Depression and what it's really like

i know that logic is a piss-poor approach to when we feel down about ourselves so sorry but i find it helps to remind myself that the way i see others is filtered a ton thru the way i see myself

Zora, the only thing I can say is, I'm really sorry that you feel like a crappy friend. I don't think of you as a crappy friend at all - if anything, you're one of the handful of UK ILX0rs who have made a consistent effort to keep in touch, even when I fall off the edge of the world - which makes you the opposite of crappy. It makes you the best kind of friend. The one who doesn't wait to be asked. Knowing you as well as I do, I think this probably has more to do with your feeling unloveable, rather than you *being* unloveable. You're a good person in a shitty situation; in my eyes, it doesn't reflect on you. (Though I know in your eyes, it probably does.) I am also in a couple of shitty situations right now which are making me kinda "bleurgh."

I don't disagree that there are people out there who will pretend to like a person, and badmouth person behind person's back - or *report* badmouthing for political reasons. That is unfortunately common - as common as how I said there are people who are prepared to hate *anyone* on the internet, and I will do as a target when they want someone to hate. But it's those moments when you deeply feel that *everyone* secretly feels a certain certain way about you, that might actually be an urgent message from your own secret feelings.

The one - and only - good takeaway I got from CBT (which otherwise was a wretched and damaging waste of time) was that that old truism - "when someone just doesn't like you, it usually says more about them than it does about you" - is capable of being completely reversed, as all great truths are. It is very easy to project hostility - or indifference, or "pretending to care" - that one feels oneself and cannot admit - onto other people. This can be the dark backing behind a hall of mirrors.

It's very easy for me, personally, to slip into self-loathing and self-pity and go "I am the most awful, useless person. Everybody hates me. See, X and Y and Z are acting in a completely hostile way towards me, that means *everyone* hates me!" Then I find out some missing piece of the puzzle about X, and discover, actually their angry behaviour towards me has nothing at all to do with me, and everything to do with some experience they are at that moment going through. (Or else the other thing can happen, and I can find out that Y and Z are being hostile towards me because they hate women/feminists/queers/immigrants/whatever else I can't help being, but that's not about me, either.) But when I externalise "X and Y and Z hate me, ergo, A and B and C hate me, too" that's not about A or B or C, that's about how I have come to recognise: that place is a harmful place for me! A, B and C don't hate me, I don't even hate A or B or C, but jesus fucking christ, I hate being in that space where all of them are, so I just see hatred everywhere." <- yes, I am thinking about a specific place when thinking about this example; I am thinking about my last workplace. It is certainly generalisable out to other experiences in my life! (including, LOL, yes, ILX) - so it might be a helpful insight to others - or it might not be and I'm a complete creep just projecting mine own experiences into places they don't belong! Either could be possible. I'm going to stop typing now because I don't think this is helpful.

p.s. Zora you are not a crappy friend. Again! ;)

CBT I've found hasn't been too great at getting at the root causes of depression. Like, it's techniques are helpful, but it's a pretty shallow approach IME.

I've struggled with the same damn stuff you guys are going through now... getting through it slowly. The only ideas I've found particularly helpful for this stuff come from Albert Ellis, one of the other founders of cognitive therapy. His approach is a little deeper and more philosophical than CBT, and he has some pretty brilliant workarounds for depressive shit. I know I've harped about him before, but his ideas are seriously the only things that have actually helped me in this wonderful journey.

A year ago I was obsessing about people hating me, not liking me, etc., and I stumbled on this article that kinda blew my mind. Tackling Your Dire Need For Approval

I just realised I think this probably has more to do with your feeling unloveable, rather than you *being* unloveable unloving.

^^^really easy mistake to have made but I think a pretty important one to rectify.

Sorry!

Thanks, I'll read your link, Spectrum.

oh hai everyone-is-only-pretending-to-like-me crew, you are good people on ILX and I am sorry that I have basically never contacted anyone outside ILX in 13 years of ILXing to be able to vouch for the same off-ILX; I am p. bad at waiting for others to make the first move, I suppose as a filter against pretenders, but really just as a bad and hypocritical habit, something I can point to to say "this guarantees that everyone is only pretending" while batting away any thoughts of "but YOU didn't phone either" with "ah but it's not my place"

and now, a deep breath, and a warning that the next post is going to be too long and too me-me-me and I'm sorry

Saw my therapist today. She's been totally nice and not criticised me outright (though maybe I need/deserve it) but was making the same "maybe this isn't the right time for therapy for you" noises I've heard from every therapist I've had.

It's true I guess, I've been mostly doing the homework so I am not 100% sure what exactly she's found disappointing, but I agree I've been halfassing it, not committing, producing the bare minimum for each CBT homework with a lame "I found this difficult" and no attempt to keep up with previous weeks' tasks on top of this week's half-assed one

or maybe it's just because my scores have barely shifted since I started, maybe I just need to fill in the first questionnaire with any new therapist at 40/40 bleak fuckin' misery and taper it down week by week so they can be all "but we've come so far!"

but I just, it's been 13 years since I first saw someone about depression and 23 years since I first thought that being dead sounded p. good but not worth putting any effort into, I've heard "maybe you're too low to fix right now, come back in a year" and "your scores are only moderate, you seem too comfortable to fix yourself, you're wasting our time" and, what is this "right time" I still need to wait for?

I agree I've been halfassing it, not committing, producing the bare minimum for each CBT homework with a lame "I found this difficult" and no attempt to keep up with previous weeks' tasks on top of this week's half-assed one...

...what is this "right time" I still need to wait for?

It seems to me like you are wanting them to take you in hand, bend you to their will, and fix you in spite of yourself. The right time, I suppose, is whenever you're prepared not to halfass it.

tough love

xp Well... I know. And it sounds so simple onscreen. I just can't find my way to lower all the barriers, a way to look at what is asked of me and go "I know exactly what that means and I can and will give it 100%", rather than convincing myself I don't understand, or I'm not getting it quite right, or it's not getting me quite right, or I was kind of busy and stressed this week but maybe next week, or...

I know, I've got to want to fix myself, I sound stupid and childish and I've brought it on myself, but it's frustrating and I felt like venting. (Although, I admit, it was the kind of venting that also is hoping someone here will take me in hand and write a reply which makes everything I need to do become perfectly clear and perfectly appealing, with a lightning bolt across the sky, a fanfare of trumpets and the presentation of the vorpal sword of self-determination, +6 to WIS, CHA and CON. That can happen, yes?)

That is all.

Yo veg embrace the unknown.

If the way forward were always clear, then being human would be soooooo much easier. Good luck, spacecadet. There doesn't seem to be any obvious blame here, just an unmet need and understandable frustration.

Sorry, I meant aps! Sending from laundromat.

Spacecadet, there's a time when therapists just say "maybe this isn't the right time for therapy for you" and there's a time for you to say "maybe CBT isn't the fucking right THERAPY for me" if all they care about is whether you conform to having improved on some NHS check-list.

Like, literally, one of the first things I said to my therapist, when we started was: I am bipolar. I am never going to *stop* being bipolar. There is shit I know and accept about myself which hasn't been fixable by anyone so far, so I doubt you'll make any progress. But there are some shitty things about my situation and my behaviour that I *need* to look at and try to change, before I get fired from another job. And she accepted that as the starting point, and instead of giving me grief about wanting to kill myself every session, she says "I'm rlly sorry you feel that way, I wish you didn't bcz I like you, but..." and then we go on to talk about the person I am *now*, suicidal urges and all, and handling situations with what I've got.

Therapists often like to turn it around and say all "maybe this isn't the time for therapy for you" when the truth is, therapy is a thing that takes two people. The place where the magic happens is when TWO people trust one another. If you don't trust your therapist to open up and lower the barriers and get at the realness of the shit that is eating you, it might not be ONLY YOU that is at fault. It might just be that this is not the therapist or the therapy for you.

I have had SO MANY shit therapists I can't even count them. But I had a good feeling about mine from like the second email, and when we met in person, she had Berenyi red hair, and tattoos on her hands and pirate boots and wore lots of things with swirlies on, and had a total badass attitude, and I looked at her and thought "You are not a bullshit therapist, you are MY PEOPLE" and the magic happened within like 3 or 4 sessions, and there was trust, and stuff started changing. I always thought therapy was supposed to hard and draining and awful, but even when it's difficult and deep, it's actually still OK and it's *easy* and there's as much laughter as there is weeping because we have *trust* not numbers and tick-boxes. If you don't look at your therapist and think "you are my people, you are on my side" why the fuck should you trust them or open up to them?

I don't even know what your therapist will be like. Probably nothing like mine. There is no one size fits all therapy experience, which is the bullshit LIE of CBT. But you will know when you find your therapist that they are *your* therapist, because you will feel OK with trusting them, first a little bit, and then a lot.

CBT is the signature dish of NHS mental health services at the mo i suspect because of its relative cheapness alongside what i believe is sound evidence of relatively high effectiveness in treating depression compared to other treatments BUT relatively high doesn't mean "this will work for everybody" and i worry that the current diagnostic regime is set up in such a way as to create a "CBT or gtfo" culture within the NHS

i've taken some things of use from it i think but i've never fully committed to it and there's no way that it should be offered as the only effective treatment for depression imo.

CBT is the signature dish of NHS mental health services at the mo

as in it's more popular than just putting people on medication?

my recent-ish experiences and those of friends suggest they assess you for CBT much faster than the wait to see a psychiatrist used to take but nah of course they give you the pills first, quickest and cheapest of all

yeah I got seen surprisingly quickly on this go through too, and whereas in the past they've questioned my not taking pills they were just like "oh, well, that's up to you" this time round. PS now I am questioning my not taking pills but I may take that to the pillz thread

I think I'm disappointed (in my lack of commitment/progress/trumpet-heralded epiphanies rather than her) because I do trust her. Or, I like her. That's not the same thing as trust or as her being right for me, but it's a lot better than I've had before.

On the other hand I worry that I like her because she's older, and... she's not My People, she's more of a mother hen, which I feel more comfortable around but it shouldn't be about comfort. And maybe I'm playing it for sympathy and a pat on the head, rather than finding the truth. And she's happy to fill silences while I nod, and that's more comfortable than the people who lay awkward silence traps to see if you fall into them saying something that they can pick apart, but maybe it's not as helpful. Eh.

feel like branwell bell is dishing out a lot of undeserved negativity toward CBT and therapists

what a relief -- was briefly worried that large health bureaucracies weren't the same after all! (Haha)

My HMO's process:

1. are you trying to kill yourself right now? if y -> emergency services, if n -> psychiatrist
2. psychiatrist makes you fill out a survey and talks to you for about 30 minutes or so, generally advises you to drink less alcohol, stop recreational drug use, eat healthier food, get exercise and get out of any domestic/work situation that is dangerous to your mental health. Then asks you how you feel about taking medication. Generally recommends medication.
3. psychiatrist will also recommend relevant group therapy meetings

basically in HMO-land, individual CBT is an expensive service to provide, so they have these classes that are CBT but with groups

group CBT can actually be pretty cool

sometimes it's nice to not have the pressure on you, to learn about someone else's problems and think about ways they can deal with those problems. kind of a good exercise that you can later apply to your own life.

yeah, I considered going a few times, but never did. But, at that point, I was in a good enough space where I had close friends that had similar problems, and I ended up doing the equivalent with them over food and drinks, which I think was better for me, because at the time I definitely suffered from "people are only pretending to like me" issues.

Dude, unless you have met my former therapists, and you were actually at those CBT sessions, I don't think you get to define whether my negativity about them is "undeserved" or not.

My opinion on CBT is the same as my opinion on medication, is the same as my opinion on every other form of mind-brain treatment: if it works for you, great. If it does not work for you, there is no reason on earth to keep doing something which is not working for you. And anyone who tries to tell you that you should keep doing something which is explicitly not working for you, that is not a healer, that is a ideologue.

Spacecadet came on here and said, person was not finding CBT useful. It was not per first attempt at it, and those other attempts were not useful, either. And it was really getting person down, because the therapists kept insisting it was something wrong with *per*. I suggest only this: if person tries something several times and it does not work, the problem might not be with *person*, it might be with THING.

group therapy was immensely awkward & painful for me but it was through my university & i think the people running it were fresh out of college. they were REALLY bad at it.

in fact my non-group therapist was also pretty "new" at her job. I need to find a new shrink with some experience.

but to spacecadet: I think you need to decide what it is you want and commit to that. Like, say, "I don't want to be miserable anymore!" Granted, it wasn't a simple straight line, there were a lot of 1 step forward, 3 steps back periods, not that I am "cured" by any means, but I've definitely realized over the past 4 years, "Hey, wait a minute, I don't actually hate myself anymore!" After 25 fucking years of self-loathing, geez.

if someone tries something several times and it does not work, surely the problem might be with how the person is doing it?

sure! But I think BB is implicitly saying, that if it is not working, then why not try something else that could work

like what?

Much of my personal difficulty with CBT was that the whole thing seemed to be structured around the idea of: have you ever *considered* that other people's motivations and thought processes might be different to your own? And that the behaviour you are reading as meaning one thing, might be caused by something completely different? And you should try to look at the problem from several different angles to see which explanations are most likely?

I'm sure for some people this may be helpful and life-changing!

But when you are a person who has literally spent their entire *life* being reminded of, and considering, and trying to compensate for, and predict, and cope with, the fact that other people's motivations and thought processes are noticeably really different from your own and arcane and neither predictable nor explicable; and when you are a person who suffers from serious OCD as part of your bio-make-up; and overthinking and trying to see things from too many angles at once is part of the problem and not the solution - then teaching someone like me CBT techniques is like handing a suicidal person a loaded gun and saying "Here, we have a new thing called Russian Roulette Therapy which will cure your self destructive urges." It's not going to help that person, and has a high likelihood it will make things a lot, lot worse.

If you find it helpful and it works for you, go forth and be healed!

But the NHS has diverted pretty much all of its mental health resources into this thing, told us it is the only alternative, because it's cost effective or whatever. When one size does not fit all, and telling people it is, and blaming *them* when it fails is really irresponsible and wrong.

People are not all alike. The same treatment may not fit all. If it does not work for you, that does not make you a "special snowflake" or a problem patient, or "this is not the right time for therapy for you is it" - it means that this person requires something else. Mental health is not one size fits all.

maybe your therapists haven't been good at explaining cognitive therapy. what I've gotten from it is that it works more along the lines of the scientific method, and you change your state of mind by challenging your thoughts with empirical evidence and experimentation. then evolving your state of mind based on an expanded set of facts.

getting a severely depressed person to successfully do this, from my own experience, is next to impossible. took me an entire year of hitting my head against a wall before I could even appreciate this. only now I feel ready to do the more hardcore cognitive work.

comparing CBT to a loaded gun seems somewhat OTT

am i right in thinking that what you're saying BB is that CBT might be considerably less effective if you're non-neurotypical? because i'd say absolutely yeah but this is also a problem assumption of a lot of talking cures

xp also from your description it seems like you are focusing on one small aspect of CBT - i don't think of CBT at all as being structured around interpreting what *other* people think

Late Great, if CBT works for you, go forth and enjoy CBT. But please, just stop trying to tell me why it's my fault it didn't work for me. It isn't. The end.

My current therapist is great! I have NO IDEA if she would work for Spacecadet, or indeed, for anyone else. Person is not currently available on the NHS, though, and I'm bankrupting myself to continue seeing her, because I (and my loved ones) have noted that something seems to be working, and I do indeed seem to be operating more easily in the world.

Person practices a mix of Jungian analysis and Existential therapy and "whatever the hell I keep my eye out for, that I know will Branwell will probably respond to, because I've got to know person really well."

Person listens to what per clients need, and responds to what they tell per, and tailors therapy to what the client responds to best. Person sometimes even asks me "What was that book, or website that you mentioned, because I'm going to recommend that to another client, it sounds like what they need right now." Person listens to, and responds to, and works with per clients, and together, we come up with what the therapy is going to be, and what actions I am going to take in the next week. Person has taught me that I know myself better than any of the people around me, and I'm the only person who can work out how to fix me. *I* am the only person that gets to define my narrative. CBT and the whole "THIS MUST WORK ON YOU OR GTFO" was just one more external narrative that other people imposed on me. How the fuck was that ever going to work, for a person like me?

The irony is, I've spent much of the past decade going "Therapy is worse than useless, therapists are useless charlatans, don't waste your time or your energy" and I certainly understand why people are projecting that narrative onto me still. But my current therapist is the first therapist I have *ever* had (and I've had shrinks of one kind or another since 1982) who has made me go "Therapy is great! Therapy is so amazing and life-changing and everybody I know should get therapy!" I am now 100% therapy-positive, because of this person, and their *bothering* to try to find something that works for me, instead of just imposing one more narrative on me, whether that's CBT or whatever.

Keep looking till you find what *you* need, Spacecadet. It might not be "comfortable" but it will feel *right*.

Medication worked for me. Therapy did not work for me without the medication. It was like conversations with my mom when I was a teenager.

xp i'm not talking about *you* bb, i'm talking about CBT. i never said it was your fault it wasn't working for you.

i do think it would be a shame if you scared anybody away from the most clinically effective treatment for depression

I think it would be a shame if anyone else was scared it was their own fault if this magic therapy didn't work for them. Good to hear both sides.

Now that my brain feels more "normal" -- those teenage conversations with mom make sense and seem relevant. Am I just rambling to myself?

Kinder OTM.

but it's not a "magic therapy". it's a hell of a lot of work, kind of like a diet + exercise regimen for the brain and lifestyle. so if it's not working, there is a good chance it IS down to you, though i would hate to use such a loaded term as "fault".

BB, Existential Therapy is a close relative to CBT ... cognitive therapy was born in large part out of existential philosophy (at least Albert Ellis and his REBT are). so if that's working for you then there has to be some parts of CBT that'd be cool by you, depending on what type of CBT you've done. there are lots of kinds ... Aaron Beck/David Burns (which seems to be the most popular), Albert Ellis' REBT (which I think is the most interesting, and has more of the existential elements to it), etc. plus you have different therapists and what they bring to it, etc. CBT just isn't one method, it's a huge field with lots of different types of practices, people involved, etc.

kind of like a diet + exercise regimen for the brain and lifestyle

I think that's a good analogy.

Maybe you could work some of your CBT thinking on why you keep turning my "If it works for you, fantastic! If it doesn't work for you, it's not necessarily your fault" into "scaring people away from the best therapy" - that might be a start. The moment you compare things to "diet & exercise regimes" you have to "work real hard at" - which HEY YOU KNOW WHAT DON'T WORK FOR EVERYONE EITHER - you have lost my attention. Now good day, to you, sir.

yo i wasn't even talking to you i was talking to kinder

eh I have some mental blocks against putting the effort in, but there are definitely aspects of CBT I think may be promising (also some I find kind of shallow and unconvincing or just impossible though)

plus I've also had non-CBT counselling, just talking and no homework, and got nowhere too. Actually those were strangely frustrating to me, cz even though in CBT I feel like I'm enjoying the play-acting thing and being listened to more than actually working out steps to solutions, without that pretence it was like, why am I here at all?

What are the current CBT alternatives? Mindfulness is kind of in vogue I guess. I've heard of DBT for borderline personality disorder - I don't think I'm borderline but I def. have some abandonment/splitting/anger issues so maybe the techniques could be helpful. Haven't heard of Existential psychotherapy as mentioned by BB, will look into that now.

so which parts do you find shallow and unconvincing?

my therapist does a combination of CBT and psychodynamic therapy, psychodynamic therapy might be something to look in to. it's basically a lot of "hmm, based on what you're saying to me to sounds like you do X when you feel Y because Z happened to you in your past and you never got over it". i find it useful.

Spacecadet, it's totally worth investigating and checking out many different flavours, and reading up on them, and feeling through which one instinctively feels right, and which one smells "omg no, this is bullshit."

Because the best therapist is really someone who will work with you, and is willing to mix and match the bits that you find helpful, rather than - and I'm going by the NHS dudes I had here - someone who turns up with a workbook and photocopied worksheets that you will take home and do, because that is what the NHS has recommended, regardless of whether it has anything to do with you. I mean, hey, if you enjoy worksheets, by all means, do more worksheets. But I just found the expectation of "This is the book, you have to do it page by page, whether or not it is relevant" was just so... no. Effort is necessary, but effort directed in the wrong direction will not move the heavy object, it will just break your leg.

But I really do believe that it is the therapist as much as the therapy. A lot of people really resist that idea, because it's not Scientific!!!!11. Science and Medicine should just *work*, regardless of who it is administering the cure. And mind-brain stuff is... it's just different. It really does matter who administers the cure, and whether *you* feel listened to is hugely Urgent and Key.