Deep Depression

[OakLeaf]

You might also consider seeing a psychologist if you haven't before.

Now, granted right now I'm with a LiSW and doing really well with her. But earlier in my life, before I learned how to (1) feel at all, (2) identify my emotions and (3) verbalize them, I went through way too many LiSWs who just weren't equipped to deal with me. I had my first real progress with a psychologist, who did some testing, identified many of my issues, and helped me to work through them.

As far as meds, I personally think that although your therapist can't prescribe, they're probably the best person to help you decide whether you should consider trying something. Unfortunately, very, very few psychiatrists do talk therapy, so it means seeing both a therapist for your talk therapy AND a psychiatrist for your med checks.

Hang in there. Take good care.

[solobiker]

Everyone has given you great advice. Like many I have had to deal with these issues and it is not a fun place to be at all. I hope you can find what works for you because everyone deserves to be happy. I sent you a pm since I think we live pretty close to each other so we can hook up and have a "girsl" night/afternoon. I have not had one of those in many many many years. Hang in there!!

[Dogmama]

m.

As far as meds, I personally think that although your therapist can't prescribe, they're probably the best person to help you decide whether you should consider trying something. Unfortunately, very, very few psychiatrists do talk therapy, so it means seeing both a therapist for your talk therapy AND a psychiatrist for your med checks.

Hang in there. Take good care.

My experience (just mine - don't want to insinuate anything) is that a psychiatrist can best assess whether or not medication is necessary. I've seen several different therapists and they all have a bias either for or against medication. Even if they don't say it outright, it comes out in the sessions eventually. My psychiatrist doesn't do talk therapy and I don't expect that. But when I describe my depression (like a fog rolling in) and tell him that the episodes last longer and are more frequent, that is valuable information. He also knows my history and that helps him with his decisions. I save the "feelings" part for a therapist.

Often, if you get the major depressive cloud to lift a little, talk therapy can be extremely beneficial. It's difficult to identify patterns that don't serve you well, e.g., black and white thinking, when you're in the midst of depression.

Regarding supplements, I am a believer in supplements and I do take them. But when it comes to my brain, I don't want to roll the dice about the actual ingredients. I belong to a group called Consumer Labs that actually examines the contents of supplements. It's amazing what they find - usually not good. If my multivitamin doesn't contain the claimed amount of vitamin C, that just merely sucks. But if you're messing with my brain, that's another thing. I need all the brain cells I have left & I need them to not be doing the Hatfield & McCoy dance between my ears.

[Crankin]

You are getting very good advice, Vegan Bike Chic. I'll just add my 2 cents (or one cent, depending on your point of view), as a therapist who can't prescribe.
No therapist should be "pro or con" medication. It is up to the client to decide for herself, with the help of a medically qualified person. If someone asks me about medication, I give them general information and specific cases where it can be helpful. Then I ask if they would like a referral to the psychiatrist I work with. A solo practitioner (whether they be an LICSW, LMHC, or a psychologist) should have a professional relationship with a psychiatrist or two that they can refer people to. Although I tend to agree with the opinion that Irulan stated, it is not my job to tell someone that they *need* to take medication. In reality, what I find is that when someone is really going through a bad time, they are often open to trying medication (or some other thing they said they would never do). Sometimes, the medication lets you take the first step.
When I was having extreme anxiety a few years ago, I was put on a small dose of an older (non SSRI) anti-depressant, for pain. In fact, it was such a small dose, it didn't even approach the beginning therapeutic dose for depression. Within 4 weeks, my pain was gone, and so was my anxiety. But, I was also doing the MBSR class, acupuncture, yoga, and therapy. I will never know if it was the medication or the other treatments, but I do know that the change was almost miraculous. After 10 weeks, I weaned off of it and have never needed it again. It allowed me to shed my disorted thinking and figure out what I wanted to do.

[indysteel]

FWIW, I have gone the "natural" route, although I hesitate to use that word. I have had bouts of minor depression and a couple bouts of more serious depressive episodes prior to being in therapy. I firmly believe in talk therapy and CBT, but it's been a long road to wellness. In many ways, I wish I'd taken something to ease the process. My thirties, while not a total waste, could have potentially been a better decade for me if I'd taken something.

So, I'd urge you not to rule it out, but either way, look hard for ways to connect to people. I learned that any level of interaction can help, even if it's just a friendly smile at the gym. Volunteering is a great way to interact with people, often for free. Do group rides, go to a yoga class (many studios offer lower cost community classes). After years of loneliness, I learned to look for places and things that inspire community, not just friendships. Are there any interests you have that are served by a group of some kind, e.g., a community garden or co-op. I know it's hard, but challenge yourself to one group event or outing each week.

Good luck; I truly feel for you. I went through some similar stuff myself.

[shootingstar]

I don't know what to say, except over 30 years ago, I did see therapist for a full year during university. There was no meds but hard work on my part. I am indebted to her guidance.

My sister died by suicide and I am dimly aware she did try meds. (after seeing a psychiatrist) for her deep depression, not sure there was a therapist to complement, if any. The depression which she hid so well from her birth family for last 15 years. I know she really would have disliked being on meds: she was a fully trained, licensed pharmacist and had pharmacokinetic understanding of drug interactions. And I knew she voluntarily took herself off when she could. You have to understand: she left the pharmacist profession because she didn't want to contribute to a system (from her perspective) on sometimes over-reliance of drug treatment /substance abuse for certain conditions, when she saw certain patient refills as pharmacist serving patients.

Because she and I are from the same family, and I can only guess some of the major issues that would have caused her depression: I so strongly believe considerable talk therapy with cross-cultural understanding would have been of enormous help to her. Not every therapist has experience in this area of counselling nor may be to establish the right "rapport" with the patient. I seriously question my sister found the right therapist-- but also for my sister if she didn't have enough of the "right" people encouraging her since she hid her deep depression.

Would I want to consider meds? No. I already had the enormous benefit of talk therapy. So I am biased (and deeply grateful).

But sad. I miss my sister --every day.

[shootingstar]

Sorry to be hitting with heavy stuff in above.

As for relocating to different city and being isolated: it is enough of a life change to warrant making more conscious choices of doing things one enjoys and doing some stuff with others. No doubt my mother fell into a depression because of not knowing the language, not having any family member except her husband in a new country, after immigrating.

Support immigrant services in your community also: some of those counsellors are dealing with this stuff too since it can be geographic, cultural relocation big time, big shock (on top of any major personal/family problems regardless of any linguistic-cultural barriers).

[Crankin]

You are right, Shooting Star, culturally sensitive counseling is a necessity in a lot of cases. It doesn't always have to be that you have a counselor of the same culture, but the counselor needs to be aware of what cultural factors may be influencing how a person thinks and how culture may have contributed to the issue. My training was very focused on dealing with these issues, but I still feel like there are some cases that would be best served by working with someone from their own culture. I just had to close a case with a Cambodian teenager. I won't go into the details, but her issues were the same issues I deal with with other girls her age. The difference was the way her family (mom) totally denied/dismissed this girl's symptoms and behavior, which were very risky. There was a huge cultural component there and I couldn't bridge it, even though I am well aware of the issues. Her school is going to refer her family to a different program. There is a large Cambodian community in one of the cities I work in, but there are very few counselors in this community. A few parole officers and DCF workers, but I have only known one young man who was training to be a clinician. So while I feel totally comfortable working with my Hispanic clients and continue to learn from them, I admit I couldn't make much difference for this one girl and her family. I hope they find someone who can help them.

[OakLeaf]

I thought this was really good advice, too. http://www.diycouturier.com/post/472...her-when-youre