Depression Thread

[Paelos]

If I've learned two things from moving from a more introverted style to a less introverted style it's this:

There's a difference between being introverted and being stand-offish.
The World will not seek you out, you have to choose when to engage people.

Waiting for people to always approach you and notice you is not a good recipe for success if you want people to understand who you are. When people ask open ended questions in group, waiting for everyone else to response or choosing not to respond at all isn't going to make you seem mysterious and interesting. It makes people forget you are there, or worse they think you are perfectly fine not interacting so they don't want to bother you.

That doesn't mean you have to be the person who starts every conversation, or that you can't be by yourself when you need to charge your batteries. However, when you choose your battles as an introvert, you need to actually engage people. Always expecting people to come to you and draw you out, then getting frustrated when nobody seems to care, is almost as self-destructive as talking about yourself non-stop at every turn.

Everybody likes the person who is "easy to talk to" which is basically code for, they listen and ask questions. You don't really have to talk about yourself at all to engage people. You just have to ask questions, and not care if they ask you a damn thing. Eventually when you start doing that, people start also engaging you back. Not every time, but most of the time. And you'll get the ebb and flow of when to interject something you enjoyed into the conversation.

[calapine]

Sorry about my public breakdown.
Struggling at the moment. Nothing clever to say about it, just in being in bed a lot and sad. And then I drink and the days after a worse. (Big surprises that)

[Khaldun]

Don't be sorry. Nothing to apologize for.

[Korachia]

Yeah really, nothing to worry about :) Most of us breaks from time to time, and then we get glued together again somehow.

Despite not being part of the generations before me, where being a stone face and strong on the outside was expected, I have somehow inherited my father´s behavioral pattern when facing hardship. I know it´s no good not talking about my mental issue with friends, familiy, or god forbid professionals, but I just have this barrier I cant get myself to cross. Never been to a doc or recieved medication, despite the obvious good it would do me. I guess this text is some how a way of trying to work this problem. I know this sound silly, but I somehow feel fear of reaching, afraid of what I might learn about myself, and what others might learn about me. Acceptance, it´s an easy word to say, but incredible hard to actually achieve for me. Fear and shame on the other hand - no problem there. I am like paralysed.

How did any of you find the courage to seek help?

[Samwise]

How did any of you find the courage to seek help?

When I finally made the commitment to go find a therapist (and it is a commitment, especially in the US where finding any kind of doctor and figuring out how you're going to pay for it is a big ordeal, much more so for anything related to mental health), it was because I very clearly reasoned out that if I didn't, there was a good chance I'd die.  Once it became "thing I need to do" as opposed to "thing I really should do" I made it happen.

[Khaldun]

I'm kind of with Korachia except that I have actually tried therapists twice and both times it was everything I feared and worse. The first guy especially was just awful.

I basically need to find someone who actually understands my world and the things I do and the things that matter to me. I asked my primary care doctor once how to find someone who could be a kind of gateway--who wouldn't instantly funnel me into what they thought was the only therapy that worked or who instantly came to a diagnostic conclusion about me. She basically said, "oh there's a wellness encounter group in our hospital system, go to that" and I just calmly said that was exactly the kind of thing that was the problem--I know too much about where all of that comes from (it's rebranded Stoicism) and I'd spend most of my time annoyed by how lame some of the ripping-off actually is. She calmly said, "Well, good luck then", which was a pretty fair rejoinder. I have some neurotic intellectual friends who recommend neurotic therapists and that's no good either. Basically I think I need someone like Atul Gawande--a wise person who knows a lot both medically and philosophically and is a good listener. I think those people are in very short supply.

[HaemishM]

Problem if you're down South is what my wife has constantly run into. Every single therapist is either in a hospital setting (i.e. their office is basically just a fucking doctor's office, which is hardly a conducive environment for calm) or they immediately start with the Jesus stuff, and I mean the evangelical flavor of Jesus. Neither of those things is helpful.

[ezrast]

How did any of you find the courage to seek help?

I started therapy for the first time in May after having it in the back of my mind as something to get around to for, oh, a decade or so. For me it took hitting a low point at work. I'm usually a pretty high-functioning depressive but my job was becoming a huge source of self-reinforcing anxiety. Every Monday we have a planning meeting where we assign tasks for the week, then I'd spend the week doing anxious-avoidant procrastinating, start stressing out around Thursday/Friday because I hadn't finished anything, and spend the weekend frantically trying to make up time so I didn't have to admit my failure at the following Monday's meeting. The actual meetings weren't bad and my boss never made a fuss about having to roll work over from one week to the next, but the anxious anticipation was completely ruining every weekend I had. I'd start the week exhausted, let myself take it easy for a couple days to make up for the weekend I didn't get to enjoy, and the cycle would repeat.

One time it got so bad that I called in sick just so I wouldn't have to think about that stupid Monday meeting. I'd never faked being sick before (I'm a goody-two-shoes at heart), and I really, really didn't want that behavior to become just part of the cycle, so I made myself spend that day researching and calling therapists. Got set up with a weekly appointment that I maintained up until just a couple weeks ago. The guy was nice enough and it was helpful to have someone to dump on for a while but ultimately I thought his advice was mostly mumbo-jumbo and I wasn't getting anything actionable from our sessions, so I called it off.

I'm kind of with Korachia except that I have actually tried therapists twice and both times it was everything I feared and worse. The first guy especially was just awful.

Anecdotally, it seems like most of the therapy success stories I hear involve switching therapists three or four times before finding one that actually helps. I suspect the only winning strategy is to treat it as a numbers game and go in expecting to bail if you don't establish chemistry in the first few sessions. That's why I'm happy I went to my sessions even if they weren't everything I'd hoped: I know more about the process than I did before and have a better idea of where to set my expectations for next time.

[Khaldun]

The first guy I had a bunch of stuff I wanted to talk about, starting with my inability to complete several long writing projects. He cut me off and said, "Oh just write, that's not hard" and then proceeded to tell me a bunch of generic Hallmark-card level aphorisms such that I maybe talked for five minutes out of 45 minutes. He also told me about his life and his successful practice. And then at the end he said I should get divorced (having not asked at all about my marriage) because "that usually makes middle-aged men feel better". He didn't ask me a single question. It was mortifying. I remember feeling about a hundred times worse walking out of that room.

[Rasix]

How did any of you find the courage to seek help?

I was really scared. It wasn't an option not to. It was either that or accept my new state of near constant crippling anxiety as the norm. I don't think myself or my family would have survived that.

This all started when I had sinus surgery due to having sinus headaches every day for multiple months in a row. Due to some complications during recovery, I stumbled upon a drug combination that caused me to have a massive "freakout". This was probably the most awful experience I've ever had. I didn't know what was real and what wasn't. I'm lucky I didn't call the cops on myself or hurt someone (including me). Although the initial scary state was done, I was left in a pretty bad spot. I had to be on a lot of drugs just to stay functional. Even then, I was super angry all the time. I was really jumpy. Loud noises would send me into a panic. It wasn't fun.

Along with a psychiatrist and a therapist, I was able to make sense of what happened and deal with a new heightened state of anxiety. I don't like therapy, but it helped get me to a stable state and helped me cope with the new way my brain wanted to do things. I stopped going when she started to go to work on me as a person. I didn't like that, and it wasn't helpful.

[Pennilenko]

I ditched the therapists when I could not find an acceptable one after the good one I had got a divorce and moved away. I now visit two community groups, one for anger management, and the other for depression. They operate anonymously unless you want to put yourself out there. The depression group is particularly hard to force myself to go to when depression sets in, but the anger management group has saved my life. 

[Hawkbit]

Tagging onto comments above, when you go, be prepared to try out multiple therapists. A few years ago I had a breakdown days after I got a lucrative IT contract. It was an open office and daily standups pushed me over the edge. There was no single moment to be away from anyone else. It pushed my anxiety to the max and I walked from the contract on day three, which made my wife mad, which pushed my anxiety further. It was a pure meltdown.

After weeding through insurance-approved therapists, half were not taking new clients. Finally found a lady that could see me right away. She starts pulling out crystals and essential oils. I'm like 'mam, I am in crisis and about to go for a very long swim'. I left after 20 minutes of the session as she was still trying to get me to smell oils and associate them with feelings. Learn to read a fucking room, lady.

Ironically, the best therapy came the week after when my dad died suddenly. It forced me to deal with everything my mom needed and it made me put myself on hold for a few months. When I got back home after dealing with all that, I found a decent therapist and she helped me by not helping me very much at all. Nice lady, but she was very focused on some childhood trauma and I disagreed. I went to her for about six sessions and was able to dump a lot of feelings out, but when it came time for to help, she just wasn't getting me. Around that time I got a job that was crappy but kept me busy, so I just didn't go back to her.

After actually writing all that out, I suppose I never really got the help but just moved on. Makes me wonder what having a good therapist is like.

[Samwise]

I got lucky out of the gate with the first one that (a) took my insurance and (b) returned my phone call.  Didn't bullshit me, and focused mostly on concrete steps that I could take to help dig myself out of the hole.  

Some of it was lifestyle stuff to help break depressive cycles (like: you're depressed and not cleaning your house and your messy house is making you more depressed?  hire a housecleaner, it's very fucking worth it).  Some of it was talking through recent experiences and feelings to help me unpack them -- a big theme for our first month or so was dealing with the fact that I'd spent years being effectively gaslit into not trusting my own perceptions, and that was going to continue making me feeling crazy until I took some time to "reset" and rebuild trust in myself.  We touched on childhood stuff here and there but mostly our sessions were grounded in whatever was going on in my life at that time, and using that to help me learn how to process my feelings better in general.  Eventually I got to a point where I had kinda built up the toolbox I needed and there was less to work through each week, so our sessions got less frequent and eventually stopped, and I've felt significantly less crazy ever since.

IIRC her methodology was cognitive behavioral therapy, which from googling I guess is the "rebranded Stoicism" that Khaldun was kvetching about.  Different things work for different people, but I obviously found it extremely helpful.

[Khaldun]

CBT I think has some real usefulness, if I could find someone who was sensible about it. What bugs me is just the "I can't change anything but myself so I will let go of the world", which is absolutely fucking fine as Stoicism or Buddhism--as a religion or philosophy--I just don't want it dressed up as medical therapy that doesn't acknowledge where it comes from. And if I'm going to sit with a philosopher or a monk--something I'm quite glad to do if I can find the right one--I want them to know what they are rather than claim an authority that obfuscates what they're working with.

[Count Nerfedalot]

I have trouble reading this thread when I'm anxious or depressed. So I didn't read it for over two years! 

But I'm feeling a lot better and thought I'd throw out  a couple thoughts that might be helpful.

The biggest one is, keep looking till you find a good DOCTOR. In the US at least, your primary care physician should be the quarterback calling the plays for a whole team of specialists. That includes therapists and/or psychiatrists.  You can't really heal a sick body while ignoring a sick mind, that just leads to whack-a-mole symptom chasing.  And vice-versa as well. So your primary needs to be INVOLVED in whatever care you're getting whether chemical or psychiatric, and monitoring its effectiveness and any side effects.  If your doctor is just handing you off to some other specialist to take care of you and isn't interested in and actively monitoring your progress with them, you need a new doctor.

Next, keep trying on the therapists.  Even if you're on meds, a good therapist can make a world of difference.  Don't be afraid to bail on one if they aren't helping you, if they aren't listening to you, or if you just don't like them.  This is someone you need to establish a trust relationship with.  If you've gotten a good primary care doctor, odds are they will be able to recommend someone (usually a group practice) to see. If the first one you get to see there doesn't work out, try the others.  Even in a group practice they are likely to all be completely different from each other.  And provide feedback to your primary care. Again, they should be actively involved in your hunt for what you need!

Now, personal anecdotes. My first breakdown was in 2002 and featured severe depression, to the point where I didn't leave the house for a month at a time (loooong before wfh and pandemic stuff). Therapy didn't help much, other than that one public assistance group therapy I ended up in when I was nearing the point of having myself committed.  Those sessions "helped" by making me realize that a) I was nowhere near the bottom yet, and b) I did NOT want to go there!  I tried 5 or 6 different therapists, learned a lot of the lingo, but didn't get squat useful out of any of them.  Fortunately, meds actually helped a lot. Well, right up until they started making things a lot worse!    But that's another story and the relevant thing is it reinforces the first point: your primary needs to be monitoring this stuff. Oh, and never trust a pill-pusher who is making more money doing "seminars" for the drug company than he is making from his medical practice!  But in the end I got out of the depression hole and was able to rejoin the workforce and eventually survive and even thrive without any meds at all.

My second breakdown occurred like a slow moving train wreck from 2017 through 2021.  Some depression was involved but the primary issue was anxiety.  And it not only basically ended my career because I didn't get it treated soon enough, but it almost killed me through stress-induced (or amplified) illnesses.  Unlike the first time, with the second one I couldn't tolerate most of the meds at all and the few I could either did nothing or left me completely numb.  I wasn't willing to settle for numb, I actually liked my life when I wasn't so freaked out I was soaked in sweat and shaking like a leaf, so I made the commitment to, once again, try to find some legit medical help that wasn't just a pill-pushing shrink or a one-size-fits-all snake-oil peddling therapist. This time I did have a good primary care physician who helped me find an honest to god good therapist.  It didn't come in time to save my career, I got to the point where I was basically unable to function at work anymore and was forced to take early retirement before I could even get started on the counseling (new patients were backlogged 3 months!). But it has helped enormously, both with dealing with the anxiety issues that took me to her in the first place, AND with dealing with the shock of the sudden unexpected change in lifestyle from a competent, productive, busy professional to a pensioner.

As best I can tell from being force-fed it several times now, Cognitive Behavioral Therapy basically boils down to convincing yourself that things aren't as bad as you think they are.  Which might be true for some people, but is frankly bullshit for many others.  But if it's true for you, or if you can con yourself into not worrying about things that actually are worrisome, then I can see it being very helpful.  Of course, so is prayer, meditation, or going on a vacation, for some people at least.

I never tried CBT for my anxiety.  I was working for state government and strangely enough they didn't bat an eye at me carrying around a prescription bottle of Xanax, but if they'd spotted CBT on a random drug test I probably would have lost my job.  And now, while getting stoned actually sounds nice, I don't need it.  I VERY rarely used the Xanax btw.  It worked so well it scared the shit out of me. Like man I could see becoming addicted to that so easily!