I think I have depression
May 26, 2020 7:21 AM   Subscribe

Can I self treat mild depression?

I’ve always suspected I might have mild depression but it seems to have only worsen through lockdown due to Covid-19. I meet all the symptoms but I don’t think I am in danger since I can still function through the day. I just feel numb and empty towards life and everything, even towards my fiancé which worries me alittle, I cry almost every day for no reason...I have a good life, I have random thoughts about how not existing would be easier but I could never ever commit suicide, I would never hurt myself or cause pain to loved ones. Still, the thoughts just pop in my head. I smile and talk to everyone as normal but inside I don’t feel happy, I feel like something is off. The sun shines but it doesn’t feel the same or feel good if it makes sense.

No one knows I feel this way. I want to try to get help but it’s so expensive it’s crazy. I was thinking maybe I can meditate, go outside and exercise, to feel better. It helps alittle but not quite.
posted by Asian_Hunnie to Human Relations (32 answers total) 16 users marked this as a favorite
Best answer: Do you mind sharing your location? It might help - especially if you're interested in hearing about options for lower-cost help.
posted by bunderful at 7:33 AM on May 26, 2020

Part of treating depression is learning skills to self-treat, it's not 100% "take this pill, you'll be fine", so it's entirely possible to self-treat a certain amount of depression.

However, feeling numb and empty towards someone you love? Crying without reason on a very frequent basis? That doesn't sound like 'mild', that sounds pretty significant, and you should really look for assistance in treatment. They may not jump right to medication either, but they certainly get you towards the right path.

I don't see where you're located, but mental health is frequently a service offered by public health systems. You likely can find somebody with a sliding scale that isn't as expensive as the more 'boutique' mental health professionals.
posted by AzraelBrown at 7:33 AM on May 26, 2020 [12 favorites]

Yes, you can self-treat, but the first step is building up a support network. That means letting the people who love you know what is going on. It means being vulnerable and open, which can be scary, but it is the depression telling you to keep this a secret.

With the help of your support network (and to be clear, you need a LOT of people - telling just one or two people isn't fair to them as you will be leaning on everyone significantly), establish a routine for yourself that includes good sleep hygiene, healthy eating, exercise, and set goals. Ask your support network to help you find low-cost professional help - there is a lot of tele-counselling so you may find an excellent therapist outside of your physical location.

And I agree this is not mild depression from how you are describing it - it sounds quite severe to me and probably crept up on you incrementally. It is wonderful that you are reaching out for help and you are worth getting better.
posted by saucysault at 7:43 AM on May 26, 2020 [3 favorites]

Response by poster: I’m in Ohio. I have insurance, but when I searched therapists it was like $300-400 a session in network....
posted by Asian_Hunnie at 7:43 AM on May 26, 2020

You’re on the right track with what you’re doing, although you don’t mention diet which is also important.

A few friends have found the Complete Idiots Guide To Managing Moods a helpful resource on this topic. It also has a few tests for self diagnosing depression, which might help you calibrate your sense of where you are on the depression scale.

If your attempts to treat it yourself continue to not work out, some short term (remote) therapy is probably in order.
posted by Tell Me No Lies at 7:44 AM on May 26, 2020

I’m in Ohio. I have insurance, but when I searched therapists it was like $300-400 a session in network....

Whoa. I’m not in Ohio but those prices sound way off.
posted by Tell Me No Lies at 7:47 AM on May 26, 2020 [19 favorites]

A lot of the things therapists will help you with when you're depressed are figuring out habits and routines that will help support you.

This is harder than it sounds, so cut yourself some slack when you try it and it's hard. The advice might be "meditate," and that might sound trivially easy, but if you're not doing it already, there are probably things getting in your way — maybe the depression itself, maybe bad associations ("I took a meditation class years ago and they were assholes") or misconceptions ("Meditating should always feel calm, so if I don't feel calm right away I'm doing it wrong"), or maybe shitty things you're telling yourself ("I don't deserve to meditate, because it feels good and I don't deserve to feel good").

So if you're working on self-treatment, be prepared to spend a lot of time debugging the treatment. You'll try to meditate, and you'll find yourself struggling to make yourself do it, and then you'll need to think calmly about the stuff that's getting in your way and how to fix it. Sometimes that's insultingly simple (maybe you need to bake yourself cookies and reward yourself with a cookie when you're done meditating) and sometimes it's intensely complicated (maybe you need to rethink your whole relationship with religious practice) but either way you can get through it on your own or with help from friends you trust.

Another thing therapists do when you're depressed is help you not beat yourself up when the debugging is frustrating you or going poorly. That's a big challenge, because depression really makes you want to beat yourself up. But it's a thing you can work on on your own too, or with friends you trust.

Some habits and routines to work on, debug, and try not to beat yourself up over:
  • Getting exercise and getting outside
  • Eating regularly and sleeping regularly
  • Bathing and getting dressed and making your body look and feel good (especially hard right now)
  • Finding ways to interact with other people even when you feel like shit
  • Opening up to other people about what you're going through
  • Keeping a routine even when you don't want to (this one takes a lot of debugging in my experience, and also a lot of telling-yourself-you're-not-a-bad-person-for-struggling, but it pays off if you can manage it)
  • Being nonjudgmental with yourself (this is a thing that some kinds of meditation are good for)
  • Getting back on track when you go off the rails with any of these habits

posted by nebulawindphone at 7:47 AM on May 26, 2020 [25 favorites]

Other people do experience what you are, you are not alone in this.

It sounds as though you will benefit from some counseling. If you are in the US these people can help you find a counselor.

There are also some things you can do that will help: daily exercise, preferably outdoors; enough sleep; good food.

You're doing the absolute right thing by reaching out. Keep doing that. Don't give up, it gets better, trust me- and all the other people responding here-, I've been where you are now and many of the other responders have too.
posted by mareli at 7:48 AM on May 26, 2020 [2 favorites]

Re cost: Check your insurance benefits. Most insurers now cover, at least partially, telephone and video counseling sessions with providers like MD Live and Doctor on Demand. (Our insurance covers those sessions 100%.)
posted by davcoo at 8:09 AM on May 26, 2020

have insurance, but when I searched therapists it was like $300-400 a session in network

This also sounds too high to me - I live in the riotously expensive New York City, and I've paid less than that for therapists who don't take insurance (few of them do around here). As a practical matter, I'd double-check that you aren't looking at psychiatrists, who can be significantly more expensive, but whom you typically see less often.

But more generally, I just want to let you know that you're going through something I've gone through, as well as many other people I know. Everyone knows that the American health insurance system sucks and presents a logistical barrier to care. In my experience (I have anxiety, not depression) that barrier is greatly exacerbated when it comes to securing mental health care. Your brain is already throwing up a bunch of hurdles to stop you from getting the help you need, so it's not surprising if you (and me, and others) crash into the process of securing initial mental health care. And that super sucks. Do you have someone, possibly your fiance, who can help you navigate these first steps? I've found that once you're actually sitting in front of (or, these days, on a video call with) a therapist, things have enough forward momentum that you can take it from there, but some assistance getting to that point can be very helpful.
posted by Ragged Richard at 8:12 AM on May 26, 2020 [3 favorites]

Response by poster: I called the number you guys gave me Nd they just provided me a list of mental health facilities with one of them being a place I worked at before which traumatized me and had bullying behavior several years ago lol.

I think I will start with a family doctor appointment. I’m not sure if I want to see a mental health specialist straight away. I’ll at least check the insurance on the list of locations they gave me.
posted by Asian_Hunnie at 8:18 AM on May 26, 2020 [2 favorites]

Just as an anecdote, I was able to do an e-visit with a local general practice doctor I’d only seen once before and explained I was having a really hard time with the whole lockdown thing and was not very OK at a time when I needed to be OK (I have small kids) and I got a prescription for an antidepressant no questions asked. It was only for 60 days at which point she asked me to check back in with her on how I was doing, and she offered to refer me to telecounseling as well if I wanted it. I think a family physician should be able to help you and would be a great starting point.
posted by castlebravo at 8:28 AM on May 26, 2020 [3 favorites]

If you’re in Columbus, I can recommend some therapists.
posted by kevinbelt at 8:30 AM on May 26, 2020

Response by poster: So I looked up my insurance again and I guess it’s like $400 for 5 follow up visits, meets agárrate $100.
posted by Asian_Hunnie at 8:32 AM on May 26, 2020

Response by poster: @kevinbelt, yes please do. Thank you.
posted by Asian_Hunnie at 8:32 AM on May 26, 2020

The MeFi Wiki ThereIsHelp page has a section for Help with Finding a Therapist and Depression, which both include links to previous AskMes and links to additional resources. In addition, the MeFi Wiki Disaster Planning & Recovery page includes a section related to Mental Health that includes previous AskMes and resources specific to the current pandemic.
posted by katra at 8:34 AM on May 26, 2020 [3 favorites]

Having seen your updates, starting with your primary care doc is a great idea. Sometimes it takes a few different starts to find the right therapist or the right treatment, so just hang in there if you hit some road blocks.

I'd suggest calling your insurance to ask about how your mental health coverage works. $300-$400 per session is more than I would expect to pay out-of-pocket with no insurance at all.

Here are a few other tools/options. There are several more out there:
* Doctor On Demand offers a free mental health assessment.
* 7 cups - offers self-help guides, free volunteer support and low-cost therapy
* Better Help - lower-cost virtual therapy

Thank you for being self-aware and reaching out. Please be nice to yourself.
posted by bunderful at 8:36 AM on May 26, 2020 [3 favorites]

Entry-level CBT-style exercises can be pretty helpful and can be done self-guided. The Anxiety, Worry, and Depression Workbook is a good CBT 101 type system. Unfuck Your Brain is a newer release that is pretty popular, and if you are a person who is interested/helped by knowing the science behind this stuff, is informative for that.

It can take a while to get onto a therapist's schedule, and workbooks are a good way to prep in advance of that, and have something to point to when you do get started to be able to say "I'm realizing my issues are X,Y,Z" as a place to start working from.

Do - once you're able to safely do so - see a GP or GYN for a physical with bloodwork. All the therapy in the world won't be as effective for depression related to thyroid dysfunction, vitamin deficiency, endocrinological problems, autoimmune disorders etc.
posted by Lyn Never at 8:44 AM on May 26, 2020 [2 favorites]

Try Simon Woliver first. If he’s not accepting new patients or just not a good fit, let me know and I can recommend others, but he’d be my first call.
posted by kevinbelt at 8:51 AM on May 26, 2020

I've been using this virtual service for a number of years and have found it very cost-effective and time-efficient. I've had the same great therapist, an MSW, since I started.

I do a check-in once per week for $150 per month but there are plans for more intensive interactions. You can use the app to exchange voice messages, as I do, or you can record videos. You can also do video chats in real time. Even once per week might be a useful support for your own self-treatment efforts.
posted by rpfields at 8:53 AM on May 26, 2020

My phd level specialized therapist treats non insurance at 200 a session in Chicago which is on the expensive end for a psychologist in the area.

Many LCSW charge up to about 150, usually a tad lower. My previous PsyD charged 160. Without insurance in the US it's not hard to find sliding scale therapists in the 25 to 50 per session range (free is harder but not unheard of) with insurance is expect your out of pocket cost to be somewhere between 25 and 50 per session, likely closer to the 25 dollar range. Many insurances have waived copays, mine is not one of them.

Your PCP can likely perscribe an antidepressant. Mine recently did for me and mentioned she was doing that alot these days. She may have some referrals to local therapists as well.

Take this one step at a time. There is help. You can find it .
posted by AlexiaSky at 9:02 AM on May 26, 2020

Response by poster: I thanks for all the resources everyone. I’ll be searching.
posted by Asian_Hunnie at 9:56 AM on May 26, 2020 [2 favorites]

Your employer might have an Employee Assistance Program(EAP), in PlagueTime, they should. You can usually get @ 10 phone or in-person(virtual?) sessions. Check the HR web pages. Ordinarily, I wouldn't let HR know I might be depressed, but needing help in CovidTime should be no big deal. Your insurance company should have a contact line you can call to help you find a therapist. Good work recognizing the possibility of depression and looking for a way to address it.

Advice about depression, and some resources:
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.
posted by theora55 at 10:04 AM on May 26, 2020 [6 favorites]

Until you find a great therapist, which is definitely the best idea, there are also some good apps out there for depression. Pacifica and Moodpath are both pretty good.
posted by namesarehard at 10:50 AM on May 26, 2020

If you’re employed or have access to an Employee Assistance Program, many of them offer some number of visits with a social worker for free - ours is 10
visits per year per issue. Maybe check that option along with the great ideas above?

Jinx, didn’t see namesarehard’s comment!
posted by OneSmartMonkey at 11:05 AM on May 26, 2020 [1 favorite]

I think a lot of people are experiencing surges of depression, anxiety, dread, and doubt during lockdown -- it is not easy on people's mental health. I think the first step would be is to see if you can access any sort of insurance benefit with your work, if any?

I think the first step is to make sure you have a solid routine - especially during lockdown. It definitely does keep one motivated being inside all the time. Are you getting enough sunlight? Lack of sunlight can contribute to depression and anxiety for some people. Have you called your Doctor or Nurse to set up an appointment? It may be a stepping stone.

Are you able to incorporate a lot of healthy fats and fruits and veggies into your diet? I find eating a lot of avocados, walnuts, nuts, berries, and some chocolate does bolster my mood to some degree (as well as a lot of good protein and good fats overall).

Walking can also help as well -- especially when it is sunny outside (definitely near a lake which can be calming as well).

Is there anything in your life that may be contributing your depression outside of lockdown? Family conflict? Work conflict? Do you feel fulfilled and satisfied? Sometimes seeking fulfillment - whatever that may be, hobbies, spirituality, and spending time with friends and family can help. I think travelling can also help to some degree, albeit, some would call it a distraction. Yet, I find it helpful during stressful times.
posted by RearWindow at 11:58 AM on May 26, 2020

Response by poster: We have EAP, I will try calling it also. Lockdown has impacted me but there were always things there like me not being completely satisfied with my job so I’ve been job searching a while. traveling and seeing family would be difficult because of covid.
posted by Asian_Hunnie at 1:11 PM on May 26, 2020

In addition to prescribing antidepressants, your PCP might also be able to recommend a counselor/psychologist/LCSW. It never hurts to ask, anyway.

This might be helpful if finding a mental health provider on your own feels overwhelming.
posted by Ndwright at 3:40 PM on May 26, 2020

I tried Talk Space for 4 weeks last year. It didn't work out for me because the first few therapists I chose weren't great fits. Right at the end I found one I liked a lot but I didn't renew because I had decided to go back to just taking an anti-depressant (I'd gone off it for about 1.5 years). Talk Space might work for you if can connect with someone who is a good fit for you. If you go the medication route, try K Health. I pay $29 per month for a text chat with a doctor once per month to evaluate how I am and then, because I'm still not magically okay, they approve my prescription refill (included in the fee) and have it shipped to me.
posted by rubberduh at 4:03 PM on May 26, 2020 [1 favorite]

Response by poster: Thanks, I will check into TalkSpace. It’s easier for me to open up if it isn’t face to face..
posted by Asian_Hunnie at 6:16 AM on May 27, 2020

Have these symptoms developed after starting or changing hormonal contraceptives? I ask because I had very similar depression symptoms, which started shortly after I went on the combined oral contraceptive, and which resolved pretty quickly after I stopped taking the pill (it took a while to figure out what was causing the depression, but a friend saw how I was and told me that some people respond this way to hormone treatments). It's worth considering, anyway.
posted by altolinguistic at 11:56 AM on May 27, 2020

Response by poster: I think it started during covid mainly. Now that my fiancé has been trying to get me out the house often I have been feeling a lot better. He’s been showing me much more comfort without me saying anything, maybe I didn’t have to and he saw it. I was going to tell him about my emotions and what I’m going through but then he just dropped it on me that his sister called him and it sounds like she is having a mental breakdown With the urge to kill herself. So I didn’t say anything since my depression is no where near as bad as hers but I let him know I understood how she feels and that she needs help too.
posted by Asian_Hunnie at 6:47 AM on May 31, 2020 [1 favorite]

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