Am I doing something wrong in therapy? Turning down recommendationss
September 1, 2018 7:19 PM   Subscribe

I'm new to therapy so maybe I'm not sure how things work. My first ever therapist terminated with me because I didn't follow her clinical recommendation, and now I'm turning down recommendations from my current therapist. I believe I'm acting in my best interests, but this also has me wondering if I'm doing something wrong here or if there's another approach I should be taking.

I'm new to therapy so maybe I'm not sure how things work. My first ever therapist terminated with me because I didn't follow her clinical recommendation, and now I'm turning down recommendations from my current therapist. I believe I'm acting in my best interests, but this also has me wondering if I'm doing something wrong here or if there's another approach I should be taking.
I started therapy for the first time in December, and two months ago my first ever therapist terminated with me with the reason being that I didn't follow her clinical recommendation, which was continue attending group therapy as she thought I needed more support than just her.

My current therapist is great, and she's been more willing to work with me even if I disagree with her recommendations. I should preface this by saying that I'm in no danger of her terminating with me at the moment, so I'm not looking for advice in that regard. More of how I can move forward and get the most out of therapy while also not alienating another therapist down the line. A big cause of concern with my therapists is that I have pretty heavy suicidal ideation, which is a big part of why I've gotten the recs that I have. I do feel like I've made really good progress in therapy, but my suicidal thoughts are still there and don't seem to be going away anytime soon. I also have lots of negative thoughts.

My former therapist told me that I'm a very honest individual, and in therapy I'm very upfront about my suicidal thoughts. Maybe I'm being too honest. I've heard of people afraid to mention these thoughts in session, but I'm not. I'm in therapy to be honest and get help, so I never shy away from how I'm feeling.

As detailed in my prior question about my ex-therapist, group therapy was definitely the worst thing I've gone through this year and nearly led me to take my own life. I also mentioned how I felt "forced" into going, which goes along with how I'm refusing higher level of care now.

I have a good therapeutic relationship with my current therapist. However, a few sessions ago she mentioned her thinking I may need a higher level of care and was going to consult with a few others at her practice for ideas, etc. This freaked me out. She still ended up consulting, but in that same session we made an agreement of compromise and have been fine since.

A few of the recommendations that I'm turning down/have disagreed with her on.

-Medication: I was on antidepressants for a few months before and refuse to go back on them. Sex/alcohol are a big part of my life and the side effects were just too much. Even just one drink in a social setting would send me spinning out of control. I also drink socially most of the time, but sometimes do drink to cope. Have been working on alcohol use in general in therapy. Also when I was on the meds I was not feeling better for the most part and still had suicidal ideation.

-Higher level of care: This freaks me the fuck out. Aside from the fact that if I miss work for a period 1-2 weeks I'm not going to be able to pay rent, the idea of higher level of care is something that scares me shitless and is something I'm a firm no on. As someone who actively wants to kill myself this doesn't really making sense, but it's how I feel and how I react. I even went as far to make a couple hasty comments regarding it, such as that I'd terminate with her if she recommended higher level of care in order to continue treatment with her...and that I'd do medication before ever taking higher level of care.

-Contacting former therapist: So far I have not allowed her to reach out to my former therapist, which she thinks would be a good idea in order to get some more info. We have been working on this in therapy but I think about her a lot, sometimes daily, and it is causing me more stress. Out of the 3 this is the rec that I am most willing to ease up on.

I've been told by another therapist that I jump to conclusions and make drastic decisions. Which is true. I've also been told by my current therapist that when I'm not in control or when things don't go my way, I get angry. This was not in relation to her recommendations but to something else, although I guess it applies here too. I never thought of myself that way but it's something to think about.

I'm doing pretty good work in therapy, and have made many positive changes in my life, so the hope is that these things can be solved through therapy and my own willingness to change. But my main concern here is what happens to me down the line if things suddenly get worse through an attempt or a hospital visit and I am still refusing these recommendations. I do realize that would put myself as well as my therapist in a tight spot.

Different perspectives, things I'm not thinking of, etc. would all be appreciated. But please be gentle. I hope I have provided enough info, thanks.
posted by signondiego to Human Relations (22 answers total) 3 users marked this as a favorite
 
Well....

Either you’re willing to change or you’re not.

You don’t sound very willing to change. You’re turning down therapeutic recommendations because you’d rather continue coping with sex and alcohol and the things you’re comfortable with. I’d say it’s one thing to be freaked out by the idea of a radical change in your daily life, and to work out a plan with your therapist to help you get from A to Z without it being unnecessarily tough on you. But it’s another thing for a therapist to say, “In order for you to get to the goal you say you want to achieve, you need to do X and Y” and you refuse to do X and Y.

So what do you want? Do you want to treat your depression or do you want to keep doing what you’re doing? It is literally your choice, you are entitled to do whatever you want. But it seems to me like you’re looking for a magic solution that will fix your depression without you having to significantly change anything about your life. I don’t think that is an option.
posted by Autumnheart at 7:42 PM on September 1, 2018 [96 favorites]


she mentioned her thinking I may need a higher level of care and was going to consult with a few others at her practice for ideas, etc. This freaked me out.

Did this freak you out because you don't think you are in that bad a mental space, and you think she is above her level for asking for help, or for privacy reasons? This is open ended, you are in no way accountable to anyone other than yourself.
posted by kellyblah at 7:46 PM on September 1, 2018


- How many therapists does it take to change a lightbulb?
- Just one, but the lightbulb has to want to change.

You've got past the first hurdle, which is to believe that things can change for the better. That's great. But you're now at the point where a therapist will suggest concrete ways to think about the process of change and steps you might take, and the perverse comfort within the black hole of depression is asserting itself. Maybe do a self-intervention on thinking about "down the line"? You are where you are, and you don't like being where you are, so you have permission to let go. (Though to some extent you do because it's familiar, a bad old friend.) "Down the line" is an imaginary elsewhere. If you do something different and it makes you feel uncomfortable, you can talk it out; you can stop. You have agency, and you're most comfortable with deploying it with refusals. Talk to your therapist about that and the route towards feeling empowered when deploying your agency with acceptance.
posted by holgate at 8:06 PM on September 1, 2018 [3 favorites]


It sounds like you're just freaked out. That's your mental health lying to you.

Antidepressants: if they're impacting your sex drive, it's not the right one for you. Some may allow you to drink in moderation. You are depressed. This is an illness. Your last medication had bad side effects. So please talk to your doctor about a different one.

Tell your therapist you're freaked out about money and the care you need. Dude, you're sick. You'd be freaked out if your appendix burst, but you'd still be in the hospital for awhile. Maybe ask her to help you make a plan.

Group therapy: fine, don't go right now. Ask if you can meet with two therapists or go to meditation or some other care type activity.

Old therapist: just say this makes you uncomfortable. Explain it makes you super comfortable. It could be a therapeutic moment. Or like, your therapist may never bring it up again. Either way is a win for you.

These things are super hard because you're really depressed. You can do this and get better.
posted by Kalmya at 8:08 PM on September 1, 2018 [7 favorites]


There is alot here to unpack honestly, and there is a ton of nuance to these things.

I'm going to address the higher level of care thing here and the medication alone.

I've had...multiple inpatient hospitalizations (between 2004 and 2012) the longest one was 45 days, average stay was 2 to 3 weeks. It was absolutely necessary and life changing. I have a rarer disorder constellation that complicated matters.

My perspective on normal functioning was so absolutely skewed I had no idea how bad things were until they started getting better. I couldn't conceive of not having constant suicidal ideation or constant panic or just a million other behaviors and feelings that were so pervasive and so normalized it took me working with others who could see the difference and my potential for recovery because I absolutely couldn't concieve it or the impact it would make.

I went to hospitals that specialized in my issues and it was incredibly useful for me. I had good insurance and lots of choice. The one time I had a crisis hospitalization at basically the nearest hospital was by far the least helpful. But depending on where you are your local treatment will vary.

You have multiple professionals recommending something for a reason. It is an absolutely scary step. There were tons of things I hated about all of it. But it really could lead to a better outcome for you. I don't regret any hospitalization I had.


Secondly, I totally get that sex and alcohol are important. I don't take any medicine now. But... When I first went on medicine, I couldn't read a book, or watch TV. I couldn't get through a meal without suicidal ideation , had panic attacks multiple times a day, and frequent flashbacks. Honestly looking back even though those things were and are important to me too, I wasn't really enjoying it. I'd have sex and still want to die. I'd drink and obessess. My experience now just don't compare (aaand it's so much better!).

It's scary and hard, but please don't stop being honest and keep reaching out for help and advocating for yourself. Ultimately you will decide what services work for you and how much effort, and interventions you will utalize in your care (excluding involuntary hospitalizations).
posted by AlexiaSky at 8:16 PM on September 1, 2018 [46 favorites]


Effective therapy requires there to be a good rapport and trust. If that isn't there work can't be done.

I began therapy last winter to finally deal with what I initially thought was the end of an abusive marriage. It turned into several months of unpacking and realizations that things ran a little deeper than I initially thought.

I too have had suicidal ideation, in fact that way what lead to my finding a therapist to begin with, that and the urging of friends who I suspect saw the signs in me. I was not comfortable disclosing that to my therapist until six months into treatment. I have wondered what the outcome could have been had I been honest from the start. I doubt she would have taken me as a client. She had plans to close her practice, and knowing that I am in need of potentially years of work, she likely would have referred me elsewhere.

I have finally found one that I think is going to work. I hope anyway. I am trying to trust the process, and I am following her recommendations even if they feel cheesy and uncomfortable.

All of that leads me to this: Therapists are like jeans, sometimes you have to try a few before you find the right fit.
posted by DelightfullyTacky at 8:37 PM on September 1, 2018


Well, I looked at your last question about your first ever therapist and read this part: "A few months ago I brought up in session and how I'm attracted to her and feel attached to her..." Regardless of whether you feel like your attraction was a non-issue, your first therapist did the right and ethical thing in terminating with you and asking you to find a new provider. Especially since it seems like the attraction has continued for you ("I think about her a lot, sometimes daily, and it is causing me more stress"). I don't think that you did anything wrong, you were just unlucky enough to find a first ever therapist who also had qualities you found attractive for whatever reason, and you fixated on her. In the future, you should stick to providers who you could not become sexually attracted to (wrong sex, wrong age group, etc) and with whom you can have an honest, open relationship without feeling infatuated.

As for anti-depressants, how many kinds of medication have you tried? I know that some cause the side effects with sex and alcohol that you described, but others do not. Most people have to try a few different drugs or different dosages before they find something that works for them and does not produce side effects that outweigh the benefit. Because of your suicidal ideation, I strongly encourage you to revisit the idea of medication by consulting a psychiatrist and explaining your past side effects so they can recommend a different class of anti-depressant for you. Also, there is now a genetic test to help figure out what types of psychoactive medication are most compatible: www.genesight.com

I found it helpful to think of hospitalization as "a chance to focus on nothing else other than getting well mentally" rather than being isolated from the real world or having your decisions limited. Talk to your therapist about why the thought of hospitalization troubles you, whether due to money or anything else, and together you can identify some options you can try before resorting to an inpatient stay. If you need some kind of group setting but can't tolerate a DBT group, you could try something like meditation classes to develop mindfulness skills, or going to (free!) AA meetings to work on drinking less.
posted by zdravo at 8:54 PM on September 1, 2018 [10 favorites]


-Higher level of care: This freaks me the fuck out. Aside from the fact that if I miss work for a period 1-2 weeks I'm not going to be able to pay rent, the idea of higher level of care is something that scares me shitless and is something I'm a firm no on. As someone who actively wants to kill myself this doesn't really making sense, but it's how I feel and how I react.

1. Therapy is a good place to work on things that freak you out. Are you willing to consider talking more about this with your therapist with the understanding that you want to talk about the many ways that it freaks you out without the discussion meaning that you agree to higher levels of care?

2. Al-Anon likes to remind members that feelings aren't facts. That you are scared shitless about the idea and react with a firm no doesn't necessarily mean that you are doomed to be scared shitless of it forever and refuse to do it forever. Nor that you have to do it. For whatever reason, this is a really powerful scary idea. I understand why it would be scary. But perhaps you can practice simply talking about it some more with your therapist to practice discussing things that are uncomfortable because that is a genuinely useful skill to have.

I am so sorry you are dealing with this. It sounds really hard. Hang in there!
posted by Bella Donna at 9:41 PM on September 1, 2018 [3 favorites]


In the case of therapist #1, she absolutely should have backed off of group therapy, especially when you said it was causing suicidal ideation. Therapist #2's suggestions are good, but uncomfortable, and maybe you're feeling extra resistant because of how therapist #1 pushed you to do something ultimately harmful to you.

You should know that all mental health professionals take suicidal ideation very seriously. This is not something they will ever brush off. It's their professional responsibility. If you bring it up, they're going to hyper focus on it. You will be risk assessed and at the very least urged to seek higher treatment. Every time.

You're in therapy because you want to get better, right? You won't make any progress unless you put some work into it. In therapy the patient is actually the one who does all the heavy lifting. You have to be willing to compromise on some issues or you're just gonna spin your wheels. Your therapist should be willing to work with you to figure out some workarounds or small steps to take forward if you aren't feeling able to go through with their suggested courses of action.

I've been told by another therapist that I jump to conclusions and make drastic decisions. Which is true. I've also been told by my current therapist that when I'm not in control or when things don't go my way, I get angry.

Super, super normal fearful person behaviour. Your therapist should be working with you on strategies to help you recognize when you're doing it.
posted by Stonkle at 10:05 PM on September 1, 2018 [4 favorites]


Not all ADs are incompatible with alcohol; my doctor has let me take SSRIs/ anti-psychotics/ mood stabilizers and drink, just with the advice to take my meds 6 hours after.

Seconding Bella Donna: feelings aren't facts - except when you are feeling acutely suicidal and need to be assessed for a higher level of care. I've been in that place of being shit-scared to go inpatient until my psych called me one day and said I want you in the ER within three hours. I went in blind and terrified, but it saved my life, and all the things I thought would fell apart if I had to "check out" of life for a while... really didn't.

what happens to me down the line if things suddenly get worse through an attempt or a hospital visit and I am still refusing these recommendations
I think your therapist will have a contract to ensure your safety and/or compliance, and you'll have to decide whether you want to adhere to it. You have every right to quit all treatment altogether and spiral towards another attempt / HLOC from there, and no one is going to stop you. But something keeps you going back right now. It took me two suicide attempts to figure this out, but I need to trust my psych to make my life better in ways I can't achieve on my own, and I can't keep fighting her if that's going to happen.
posted by ahundredjarsofsky at 1:16 AM on September 2, 2018 [2 favorites]


I'm doing pretty good work in therapy, and have made many positive changes in my life, so the hope is that these things can be solved through therapy and my own willingness to change.

This is terrific and you should feel proud and happy about this. But as you note, you have a few deeply-entrenched behaviors that don't contribute to your overall wellness.

Think of it this way: your best friend has a broken ankle and while going to the hospital and getting it reset will make it better, she doesn't want to do that. Instead, she is popping ibuprofen and tylenol in massive quantities, possibly causing liver/kidney failure, and the pain is so bad she can't do anything other than sit quietly. But this is how she's choosing to deal with her ankle. She can still eat and function to some extent. And the longer she sits on her couch, the more that way of living feels natural and the less she wants to change. Her brain has accepted this way of being as normal.

Similarly, your brain's wiring has accepted suicidal ideation as a normal way of thinking, which it isn't AND IS TREATABLE. Your therapist's concern is that it doesn't take much for your brain to decide to act upon ideation, hence their desire to have you go inpatient where their primary goal is to stabilize those thoughts away.

We all have this tendency to think of mental issues as somehow separate, other and somewhat shameful. They're not. It's just funky wiring which can be remedied. But we still hold these deep convictions that this screwy and completely fixable wiring shows a deep character flaw about us. Are you going to blame your friend for breaking her ankle? No, right? But as an outsider you can see the broken ankle is completely fixable.

What I'm saying is you need to reframe your feelings of control right now into, "I want to feel better and I am willing to try a higher level of help. I want to get through the hour without having those thoughts, and inpatient support will do that." Reframe this decision so it's *your choice* to get more help.

Good luck. You can do this and please keep us updated.
posted by yes I said yes I will Yes at 2:46 AM on September 2, 2018 [11 favorites]


Jeez-I forgot the important part of the ankle analogy: over time, the ankle will heal to the point where she can get outside again, but the bone and tendons and muscles will be out of alignment and unless she gets it repaired--which can be done at any time--she'll walk with difficulty. Her knees, hips and shoulders will get out of alignment, causing chronic discomfort for the rest of her life.

At any point, she can STILL go to a hospital and get it fixed and feel sooo much better, but she keeps refusing, saying it's good enough for her and it's fine.
posted by yes I said yes I will Yes at 3:42 AM on September 2, 2018 [1 favorite]


It sounds like your stance on group therapy is
  1. Right now it makes me suicidal.
  2. I don't care to find out why it makes me suicidal.
  3. I refuse to believe it will ever stop making me suicidal.
So okay. #1 is important. It's okay to dig in your heels on #1. You don't want Therapist to forget about #1.

But digging in your heels on #2 and #3 is less productive — and your therapist is right to challenge you on it. Basically any time you find yourself saying "I don't want to understand this and I refuse to believe it will change," any good therapist is going to be like "Huh, interesting. Let's talk more about that."

On some level, therapy is about getting curious about the things that make your brain go "NOPE NOPE NOPE DON'T LOOK NOTHING TO SEE HERE." Which is fucking scary — I don't blame you at all for being freaked out about it. But it's how this shit works. And sometimes working up the courage to look closely at those scary things actually helps them get less scary, or helps them go away entirely. The more you learn about why group makes you suicidal, the better your odds of getting to a place where group doesn't make you suicidal.

Because here's the other thing. Just on a practical level, if you're someone with untreated suicidal ideation and you're unwilling to address that with meds, there's probably group therapy in your future. Either you're going to need to do a partial program at some point, or you're going to make another attempt and end up inpatient, and in either of those settings they make you do group. So even if you never love group therapy, learning to cope with it is a survival skill that will help you get through the lowest points in your life, and cultivating that survival skill is a way of staying safe.

So. What if you say to Therapist, "I don't feel safe doing group right now. It freaks me out hard and makes me unsafe and I don't understand why. I would like to understand why, and I would like to get to a place where it freaks me out less. Can we work on that here?"

Or what if you say to Therapist, "I'll try group again. But I'm going to need a lot of support around that, because it freaks my shit out. We need to come up with a safety plan for what I'll do if group makes me suicidal, and we're going to need to spend a lot of time in individual unpacking all the shitty thoughts and feelings that I experienced during group. Are you up for that?"

Also: add me to the list of people saying "Try meds again." You have a potentially fatal health condition, and refusing to treat it is not a great idea. There are loads of non-SSRI meds that won't fuck up your sex life. Trying a couple different meds before you find one that works for you is super normal, and figuring out what side effects you get and whether you can accept them is part of that process. If you go to a psychiatrist and say "I've got suicidal ideation, but SSRIs kill my libido and I refuse to take them," they will have a laundry list of other suggestions — probably starting with Wellbutrin, but with various backup options should Wellbutrin fail.
posted by nebulawindphone at 6:04 AM on September 2, 2018 [15 favorites]


Another voice adding to the chorus to try medication. I tried two different SSRIs and hated them, but a Tricyclic changed my life. I took that for a few years, and I'm off it now. It worked for as long as I needed it to.

Life is a lot better, I can handle the ups and downs when they come, but I also know that if things do ever take a turn for the worse, I can go back on it for a while.

I sympathise with you, because I hated the idea of medication and group therapy sounds like something I'd hate too, but I think I'd try it if someone I trusted felt like it was worth me trying it.

I also sympathise with your therapists - it's so great that you're being honest about your heavy suicidal ideation, but it sounds like what they want to do is cast a wide net for you, to make sure if anything suddenly goes awry that there are lots of things running in the background to help you.

Good luck and please memail me if there's anything I can tell you about life on SSRIs vs Tricyclics.
posted by greenish at 7:12 AM on September 2, 2018


Just as a practical comment, if you quit drinking it might help you save up for taking some time off work.
posted by salvia at 10:00 AM on September 2, 2018


I just spent a year trying a bunch of different medications. I'm finally on a mood stabilizer that's helping a lot. My psychiatrist said, "Well, now you know SSRI's don't work for you." It sounds like you really do need to try medication again. It is exhausting and discouraging to spend a year dealing with side effects and meds that don't help, but it's worth it.

Using alcohol to cope is common, a big red flag, and is not actually helping even though it feels like it is. Even if you aren't ready to quit drinking to cope, I strongly suggest that you try to get comfortable with the idea that you will need to quit eventually. It took me a long time to quit problematic drinking, but it helped a lot when I did.
posted by Mavri at 10:40 AM on September 2, 2018 [2 favorites]


Depression is God’s great joke on mankind. It is the only disease that makes you feel like you deserve to have it.

I mention this in hopes it might help with the freaking out portion of things. Having severe doubts is often a reasonable thing driven by personality and experience; Freaking out is driven by something more visceral and that something may not have your best interests at heart.

I’ve had a successful journey through therapy for suicidal depression. One of the first things I did was learn to deal with freak outs through regular meditation. That took a long time on its own, and despite my therapist periodically suggesting medication it was still two and a half years before I was willing to experiment with it for depression.

My therapist also periodically suggested group therapy, which he knew I was categorically against. Since I was no longer freaked out about it being suggested I was able to say "Nope, not ready for it" and move on.

From what you’ve said it sounds like you are worse off than I was, and I’m not going to second guess a therapist about what you may need. What I will say is that taming your anxiety is possible, and doing so will allow you to simply say "No, thank you" when uncomftable options are offered.
posted by Tell Me No Lies at 10:43 AM on September 2, 2018


Please quit drinking, it contributes to your depression.
posted by ClarissaWAM at 11:44 AM on September 2, 2018


You want things to change. So here's something true: in order for things to change, things have to change. You are looking for a mindset, an experience of daily life, that feels completely different. And to get there, you will have to experience difference! I wonder if you can frame the *change* and *difference* as positives. They are likely constructive. At minimum, if things are different and strange, at least that's some practice in being okay with difference -- regardless of whether those changes are the ones that eventually take you where you want to be.

I think you want to be in a place where you can trust the person who's guiding you enough that you will actually follow them. Some of this--the brainy stuff--is an area where your expertise and knowledge of the world can't guide you. So trust the guide who has trained to help you. Consider what it would take for you to be able to trust a therapist -- you can't rely on your sense of comfort or rightness, in some areas, because that sense is being affected by the mental illness. So think about what it will take for you. Maybe you want to see evidence, testimonials, that the therapist has helped people like you. Maybe you have to know you aren't attracted to them. Maybe you need an assurance of some kind. But once you get that, it's the time to trust and follow, and your inner dialogue can change from "Should I trust them?" to "Since I trust them..." This is actually something you could work with your therapist on.

Perhaps managing your brain/emotions is like a set of tools in a toolbox. You don't know how to use these tools right now. So your therapist is guiding your hands. Later you'll know how to use them, but for now, you do need that support. Let them put your hands over yours and guide where they go with those tools. Aim to become gradually more open to the suggestions of people who are accustomed to the tools and whose job is to train people to use them.

Personally, I did have an experience with a therapist where I thought their advice was ridiculous and unnecessary and it was frustrating and I didn't like it. After several months (repeated for emphasis - MONTHS) I began to see that positive things were happening. After even more months I was able to look back with a little perspective and understand what that therapist was seeing. Now, years later, I can exercise the same logic and care for myself without having to go in. Fortunately, the thing they asked of me was minor enough that I did it even though I was grumpy. I'm so glad I did. I trusted in part because the therapist was trained in the right areas for me, and also because I was desperate for a change.

Remember it's not a moral failing if you don't keep working with someone; I'd see it as a success of discernment. You (or they) figured out it's not the right fit now. Great--now you're freed up to move to something better.

Responding specifically to your points:

Medication - I can't speak to medicine. I will say that it's your life and your recovery. If there's something that slows your recovery down, you're basically prioritizing that over your recovery. You get to choose when/what takes priority in different seasons of your life. Things you may choose to minimize now (like drinking) could come back later in your life, in a different form. Here, too, I'd just encourage you to be open to moving forward into a different way of being, just to try it.

Higher level of care - I would personally want "This freaks me out" to lead not to the end of the conversation, but to the start of the conversation about why it freaks me out and how to get closer to at least not having my decision be emotionally-motivated. I would also want to trust professionals to know what is going to be helpful for me.

Former therapist - If your current therapist is competent, I think they would be able to sort through things like your past therapy, and take out what's going to be helpful for you now. I would trust them to do what they think is needed. I would allow the contact.
posted by ramenopres at 3:27 PM on September 2, 2018 [2 favorites]


Thank you everyone. I really think I'm in a world of trouble...so all these answers, different opinions, and perspectives really do help. I do think I'm willing to change as evidenced by some of the progress made in therapy, but I've definitely created barriers in some of the more important areas to recovery.
posted by signondiego at 12:53 AM on September 3, 2018 [3 favorites]


Sexual side effects:

talk to your Dr about Brintellix (Vortioxetine), which has a very low chance of sexual side effects compared to other anti-depressants,

and Bupropion/Wellbutrin/Zyban, an anti-depressant which often actively BOOSTS peoples libido, and which is often used to counteract the sexual side effects of other anti-depressants.
posted by Murderbot at 10:17 AM on September 3, 2018


You're doing great. I think you are so brave and it's clear you're showing up for yourself in the best way you can.

One thing I want to add -- you can ask your therapist about timelines, like, how long would this typically take until [x] result? What do you anticipate in my case if I do [y] and [z] and follow plan [a]? "What are reasonable expectations for me to have of this process?" "What might happen -- before things get better, will they feel worse, and how does that typically go?"

They probably can't tell you for sure but they might be able to give you some idea, broadly speaking, of what your expectations could be. Like, not earlier then month, but not later than three years. Or like, there can't be expectations because that's just not how it works. When I feel uncertain it can help to get a sense of what may happen and when to expect a course shift and how much "Whaaaat is going on?!" to anticipate. This also puts you and therapist together, more as a team -- Team You -- which is working for your wellbeing.
posted by ramenopres at 3:53 PM on September 3, 2018 [1 favorite]


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