ok though. Because these things might not do any good after all. Or they might. At this stage, maybe you don't even care. But the part of you that wants to live is still in there, and it wants you to do them. Don't do them now. You've survived this long, you can wait til after Saturday when you've dealt with that thing and recovered from it. Don't beat yourself up about not doing them today.

But the thing is, you just are going to do them. Don't even think about the next step. Make the calls. Then cry about it or spend the next three days in bed. Doesn't matter. You're not suddenly saying "that's it, it's all going to be better now" because of doing those things. You're just doing the first step. It's do-able. It's ok.

This morning I phoned my GP about a follow-up following a psych appointment a week ago. I should've phoned him last week. Never mind, done it now. The appointment with him isn't for two weeks. Will I lie around and probably get worse in those two weeks? Maybe. Doesn't matter. I have made a step and I am accessing help. We need help. They will help us. It's ok.

Depression will make it feel like we take three steps back for every one forward. The only thing that matters is that we keep making that one step. The one step is saying "Yes, I want to live" even though it feels impossible. That's all you need to do.
posted by mymbleth at 3:50 AM on July 9, 2015 [11 favorites]


I know it's really perplexing and frustrating, but this kind of inability to do certain things is just another symptom of the depression.

Please enlist someone's help to make the calls to the insurance company and to the psychiatrist. Your parents, your best friend, your boyfriend, or your counselor. Can you use a session with the counselor to try to do this? It doesn't matter if you are paying out if pocket.
posted by zennie at 4:03 AM on July 9, 2015 [11 favorites]


For twenty years I coped with depression through CBT etc., but as I got older the depression got worse and finally I went on meds (cipralex, lexapro in the US, escitalopram is the generic term). It's been life changing for me. Meds aren't for everyone but if you can make the call even if it seems impossible (as mymbleth noted), it's worth a try IMO, echoing what rocksteady said. Hugs sweetheart.
posted by biggreenplant at 4:07 AM on July 9, 2015 [5 favorites]


What zennie said - This is the point when your parents, your best friend, or your boyfriend can really tangibly offer you support, so let them! The people who see you in pain would love to be able to do something besides be sympathetic. Ask one of them to be there with you when you make the call to the psychiatrist to make an appointment. Ask one of them to go to the insurance's website or call the help line to find out about your coverage, too.
Talk therapy only got me so far, though it helped a lot. I responded well to medication. Keep trying if the first one doesn't take.
I'm sorry that you're struggling so much, good on you for fighting hard. You will get better!
posted by hiker U. at 4:14 AM on July 9, 2015 [6 favorites]


I have been there, and I was fortunate enough to have an employee assistance phone number to call. After struggling for a month, I called their phone number bawling, said I wanted to see a counselor but needed an evening appointment that took my insurance, and gave them my address. Half an hour later, they called back and told me I had an appointment in a couple days near me. I didn't have to search online or call multiple counselors to set up an appointment.

Are you currently employed? Can you check with HR or your work benefits if you have an employee assistance line? It is confidential from your workplace, and in my case it was a free service that included 4 free sessions with a counselor (which was enough for me to decide I wanted to continue with her.)
posted by shortyJBot at 4:19 AM on July 9, 2015 [1 favorite]


Big thank you to all of you who've answered so far. You've brought me to tears with your compassionate answers. I made the call to the psychiatrist. I called during after hours but the woman who answered said she would leave a message for them telling them to call me back.
posted by NowYouKnow at 4:30 AM on July 9, 2015 [43 favorites]


Good for you.

Sometimes what I need is someone to just sit with me or even actually dial the phone for me. Maybe you can have a friend do that so you can make the follow-up calls you will need to make. (If that would be helpful, someone could even do that for you over Skype and be your video call buddy while you make phone calls.)
posted by DarlingBri at 4:37 AM on July 9, 2015 [4 favorites]


That's awesome, good job. The really powerful thing to consider is that, by defying that paralysis that comes with clinical depression, you are already healing yourself. Don't hesitate to drop me a MeMail if you need any further encouragement, OK?
posted by Rock Steady at 5:13 AM on July 9, 2015 [3 favorites]


Follow up with the psychiatrist and good for you for making that first call. It sounds like you have anxiety with depression. Depression can make you feel sad and listless but when you add in anxiety, you get those moments where you are so stuck in indecision that the listlessness from the depression almost feels like a comfort. You could actually be using your depression as a crutch to deal with your anxiety. Medication will help all of that but, until it starts working, you need to focus on getting out of those locked in moments. This is easier than you might think. All it takes is making yourself do one thing different, and it can be anything. It can be something fun. It can be a Designing Women marathon where you sit outside for 5 minutes between every episode. It can be learning something new or going someplace that you have never been. The hardest part is that first step. It can take hours some days to get to it but once it's made, the anxiety moment is broken. Think back to when talking to someone helped. Before the phone call, you were locked in. Afterwards, you were not. With anxiety, sometimes just changing the moment by talking to someone or going to a different location can break the locked in feeling. Take a shower, blast some music, yell at your neighbor, anything that will get you to that first step.

You've been going through this for a long time which means that your body and mind has turned this into the norm. It's going to take some time and work to change that but, once you do, your life is going to get so much easier. It's normal to feel a little worse at first on the medication. It will be taking away your crutch. During those first few months on the medication, do see a counselor at least twice a week. This will mean changing over to one who takes your insurance so go ahead and set that up. Part of retraining your brain and body is retraining your body. Get some sunshine! At least 10 minutes a day! Go for long walks. Try to stay as active as possible. Get all the crap food out of your life. If it can't be grown, raised, or caught, it isn't food and should not be consumed. You can do this! You can create the life that you want. It will be okay. As problems go, you do have the kind that are treatable, and that is a blessing.

Start looking for ways to contribute to the world. Volunteer somewhere that interests you. Helping others is the most effective way to help yourself get out of your head and into your life. Reading the Bible brings many people comfort, even if you aren't a believer. There is a certain beauty in words that are that old and still have meaning. It connects us all as humans. How you feel has been felt by so many since the beginning of man. It isn't new. You have never been alone.
posted by myselfasme at 5:17 AM on July 9, 2015 [5 favorites]


Medication. Try it. It may not be a magic bullet for you but it will likely give you enough breathing space to be able to tackle your day. And when you're having all bad days that breathing space can be the most helpful thing to get you to keep going forward.
posted by fluffy battle kitten at 5:30 AM on July 9, 2015 [1 favorite]


Oh fantastic, glad you have called the psych!

I was about to write a script for you, as I have found that really helps with paralysis.
It can still help to write out a script for yourself to follow.

E.g *Dial number*
Hi [Psychiatrist/Receptionist], my name is NowYouKnow, I have been referred to you by my therapist, [Therapist], for help with depression. What do I need to do to make an appointment?

For Insurance:
*find a letter or email with insurance details*
*Dial insurance*
*Answer their questions*
What are you calling about? "First, I need to check that my policy covers counseling, and secondly, get a referral or list of counselors I am eligible to see who work with [Insurance company]"


If you don't have someone else to help with this, pretend a friend is asking you to tell them exactly what to say, and then write down just the first sentence or two, to get the ball rolling.


Meds will almost definitely help.

Also try going for a walk.

Consider quitting caffeine - the feeling of paralysis can make me think I need something to pep me up, but usually it is actually masked anxiety that is making me freeze up, so caffeine makes me more jittery and anxious.

If you are getting nothing done, and are feeling paralysed about what you should be doing, often I am actually doing some kind of filler task - internet etc. Stop what you are doing, and do proper nothing for a bit. Set an alarm for 15-30 minutes at least, and just lie down, put something over your eyes, and do nothing, knowing that all you should be doing right at this moment is nothing, not thinking or worrying, but just drifting. If you have any relaxation or meditation tracks you like, try listening to those with some earbuds in, I like Glenn Harrold.

Afterwards, or if you can't lie down, go to the bathroom, go toilet if you need to, wash your hands, wash your face, brush your teeth if you can, and brush your hair or tie it back.

Write yourself a list of what you want to do in the next hour, doing things is hard enough, set it up so you don't have to make decisions as well. It is less mental effort to separate giving yourself instructions (decisions), and following them (doing).
posted by Elysum at 5:33 AM on July 9, 2015 [6 favorites]


I feel for you. I call it the "inertia voice" the voice in my head that just says "Do nothing, do absolutely nothing" It's awful advice and I only give it to myself.

I find, I must accomplish SOMETHING, anything but I have to open my eyes, I have get out of bed. I have to get dressed. I have to walk downstairs. I have to eat a tiny bit something.

I think of only one thing at a time (not the whole day/week/month) and just do that. Each thing I accomplish gives me a little momentum to overcome the call of the "inertia voice"

Good job calling the doctor. That's an accomplishment.
posted by French Fry at 6:56 AM on July 9, 2015 [4 favorites]


Don't worry about the insurance card right now. Keep seeing the counselor, even if it's costing you money. You are worth it. Eventually, you'll find the insurance card and get that taken care of, but in the meantime you are still getting the benefits of talking to her.

I've been through something similar. I wanted to take a positive step, but it would be expensive if I didn't do this other thing first. I realized that I was avoiding the other thing, and still not taking the positive step, so I said screw it and took the positive step anyway. Do I miss that money? Sure. But it was totally worth it, because I was eventually able to tackle the other thing, but probably only because I had taken the positive step.

When I feel paralyzed, I pick one thing to do, and don't think about the rest. Sometimes just doing that one thing gives me motivation to do another thing. Sometimes it doesn't. Either way I've accomplished something, so it's okay. Break the hard things up into smaller pieces. For example, one day your goal is to just find the insurance card. Calling them is a goal for another day.
posted by rakaidan at 7:59 AM on July 9, 2015 [1 favorite]


Have you tried other approaches besides talk therapy? Talk therapy feels good, but I don't know if it actually does much except keep people embroiled in whatever brought them in. I think CBT is better for actually giving you something actionable and seeing progress in a shorter amount of time.
posted by Aranquis at 8:25 AM on July 9, 2015 [2 favorites]


Feelings come from somewhere. If talking about the feelings is no longer sufficient to give relief, it is time to start looking for root causes to address. Depression can have a component of brain chemistry. No amount of talking helps brain chemistry. Things that can help include meds, diet and exercise.

Another thing that can cause depression is a situation that makes you feel trapped and helpless. It could be a job or a bad relationship of some sort. Figuring out how to start getting untrapped is the solution for that. It involves sometimes scary and frustrating problem solving and decision making. It took me years and years to get my life in order so I could get divorced. But being free of my marriage has been the best thing for my mental health because it removed a very serious obstacle to my ability to exercise agency and do what I needed to do for myself.

Best of luck and congrats on making the call.
posted by Michele in California at 8:59 AM on July 9, 2015 [2 favorites]


High five to you for making that call! It's so hard to get over that first hump, no matter how small that first hump is.

I've struggled with the kind of depression that keeps me in bed, in the house, unshowered. It's a brutal one because not only do you feel like shit, you feel like shit because you feel like shit, and you start blaming yourself for feeling the way you do and not doing anything about when, at the same time, it feels like you can't do anything about anything.

What has been helpful for me to remember is that that kind of depression? It's a thing that exists. It's something that lots and lots of people experience. When you're in it, it feels so unique to you, and it feels like you are uniquely broken, but you're not. You're just suffering through a disease, and so are other people, and while it sucks, it's okay. It's okay to have a disease. It doesn't make you any weaker than anyone else, no matter what your stupid depression brain says. I'd argue that it makes you stronger, actually, because look at you! You're getting through it! It's not fun and it's not easy, but you are resilient and you are getting through it. You are stronger than your depression allows you to realize. You made a phone call, and the end result of that call will be help! That is awesome. You are strong. It may take a while, and it may take trying a bunch of new things -- new meds, different meds, different therapy, etc. -- but you'll get there. You're already headed that way.
posted by mudpuppie at 10:19 AM on July 9, 2015 [4 favorites]


Just take things one step at a time, and don't be hard on yourself when you're doing the best you can even if it seems like it isn't enough.
posted by monopas at 10:21 AM on July 9, 2015 [2 favorites]


I would like suggestions for coping mechanisms in the meantime between today and Saturday. Also I just need hope? If anybody has felt this way and successfully overcame it, I want to hear what you did to help yourself.

I struggled for a long time and was locked down by a combination of the depression lethargy and a hostility towards chemical solutions. After the umpteenth life problem and a request to a caring professor for some allowances she asked why I wasn't pursuing other solutions. I said I didn't want to alter my brain chemistry and I wasn't thrilled about taking a pill for the rest of my life.

She asked me if I was all that thrilled with how my brain chemistry was working right now and whether I'd take insulin if I was a diabetic. I said no, and yes of course. She said, "ask your doctor about the damned pill then." Thank you Dr Northrup; you changed my life. And your course was awesome too.

In the mean time, I have never heard anyone say that mild exercise did their depression any harm. Go for some walks. It really helps, both physically and by being something you can get yourself to do and point back to as an achievement. Maybe it was just me, but I found I could get myself to do that sort of thing since I didn't necessarily have to interact with anyone and it wasn't an aspect of my life I was currently feeling beaten by. If I put on my shoes and walked down the block I'd done something and I'd gotten started. Keeping going for a while was easier, but if I turned around and it was all of a 5 minute outing it was still fine.

I started taking prozac and cannot overstate how much it changed my life. SSRIs are sometimes connected with some drowsiness but I found I suddenly was awake and had productive time after 830p, when I normally had been going home and plopping myself onto the couch and subsequently to bed - mostly because why would I do anything else?

You have a lot of reason to hope. There's huge swathes of additional approaches to pursue and things that have worked well for a lot of people. Good luck, I know you'll do well.
posted by phearlez at 10:23 AM on July 9, 2015 [5 favorites]


It's not you, it's the depression. You're doing just fine! You wrote to us, you made a phone call! Pat yourself on the back.

Meds can help you A LOT, especially at the beginning. It can be like the sun coming out, like getting new glasses for short sightedness and seeing color again. You still have to work against the depression's inertia and go out, do things differently, but meds can truly make the road less arduous. Like you left your baggage in the luggage room.
posted by ipsative at 10:28 AM on July 9, 2015 [3 favorites]


Sometimes I tell myself that my depression is a monster I'm fighting. Not refilling my prescriptions, not asking for help when I need it, laying in bed or on the couch all day because anything else is just too hard - the depression monster loves it when I do that. It makes the depression monster stronger. It's the devil on my shoulder telling me to cancel plans with my friends because it'll be embarrassing when they ask me what I did over the weekend and I have to respond that literally all I did was sleep and eat. The depression monster cheers when I succumb to tears when my pants feel too tight and decide I'd really rather just order a pizza and stay home anyway. And every time I call myself fat, stupid, ugly, lazy, the monster grows and grows.

But the depression monster can't win. That's just not what happens next. I don't always know what happens next but I know the monster doesn't win. So I pick up and take my meds and the depression monster glares at me. I put on a jersey dress in a fun color and the depression monster pouts. I go to a party, see old friends, and meet interesting people and the depression monster lets me know that it is not happy. Tough shit, depression monster. You're not going to win.

I don't know how I am going to beat the depression monster but I don't need to know. I just need to win today's match with the depression monster. There will likely be setbacks and its not going to be easy. But I decided that the depression monster is not going to win. I hope that helps and that you won't let the depression monster win either.
posted by kat518 at 12:35 PM on July 9, 2015 [5 favorites]


Another person here who was in your situation. Years and years of talk therapy, not much benefit, then I went on meds and my whole life turned around. Don't give up hope.
posted by Cinnamon Bear at 1:05 PM on July 9, 2015 [2 favorites]


I'm so sorry you're going through this. It's really hard. I'm going through it, too. (hug)

Make a list of things to do every day:
. Take a walk or get some form of exercise.
. If possible, get that exercise outdoors - nature and sunshine are good for depression.
. Take vitamin D.
. Get good nutrition.
. Make mental or written lists of good things about yourself. say one or 2 things out loud every day.
. Find something good and be grateful and/or a little bit happy about it. The sun came out. Lunch was delicious. That shower felt good.
. Know anybody with a dog or cat or other loving pet? Walking and playing with my dog gives me moments of respite.

If you don't do any of these things, no beating yourself up. Maybe you can do some of them tomorrow.

Read Allie Brosh's Adventures in Depression and Depression Part II. Read the Bloggess' Depression Lies. Sometimes I just keep them open in my browser.

MeFi Wiki There is Help.
Reddit What do you know about depression?
Reddit My Massive List of Depression Resources Part 1.

I've had episodes of major depression many times in my life. But at some point I realized/ decided that it's worth living. It goes away sometimes. Sometimes I'm a bit depressed but able to appreciate life. Sometimes I'm depressed but still say Fuck You Depression, and I enjoy the feeling of the sun on my face, the view out my windows, my warm snuggly dog. My cousin was sweet to me on the phone the other day, and I cried like a baby, which is really embarrassing, but, jeez, what a nice person, and that person loves me. So, you know, keep getting up every day.
posted by theora55 at 1:06 PM on July 9, 2015 [6 favorites]


I totally get this. I've been immobilized by depression for long periods of my life. Meds changed my life, though they don't always work. Or a better way to put it, it can take a while to get the right combo. Counseling didn't help me much mainly because the depression wasn't caused by bad circumstances in my life.

Hang in there. Be kind to yourself. Let yourself take the downtime you need. And hold onto the promise that this does get better.
posted by persona au gratin at 2:56 AM on July 10, 2015 [2 favorites]


Thought of you when I had a recent appointment with my psych. Hope it's getting better.
posted by Rock Steady at 7:27 AM on July 20, 2015 [2 favorites]


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