Depression and what it's really like

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.

xp I know I'm lucky here but I don't have any particularly traumatic childhood events to blame for my feelings. Wonder if my therapist does that too because she accidentally gave me the wrong 5-column thought record today before noticing and getting the right one, and column 5 in the other one was something about "past event this reminds me of: who said this to me? when?"

I uh... I just find the "what other ways are there to look at things?" bits awkward, because the blurb I was given said it wouldn't help if you didn't believe them. Well, I can make up other explanations for things all day, but no, I don't believe any of them. Things like that.

(this is kind of vague, there are other things too but tbh we haven't been doing much CBTing for the past month, partly because of the holidays and partly because I guess I was starting to flake and she was going easy on me)

yeah i always struggled with that too ... it's easy for me to come up with positive affirmations but i find it hard to internalize them.

it has gotten easier over time ...

aps don't have anything but i hope you find whatever method is out there to help you

xp

that's where the habit and repetition comes in, no? part of why i mistrusted the idea of CBT was because i cdn't see the route to internalization but now i feel like worrying about how stuff happens is counterproductive, for me.

which is perfectly sensical if you believe that you didn't acquire your self-destructive thinking habits in a couple of days

otm

TS: therapists that tell you to pull yourself together vs. therapists that tell you to accept yourself as you are.

accept who you want to be and work toward it imo

I'm going back to therapy starting this saturday and I am going to try to take the CBT exercises really seriously this time. I think tangibly changing my habits would be empowering, and is necessary for me to actually accept myself.

Thanks for this conversation. It's been really helpful for me, both in terms of solidifying my understanding of why CBT didn't work for me, and also the basis of my mistrust of the use of it as an NHS panacea.

Any time a person, or a method starts disregarding the variety of human beings, and starts insisting "This method will work for everyone, if the method doesn't work, it is the fault of the person not working hard enough, not the fault of the method" - that is not science, that is cult-like thinking.

And that analogy - it's like a diet and exercise regime - that was the moment that the realisation snapped into my head. I have heard this *exact* argument before. Many, many times. "Diet and exercise regimes work for everyone, and if you are not losing weight, you're just not working hard enough!" Thank goodness there are movements like HAES and Body Acceptance that have said, quietly compared to prevailing culture, but often enough for the message to reach me: "that is bullshit." It's empowering to stop blaming myself for failure which is not my fault, and look for something that just helps me be more healthy.

Even in the realm of more physical medicine, after the advent of "wonder drugs" which really did save the lives of billions of people, penicillin and the like, there was the slow realisation that 1) some people (including myself) have penicillin allergies, and the drugs will harm them more than help them and 2) that there are such things as penicillin-resistant strains of disease.

I'm putting CBT firmly into the category of "penicillin" - works great for many people, not so great for others. But I'm putting people who continue to advocate CBT as the "best treatment" in the face of the many people it does not help, into the realm of "dangerous, cult-like thinkers" to be avoided the same way I avoid the "OMG death-fatties" crowd.

Thanks for the reassurances upthread BB. :)

I agree with BB, but also see how people who think they are benefiting from CBT would get defensive at the suggestion that it's not 100% effective for 100% of people. Having faith in whatever therapeutic model you are using is probably an important factor in whether or not that model is effective. This connects to a larger issue I have where I think my skepticism -- or "objectivity" -- about things can be self-defeating. To get results in anything, I am slowly realizing, you have to look down and follow some sort of plan while blocking out distractions and uncertainties. This is hard for me, and I don't even find it appealing as a personality trait or whatever, but I think it's necessary sometimes, and a thing CBT tries to help people do with its emphasis on "productive" rather than "open-ended, infinitely regressive" thinking. People who are fitness fanatics, or really defensive about whatever habits they've cultivated, are probably just scared of looking up, recognizing they don't know everything, and losing the motivation to keep doing the thing that's working for them.

I'm not excusing people who have close minded, prescriptive attitudes about mental health and certainly not excusing the NHS, obviously. Again, BB otm, and people should learn to separate what's best for them from what's best for other people.

wtf is this talk about fitness fanatics?

doing a thing you find helpful is great and it makes sense you'd be a believer and evangelist for it, but it's not everyone's path

is wtf this talk is about, i think.

yeah okay but i've hardly been an evangelist for it, nor have i tried to push it on anybody

Talking like people who decide to follow a regimen are blinkered, self-deluding cultists is a pretty high level of condescending, we could probably have more or less the same conversation by allowing that sometimes you have to focus your efforts in order to fulfill your expectations for a thing.

fair point!

http://m.youtube.com/watch?v=qld7WvHa5kc&desktop_uri=%2Fwatch%3Fv%3Dqld7WvHa5kc

I never said that people who decide to follow a regimen are blinkered self-deluding cultists.

I said that people who decide that *their* regimen is the *only* answer, and is applicable to everyone, regardless of other people's self-reported evidence that it is not, are blinkered self-deluding cultists.

If no one in the thread has said the latter, then we do not have an argument on this thread. But both of these things have been said to me, in many contexts, and I do not find it a stretch to equate the two attitudes.

And condescension is in the eye of the beholder. I mean that in many different senses, all of them applicable.

Are you taking an ilx break or not taking an ilx break, BB?

I took a break from ILX last night, because I had just come from a difficult therapy session. It was good to take time and rethink and get a clear head for the evening. Sorry if you didn't catch that.

spost I mean duh clearly not, but when people say they are going to go away in an effort to support their mental health, and then do not, well. . . oh well never mind what CBT may have to say about that, right?

Here's the thing: I have long valued this thread for its honest insights as to what it is like to suffer from depression; from its sincere support for those who are suffering; and for providing a thoughtful place to consider all of the issues surrounding depression.

Your heavy-handed, bull-in-china-shop presence here is not one I, for one, find valuable.

Thanks for your opinion. I will not comment on whether I find it valuable.

If you don't find it valuable, than stfu. If you do, try to be respectful of others.

*then*

"STFU"

"respectful."

Wow. Just... wow. Good day to you, Quincie.

I'm not sure if I'm just drunk, or if you're being kind of an ass, quincie. Either way, everyone else on this thread without this horrible arguing.

say what?

"everyone else on this thread *feels terrible enough* without this horrible arguing"

ah, true

surely depression is one of the foulest demons ever to crawl into a human !!

https://www.youtube.com/watch?v=XU1MAokrrUk

everyone else on this thread *feels terrible enough* without this horrible arguing

This is entirely true, of course, and I am sorry I brought it up. I'll stfu now.

I've tried to contact my therapist 5 times over the past two weeks. I've gotten his answering service, his receptionist twice, his voicemail and I've emailed him but no reply. I understand he is busy being one of the better psychologists in this part of the country

haven't read last this so maybe this has already been taken care of, but give your pharmacy a call, explain the situation, and ask them to call the prescriber's office and take a prescription over the phone. even if the prescriber is not there, a nurse or medical assistant should be able to read his/her notes, understand the situation, and authorize a refill for a month's supply in the meantime

also, is this a psychologist or psychiatrist we're talking about?

do psychologists prescribe medicine in the UK?

No, in the UK your GP prescribes the medicine, but after a few months may send you for a review by a specialised psychiatrist, who will generally tell you to keep taking whatever the GP's already given you and send you away again within 30 seconds

you usually get referred to a clinical psychologist by your GP, and the psychologist can suggest that medication might be helpful or write to your GP (with your permission?) to suggest a review of your medication, but can't prescribe any or tell you outright to take it or not take it. at least, that is my understanding

sunny isn't in the UK though. hope you got it sorted out

prescribing in the UK is sort of odd right now - the government's been shaking up the NHS and one of their moves to "reduce red tape" and "give GPs more power" was to make GPs more responsible for prescribing medicines, largely because they're now responsible for the budget for prescription costs/community services/hospital treatments/etc.

so e.g. last time i went to the hospital and was prescribed a course of medication, the specialist there could give me a prescription for one item, but for the other (which i needed to take alongside it!) I was given a letter of advice to take to my GP to ask them to do the actual prescribing.

(and so i had to make an appointment with my GP in order to get them to issue the prescription and i felt like a huge waste of their time and money but at least got to dine out on my personal 'the tories are increasing waste in the nhs and here's how' store)

(*story)

wow that's outrageous

That is a pretty terrible idea! Is that true for inpatients too? Because on your first day out after major surgery there's nothing you want to do more than make appointments, go into town, see doctors, go to the chemists, etc.

(the two things I loved most about coming out of my last hospital stay were the big bag of codeine I was sent home with and the possibility of sleeping all day in my own bed to make up for the impossibility of sleeping through the night in a hospital)

depression + having a job is a bad mix for me right now. i'm in a weird, low place right now, plus i'm quitting smoking, so i feel like anti-social and shitty right now. my job environment is really social and i just feel like doing my own thing right now ... but that's like a crime or something. GOTTA BE SOCIAL. MUST HAVE SMILE ON FACE AT ALL TIMES. like it's a crime if I don't feel chit-chatty all the time. guess it's good that people want to talk to me, i just feel overwhelmed by the whole idea. the pressure just makes it a thousand times worse.

at the team meeting we were introduced to a new guy, and new guy said to everyone that it looked like I "wanted to hide". everyone looked at me with this mixture of pity, sadness, and discomfort. i wanted to deck the guy right in the face.

you should have, imo

i don't know if it's me or this job. other team members here have called me pretentious, weird, "maiden" since I work on fashion stuff and I'm a dude, etc. definitely didn't need this today i can tell ya that much.