counseling and antidepressants

[yayfulness]

Two questions here.

First, I'm meeting with a psychiatrist on Wednesday to discuss going on antidepressants. I honestly know next to nothing about them, except that they treat symptoms rather than curing the root disease. Is there anything I should know before the appointment in order to get the most out of it? My biggest worry is that my depression is highly episodic--for instance, yesterday would have qualified as an awesome day even if I wasn't dealing with depression, and I'm feeling perfectly fine right now, and yet the week began with some of the most miserable days I've had since my depression first came back more than a year ago, and yet the week before, I felt, if not really good, at least stable. Does this affect how much antidepressants would help me? It's certainly frustrating... I don't even know how many times in the past year I've thought I was through with depression only to crash again.

Second, how do you know when it's time to switch to a new counselor? I've met with my current counselor five times over the past six weeks, and we've made essentially no progress. However, I'm afraid the problem is mostly on my end--for whatever reason, it's extremely difficult for me to open up emotionally to a counselor, and I don't know if switching would be any good or not. Any tips? (On whether to switch, or how to open up. The ambiguity is retroactively intentional.)

Thank you.

[Whistler]

from what I've heard from people who try them, antidepressants can help even out your emotional days?

Switching to a different counselor might help, or it might not. It's possible something about your counselor makes it harder for you to open up to her/him? If you want to stick with the same counselor, try to address the problem head-on, or at least from the side. Something like "I have a hard time telling you (or friends) how I really feel because (I don't know you very well, or I don't want to burden you with my problems even though it's your job, etc.)."

Anyway, hopefully other people around here will be more helpful .

[krebscout]

I'm a huge fan of my pill, Wellbutrin. My brother and my dad are also on it, and they love it, too. My brother put it well when he said that it doesn't cure all your problems or keep you from having bad days, but it does put it all within in the "I can handle this, this is normal" realm. I was pretty episodic, too, with a lot of anxiety thrown in there. Some people have a problem mixing Wellbutrin with anxiety, but its effect was nothing but positive for me.

Something else I love about Wellbutrin is that it doesn't have all the bad side effects people usually associate with antidepressants. It doesn't suck away my creativity or my personality, and it also (can) increase libido and energy while causing weight loss (in some). Those are all pretty good things in my book. I only wish that I hadn't been so scared to try it sooner. It's been so good for me and my family.

As far as counselors go, I don't know that I've ever connected completely with one. I've liked them all in different ways but haven't found one that I completely adore yet. So...dunno.

[NerdGirl]

I think that the best thing I can tell you is that there are many different anti-depressants, and a psychiatrist will figure out which one might work best for you based on your own medical history and symptoms. So just explain what kind of symptoms you experience when you have an episode of depression, and explain how often you get episodes and what you feel like in between. It's a very individualized approach. And I don't know that I completely agree that anti-depressants only treat the symptoms. They aren't a magic cure, but in depression the underlying cause has a lot to with neurotransmitters in your brain not being in the proper balance, and anti-depressants basically change that balance. So they are helping to fix the underlying cause of depression and not just alleviating symptoms. I see them the same way I see my thyroid medication - my thyroid has been destroyed by my immune system and there is no cure for that, but my medication replaces the hormones that my thyroid used to make, which is more than just treating my symptoms.

As far as your counsellor, if you've only been going for six weeks, I would say don't switch yet unless you actually don't like your counsellor or you feel like there's a personality conflict. If you have trouble opening up, then I think it would be better for you to stay with the same person and work on getting to the point where you can open up. Tell your counsellor that you're having problems opening up and see if they have any suggestions. Unless there's something specific about your counsellor's personality or style that is making things not work, I would give it more time to see if you can get to the point where you can open up with them. I think it took me about 3 months with the same counsellor before I felt like I was actually making progress. It can take time to build that relationship.

Sending you lots of hugs. I have a good amount of experience with depression on a personal level, with family and friends, and now with patients. It's a hard thing to deal with, but it is not your fault and I'm glad that you're trying to get help.

[Tally M.]

If your counselor is wearing what appears to be a Bluetooth headset, she has probably been upgraded to a Cyberman. In that case, switching is highly recommended.

(True story. A friend actually switched therapists because the only thing my friend could think of was the therapist being a Cyberman.)

[yayfulness]

Thanks for the input.

We've actually spent all of the last two or three sessions working on almost literally nothing but getting me to open up, and even though I consciously attempt it, I guess that part of me just isn't strong enough to break down the walls I've put up. I'm really not sure how to get past that.

The only issue I can consciously pick out is that my counselor reminds me of my mom, or actually more of a mother figure in general. And that is something that I am extremely unfriendly to on a level of emotional connections. Granted, I don't know how to avoid that; I also hate trying to connect emotionally with guys.

[Emiliana]

I'd say that if you've dealt with depression this seriously for a significant portion of your life, it might be worth trying antidepressants. I think it's pretty characteristic of a lot of people's struggles with depression that you don't feel horrible all the time, but the days when you do are so bad that it's unbearable. I've found that my antidepressant (Cymbalta) helps a lot with those days. Like NerdGirl said, a good psychiatrist will work to prescribe the medicine that's most likely to help with your particular circumstances.

As far as counseling ... hm, I really don't know. Of the three counselors I've been to in adulthood, one I connected with well and saw for several months. One I saw a few times before realizing I just didn't click with her. And one I diagnosed as a complete psycho within 15 minutes. Maybe if you feel like it's not just a personality thing, that you'd have trouble opening up to *anyone*, then it would be worthwhile to stick it out with the one you've already invested some time in. And possibly you'll be able to communicate with her better when/if the medicine kicks in and helps you feel better in general.

Hang in there, yay.

[Portia]

I don't think I've ever had depression, per se. I would describe what I have as more on the nervous breakdown/anxiety side of things.

I've actually found writing about what I feel to be far more helpful than yapping away to someone. I don't particularly have a hard time opening up to people, but I feel like counselors are only human, and Utah County ones are pretty biased into worldview, if that makes sense.

I've never been on medication (although I've gone through self-medication phases ... not recommended). I've found that solving the root problem, or time, or a change of situation, help it pass, although I get the impression that anxiousness and breakdowns are probably more tied to stress than depression, which can have no apparent cause, I guess? But I don't think mental issues are ever "cured," only managed. But I will never be cured of my allergies, but I can manage them.

Hopefully this isn't too much "well here's what I did for my celiac disease!" and you're thinking "I can't eat peanuts."

Too long & didn't read: some people like counseling, some don't. Some people go on meds, some don't. I'm one of the latter, but my mental issues are directly tied to life events or the environment, so take it with a grain of salt.

[Violet]

For me, I knew I needed to switch when my needs weren't being addressed. Right now it seems like you're trying to get there by opening up, but you're worried it's you, not the counselor causing the issue. Have you been able to open up to other counselors? If you have, maybe it's time to find someone like the ones you've opened up to. If you haven't, stick with it a few more sessions before making a decision.

As far as medication, I'm on a very low dose of celexa that has helped me manage a lot better. Like you, I did have some really good days, but I also had stretches of terrible. Given similarities, I think it probably could help, although your psychiatrist (Dr. Bunn?) is probably the one who could tell you better. If you're still averse to medication, I know that daily exercise has been shown to help in some cases (mine included).

[S.A.M.]

Consistent, daily exercise can be one of the best meds, with multiple bonuses, and very few bad side effects. Pick an excercise/activity that you enjoy, or it can become another source of stress/frustration. Make time for it.

[yayfulness]

Well, I'm officially starting antidepressants today. So we'll see what happens.

Also, I was going to say that I make a point of biking everywhere, but I kind of crashed my bike yesterday and had to get stitches in my arm, and I'm still waiting on final word about whether I broke anything in my elbow, so exercise is kind of temporarily out of the question.

For the record, it is actually really cool to watch a doctor sew up your arm. I have never been more glad to live in the 21st century.

[S.A.M.]

it is actually really cool to watch a doctor sew up your arm.

Yes! Biking injuries are awesome.

[yayfulness]

At least I didn't get any facial piercings this time around.

[TheBlackSheep]

I just wanted to say that antidepressants DO treat the root cause of depression, if your root cause is chemical imbalance. Otherwise, it just helps regulate the chemicals in your brain and takes the edge off of whatever is going on. Antidepressants just don't cure anything.

Also, my advice is switch therapists. Either you connect with a therapist or you don't, and I think six weeks is long enough to know. If your therapist can't encourage you open up in that amount of time, I think chances are slim to none that that will change. Then again, I'm apt to change therapists ALL THE TIME WOO.

[NerdGirl]

it is actually really cool to watch a doctor sew up your arm.

Yes! Biking injuries are awesome.

It's also really cool to be the one sewing up people's arms. It's one of my new favorite things.

[TheBlackSheep]

Here's my therapy-related question of the day:

I've decided it's time to go back to therapy. I am quitting my full time job in order to go back to school in about two months, at which time I will lose my insurance coverage. At that time, I can start getting therapy through the school, but I kind of need therapy now. Switching therapists majorly blows, and I have a horrible track record when it comes to trusting therapists anyway. There is one therapist that has come highly recommended by people who I trust, but she is not on my insurance. Should I see her, since I will only be doing about six to eight weeks anyway, or see someone on my plan who I will probably hate in favor of only paying the copay?

[Katya]

Here's my therapy-related question of the day:

I've decided it's time to go back to therapy. I am quitting my full time job in order to go back to school in about two months, at which time I will lose my insurance coverage. At that time, I can start getting therapy through the school, but I kind of need therapy now. Switching therapists majorly blows, and I have a horrible track record when it comes to trusting therapists anyway. There is one therapist that has come highly recommended by people who I trust, but she is not on my insurance. Should I see her, since I will only be doing about six to eight weeks anyway, or see someone on my plan who I will probably hate in favor of only paying the copay?

I vote that you go see the therapist who comes highly recommended, and ask her about sliding scale options.

[Whistler]

well, depending on how you're doing, you could at least try someone on your plan, with the backup plan of going with the recommended therapist

[NerdGirl]

If it were me and there was any possible way to afford the highly recommended one without destroying my financial situation, I would go with that one.

[Squirrel]

Well, I'm officially starting antidepressants today. So we'll see what happens.

Also, I was going to say that I make a point of biking everywhere, but I kind of crashed my bike yesterday and had to get stitches in my arm, and I'm still waiting on final word about whether I broke anything in my elbow, so exercise is kind of temporarily out of the question.

For the record, it is actually really cool to watch a doctor sew up your arm. I have never been more glad to live in the 21st century.

Good luck! I hope everything turns out well