When I was first treated, a part of me hated the new, not depressed person I was becoming. I was becoming what I felt was selfish and I hated that I was able to think good things about myself. How silly is that?
If there’s nothing else left to try, and nothing left to lose, then why the hey not?
Better than suicide, even if it is a form of suicide in the end…
[Living proof]
The priesthood of psychiatric therapy has revealed to us the Way and the Light to Eternal Happiness (CBT being one of the popular theologies of the latest Revelation). Their Revelations are entirely unfalsifiable, of course, and are deigned to be Holy Scripture. It is forbidden to blaspheme them, that being a heresy of which the only result can be Excommunication from one’s community. Yes, even on SDMB. One quickly learns to keep one’s blasphemies to oneself.
Would you care to share with the group what the hell you’re talking about?
It sounds like most people were aware for some time that something was wrong but for various justifiable reasons did not seek or even realize they needed to seek/ask for help. If someone you love/respect/trust had come to you and extended an offer of help, would you have been likely to accept it? If not, what is the biggest hurdle to you in seeking out or accepting help?
“Wish I was ocean size
They cannot move you
No one tries
No one pulls you
Out from your hole
Like a tooth aching a jawbone…”
In other words, the offer of help = an opinion that you are a burden and need to be fixed. Why else would someone want to help you if you weren’t putting them out? For me at least, it’s really hard to believe someone would want to help ME (because I know I’m worthless and a general drag to have around) so I could be better off–it must be because I’d be more useful to them if I functioned better. So I’d spare them thre trouble, withdraw further, and stay out of their life as much as possible (and listen to more rock n roll)
All alone, or in two’s,
The ones who really love you walk up and down outside the wall.
Some hand in hand, and some gathered together in bands.
The bleeding hearts and artists make their stand.
And when they’ve given you their all, some stagger and fall,
after all it’s not easy banging your heart against some mad bugger’s wall.
Shame, embarassment - I’m afraid to admit to, face up to and deal with how flawed I am.
The feeling that so many people have it worse than I do so what gives me the right to seek help and use a resource that could go towards someone who needs it more.
The stigma associated with depression (“mental illness”.)
This:
Wow. So true.
Say what you like, but CBT worked for me, and continues to do so. It really isn’t some sort of mystical, metaphysical mumbo-jumbo like a lot of people believe.
If anything, it’s almost the opposite of what people think of as “therapy”, in that it’s not ultimately about evaluating your feelings and emotions, as it is becoming aware of your inner monologue (for lack of a better term), and realizing that how you think about a particular thing, and even your internal word choices matter in terms of how you perceive the world. In computer terms, it’s like a patch or new release of your OS.
Now if you have some kind of physiological issue that’s causing or exacerbating your depression, then CBT is going to be of limited help- that physical issue is going to make you think and feel in ways that are out of your control. In computer terms, no amount of patching is going to remedy a hardware issue.
But if you don’t have any physiological issues, CBT can be very powerful, without necessarily being personality-changing. That’s not to say that it isn’t or can’t be personality changing; it most definitely can if your personality is more or less defined by your insecurities and your incorrect perceptions of the world. For my part, I’ve noticed that where I used to be more ambitious, I’m not that way anymore, and it’s because I’ve quit trying to compare myself to my peers, and when I do, that it’s not quite a fair comparison; some of my friends are extremely successful, and just because I may not be a national authority on anything, or CEO of my own company, it doesn’t make me unsuccessful. Overall, a much healthier way to view myself and my place in the world, than to bust my ass to meet some impossible and unrealistic standard that I was holding myself to.
The real beauty is that YOU control CBT, since it’s something you have to do to yourself- you have to become aware of what you’re thinking AS you’re thinking it, and stop, and rethink what you’re saying. It sounds a little odd but it can be done, and it does work. I personally think a lot of depressed people wind more than a little bit of their identity up in being depressed and miserable, and something like CBT represents a threat to that identity, and if they were to take up CBT seriously, they’d lose that part of their identity. Kind of stupid really, but depression isn’t a rational thing.
Okay. That’s a pretty bleak picture you’ve all painted.
Let me ask the question in a different way…
IF you were to seek/ask for help, how would you have done so? Better yet, what approach would stand the best chance of making you least resistant to the offer or opportunity for change and improvement of quality of life?
Another therapy failure. I’m sure it works for some people - I’ve had a dozen therapists over 40 years and have spent - not kidding - thousands of hours in therapy…and I’ve come to terms with “I have a chemical imbalance.”
Medication, knowing your own emotional state, avoiding things that will trigger you down some dark path (for me, world atrocities can set me off, so I don’t know what’s going on in refugee camps in Yeman, and financial anxiety in my own life is huge - with money I’m like a squirrel hording nuts, but it helps with the anxiety), meditation, exercise, positive thinking (as much as possible) and good avenues of escape (tv, books, internet, friends, sports, whatever you do to escape).
If you need help identifying your emotional state or figuring out your triggers and how to deal with them - therapy would be awesome. I know mine - and can quickly identify new ones if they change.
I know you’re thinking about your son with all this. But the thing is, a teenager who is depressed is different than an adult who is depressed. If I had been depressed as a teenager the same way that I was a few years ago, it would have been a lot worse. Because at least as an adult, I can make my own choices. I have the power to shape my environment to cater to my mental health. A teenager doesn’t have that ability. An adult is allowed to make executive decisions without consulting anyone or asking for permission. A teenager is kind of at the whims of whomever is paying the bills.
I wasn’t resistent at all about getting help. But I probably would have been if I were a teenager who is still living at home. I can see my 15-year-old self imagining a therapist as someone who is just a more clinical version of my parents. No thanks.
The big question is whether or not the depression is a physiological thing or not. If it’s physiological, it’s literally some kind of chemical imbalance type thing that no amount of therapy is going to fix. I have a very close friend who’s like that- years of therapy, etc… and the thing that works for him is one of Wellbutrin/Zoloft/Paxil/Prozac (can’t recall which one he takes now). But it’s night and day from his depressed self.
If it’s not a physiological thing, then therapy might work. It did for me.
In my experience (I’m neither a psychologist nor a doctor of any sort), it seems like the more chronically depressed people seem to have more physiological issues- they’re unhappy for no reason, or for irrational ones. They’re the ones who people might say “What do you have to be depressed about?” to. The buddy I mentioned earlier had his first real bout with chronic depression while we were roommates in college- he had nearly a 4.0, a girlfriend who he was sleeping with, a good group of friends, fairly secure finances (neither parent was broke), was thin and in good shape… yet he was seriously, suicidally depressed. By contrast, I was still a virgin at 23, had a 2.5, the same group of friends, much more precarious finances (each semester was a cliffhanger if my parents were going to be able to pay, or if I was going to have to get a loan), and to top it off I was overweight. I was having the time of my life. Like I was saying, it’s not at all a rational thing, especially when chemical imbalances and the like are in play.
The non-physiological ones are depressed for reasons that are somewhat more rational- life has gone to shit, deaths, etc… but that doesn’t make it any less or more intense or real to either category.
Ultimately my wife forced me to seek help; one of the hallmarks of depression is a sort of apathy/lack of motivation, so the person may need an outside prod to get rolling, or at least diagnosed.
You’re excluding a whole swath of people who are a mix of both. Maybe a person’s depression started off as a physiological thing, but living in a depressed state for years has now created a situation where their lives genuinely ARE shitty (poor grades, low income, physical health problems, bad relationships, etc.) The thoughts that were once irrational (“I’m a loser”, “No one likes me”, “I’m hopeless”, “My life sucks”) now actually are based on reality.
A pill alone isn’t going to be enough to turn those thoughts around. A pill isn’t enough to teach someone the skills they failed to learn while they were depressed. Like, the OP’s son. If he’s spent the last few years being low-achieving, he’s likely got a lot of maladaptive behaviors to shake off and self-defeating thoughts to change (like, “It’s too late for me to fix the mess I’ve made of my life.”)
I am convinced that my depression was organic. But meds were not sufficient to “fix” me. Plus, the meds created other problems, so I wasn’t compliant. I was compliant with therapy, though. It doesn’t have to be either/or.
The body-mind dichotomy is a false one, IMHO. The mind is just as much the body as your arm or your kidney. You can totally jigger with the “biochemicals” by changing behavior and cognition.
I’m having trouble figuring out if I’m a high functioning depressive or a low functioning non-depressive. I’ve been vacillating over it since around 1983. Which, ironically, is about the first time I heard the word vacillate used in a sentence.
This.
(bolding mine)
And also this.
Looking back over the behaviour patterns of the past four years (especially), evidence suggests that it could be one or the other, or some of both for my son.
If I’m honest, there seems to be better evidence for “low functioning non-depressive”, but I’m in no position to diagnose and probably way to emotionally invested to view this entirely objectively. He repeatedly shows the ability for success but far too often than not chooses failure. And yes, it very much feels like a choice he’s making from my vantage point. But I just don’t know if that’s a fair characterization and it frustrates the hell out of me because I vacilate about which is more likely - depression or pathological inertia that is the major cause.
I was diagnosed with “situational depression.” To quote the shrink I saw: I don’t understand why you can’t be happy on disability. Okay, you’re a Ph.D. in psychology and you don’t understand the basic human need to feel useful in your life? I told everybody I just needed a job to make me feel okay. The “professionals” told me to stay in the same situation and take drugs (excuse me, medication) to feel better!!!
Odd that, since getting a job, I’ve been fine.
I got through high school. I got through college/university. I survived the dreadful interim. I got through graduate school. I’m still alive today. I suppose that’s High-Functioning Depression.
Until just a few months ago, I thought I was dealing with a return of the dysthymia that had plagued me off and on for many years. Actually, a psychiatrist recently diagnosed me with major depressive disorder, saying that I “checked all the boxes.” This was a surprise to me, I had always been able to get out of bed, and the like, and I’ve been much more depressed in the past.
I don’t know when it started. I was always a strange child. It fully crept in during my teens (though did not begin then), and by the beginning of high school I had very poor self-esteem (to put it mildly), and it manifested itself in ways that were insidiously subtle. I was smart enough to “act out” in ways that didn’t get me in any trouble, they just got me labelled as weird. Some of my grades suffered, and I had a hard time keeping up socially with my peers, although I still had friends.
I tried to repress my heterosexuality, partly because I just wanted to be different, but to a large degree because I was terrified of being teased by my parents. Finally, I had to face facts, but, since depressed people want to hurt themselves, I developed fixations on girls I didn’t even like. One in particular lasted from the end of ninth grade until partway through eleventh grade. I really embarrassed myself, and worst of all, this would happen again!
Things just got worse over the next few years, exacerbated by lack of sleep and stress. I didn’t want to go to college. I never had a date until graduation neared. Many of the conversations I had with peers via AIM and the phone during those years would have seriously alarmed my parents, had they known, not to mention mental health professionals. I tried to conceal most of this from my parents, except for one weak moment where I babbled to them about how I was thinking about death, including my own. They asked me if I needed help, and I declined. I think I said something about how there was just one thing that would make me happy (that damn girl!!?!?!) and it never came up again.
A year later, around Thanksgiving of my Senior year, I had nearly given up. I was thinking long and hard about jumping in front of the freight train that traveled behind my house, when a fellow marching band member lost the battle with cancer she’d been fighting since the summer. Her wake and funeral knocked me flat, considering my vulnerable state. She was a really wonderful, special person, and seeing the impression she made on so many people, just by being herself, changed my life, and might have saved it.
Of course, I got depressed again in college. I saw a psychiatrist once, who decided within fifteen minutes that I needed antidepressants. I never went back. I started seeing therapists the following year. They helped me get through those years, but it was a nightmare. I spent some time in the closet with a noose around my neck, thinking. By the end, I was poorly nourished, having a hard time communicating, doing and saying all kinds of bizarre things. I wasn’t on drugs, but I was strung out.
After college, I had no idea how to get a job that paid a living wage. My parents probably thought I did know, and just needed to “find myself” or whatever. I spent the next several years working in a bookstore, living at home, going to lots of movies and concerts alone, not eating or socializing much, reading a lot on the Internet at night, sometimes going to therapy, and watching my mental and physical health decline. One therapist prescribed Zoloft, but I didn’t fill the prescription. She was incompetent anyway. As years went by and things got unpleasant for my family, I began to consider killing myself, and researched insurance policies to see if my parents could still collect on me.
Instead, I went to graduate school, far away. It changed my world for the better, even though it was very difficult for me to try and learn how to function on my own, and once again with a peer group. As much progress as I made, I rue all the potential relationships that never happened due to my learning the hard way how to be less weird. I started going to therapy again during this time, stopping only once I was no longer a student.
After graduation, even though I was unable to get anywhere on my career path, I felt I had gotten over my depression. Eventually, however, I had a period in which I was fearing bankruptcy, eviction, and homelessness, and was considering suicide if all of those things came to pass. I found a better “day job,” making me feel much better, but, with new insurance, I went back into therapy anyway. I was on amitriptyline for about two years, which just didn’t do the job.
That brings me to the present. I have a new therapist, a psychiatrist as well, a new diagnosis, and a new prescription (Zoloft, which isn’t working either.) I’m 33, despite my Master’s degree I work in an antique store, I’ve never had a girlfriend (although I’ve very occasionally been involved with women, and I’m not a virgin), my room is a mess, I don’t have many friends, there are very few things I like to do, and I have suicidal ideations every day (I’m trying to understand that this isn’t normal, but it’s been my normal for a very long time.) Amazingly, I have actually succeeded (for now) in my dream of forming a band, recording songs and playing concerts, but it really ought to make me happier.
High-functioning?
To all how have contributed so far or are following along, how much of your individual experiences with depression or dysthymia can be characterized as follows?:
"I realize I’m required to jump through these hoops and rise to these imposed expectations but to be honest I think all this is a circus and and I simply refuse to deal with all this bullshit and want to be left alone to live my life on my own terms and pick and choose the things I will or will not do. "
I wouldn’t say that summarizes the source of my angst (if you could call dysthymia “angst”). It was more like, “I don’t belong in this species, on this planet, in this galaxy. I will never belong here, no matter how much I try. Everyone knows that I don’t belong here, and it’s just a matter of time before they stop humoring me and let me know how much I suck. But I can’t stop pretending I belong. As exhausting as it is to be fake, I can never let anyone know how I really am. Maybe my earnestness will make me more sympathetic to those who would otherwise be inclined to say I suck. But being fake is also killing me. Shit, I hate this life!”
I’ve never been a low achiever. I have always cared about giving it my all and not being marginalized. I have entertained fantasies about escaping the rat race by running away to live off the grid. But I’ve never had enough self-confidence to believe that I could do this without incurring a whole lot of pain and discomfort.
I haven’t had it as a patient, but have worked closely with two people who had it and who didn’t manage it as well as they thought.
One of them was the graduate advisor in my school. On good days he was ok (never the shiniest firefly), on bad days he’d say things like “I’m surprised so many people signed up for this class” (it was the only subject none of us had had as undergrads - of course we signed up! Something new for a change!) or respond to any kind of worries, questions about safety, whatever with a delayed “what does it matter…” I don’t think I saw him smile a single time in three years.
The other one was HR in a not-so-small factory; about 120 people, which for chemicals is quite big. If it had been legal we would have dragged him to the doctor; sometimes we’d not-so-jokingly talk about calling the company doctor and asking him to come “have a cuppa” so he’d see this guy and maybe try to take action. Life was a fog… he didn’t particularly like or even know his gf (one coworker sold catalog jewelry; dude wanted to buy something for the gf but didn’t know if she ever wore jewelry, much less “silver or gold”) but stuck to her because “she puts up with me”. Rarely came before 11; he’d get in…
sat down…
removed his jacket…
stared at it…
stood up…
put it on the hanger…
sat back down…
opened his email…
well, often when we went to pick him up for lunch at 1, he hadn’t opened the first letter yet. He lived (or rather lasted) in slow motion, it was as if he carried his own fog bank.
The first was in medical treatment; the second refused to see a doctor.