Posted by katekite on May 1, 2002, at 14:31:09
In reply to Help... my problems or pdocs, posted by amber_spirit on April 30, 2002, at 16:57:01
Hang in there!
One of the wicked cruel things about depression is the inability to see other people are being nice.... to me, when I'm depressed, they seem like they are just sitting there not caring. That they probably have more important things going on and that they don't understand that I feel as bad as I do. The low self esteem is saying 'why would they care?'. The expressions on their faces seem contrived, almost, but all of that is just (just, hah, its a huge deal) because the interpretation of emotional expression is all screwed up by depression chemistry.
Your considering dumping your therapist and pdoc is most likely a part of depression. If you were gaining trust for them and were at a level of trust a month ago that was good in comparison to when you started then trust that. Unless something big and horrible has actually happened in the office (such as them forgetting show up, or them telling some secret of yours to the papers) then it is most likely the depression doing your feeling for you.
Print out your post and take it in and talk about it.
The fact that they are specifically making sure you promise to be back for your next session shows they are worried about you. Worry = caring. They do care.
If you think they are not aware of quite how depressed you are, that you are having close to intolerable suicidal feelings, then its your job to tell them. One thing that has happened with me in the past is that the morning of a therapy appontment I get up and get going and feel a little better because I have somewhere to go that I think might be helpful, and I try to be proud of myself just for going, and then I get there and have some trouble describing how bad the rest of the previous week was. When I walk out there is a bit of a let down that I don't see them for another week, that I didn't say something, that somehow its over before I started. If that happened in the past, make sure to remind yourself before you go in everytime that it might be a down day afterwards.
The decision over whether a therapist is a good one, only adds to worrying and depression, the 'why bother to go' thoughts.
A rational, logical thing to do would be to set a time limit for getting better with this therapist. Starting now, since you've just barely gotten to trust level. Its individual, but some people say that once you feel comfortable with a therapist you should hope to see some improvement in 4 months, if you are seeing them weekly.
As far as pdocs, that is a little different. All pdocs can make severe depression better because some drug will eventually work. I would stick with them, at least for 3-4 months if you continue to be really depressed, unless they are openly mean or dismissive of how you feel or side effects you are having or can't answer your questions reasonably. Then you would want to get a second opinion, and that is never wrong.
The time to switch pdocs because it isn't working is when they have helped some but can't get any further. Like you are left with a mild depression that won't go away after some months. Right now, the fact that they know you pretty well is probably more important than that this particular drug combo isn't working out so far.
Don't change pdocs at the same time as changing therapists, leave at least 6 months inbetween if you can.
It's normal to be pissed off about medications when they aren't working yet. Try not to generalize to all medications. Its so hard to wait. Every day going to bed wondering if tomorrow will be better or if maybe by some lucky chance a tornado will strike and get you in your sleep to make it stop. This is normal thinking for being depressed but its not really 'normal'.
Suicidal thoughts go against every self-survival mechanism we have as humans. It feels logical, but its not really. Just because other people in history have killed themselves doesn't make it logical, ever. Avoid making any big decisions right now. Wait until at least you don't feel belligerant.
You won't always feel this way. No one ever has who has experienced feeling ok in the past. There are scary stories of people who go through every drug and end up in some institution or with shock therapy, but that's something like 0.001 per cent. If you think its unlikely you'll win the lottery today then you're less likely to end up like that. You're more likely to die first in a car wreck (and don't even think to smile about that possiblity). There is a medication out there that will help, and if not, major depressions tend to last 6 months entirely untreated and then they go away. (which is something that gets in the way of drug trials all the time). Time feels like forever but its absolutely worth it (saying this having spent totals of years of my life really depressed) to wait it out.
Hope today was better than yesterday. Sorry this is so long.
kate
poster:katekite
thread:22925
URL: http://www.dr-bob.org/babble/social/20020430/msgs/22956.html