Posted by violette on July 7, 2010, at 22:49:40
In reply to where to go from here?, posted by europerep on July 5, 2010, at 10:52:44
Hi Europerep,
I get the impression the PDoc thinks you might have dysthmia rather than TRD/MDD. I also think he would be doing you a great disservice if he went against his professional opinion and prescribed you a medication when after the assessment he concluded psychotherapy to be the best treatment to get you to your goal of feeling good again. Do you feel some indication he does not want you to get better, or does it benefit him somehow to not prescribe you another medication trial? Maybe he was just a miserable jerk? Or did he truly believe he could help you by not telling you what you might have wanted to hear?
Some PDocs feel TRD, often in the form of ahedonia, can be related to how your brain adapted to childhood experiences and can be fixed through psychotherapy. If you have had crappy psychotherapy, or maybe were not fully committed at the time, that doesn't necessarily mean that a therapist who is a better match will not be able to help you as opposed to medications. I've had my share of poor therapy experiences, for sure. I've found that finding a good match in a therapist is very difficult, and I'm not the only one who has been turned off by bad therapy-either the wrong type, a crappy therapist, or maybe just having a poorly matched therapist.
Regardless of good or bad therapy, I never had to be stablized to engage in it first. And not taking a med for the therapy I'm in now gives us lots of material to work through and I have found it to be insightful and healing. If I was taking Effexor, which I've taken before, I'd be too emotionally numb to feel the emotions that are necessary to work through in the type of therapy I'm in. If I was afraid to address the feelings full force, then I might have stayed on the Effexor.
"I need a medication that gives me back the essential parts of what used to be "me", before a therapy can succeed...the depression took away all my "social competence": the ability to talk to people (people used to, almost unanimously say "it's great talking to him", which has been related to me through others later on) because I was interested in others, I was curious etc., while now I just do not care about anything any more; I was able to make people laugh, not by being a clown, but by just being me, and I was so proud of that; I used to be able to approach people and be self-confident, because I could just "be myself" while now I always have to think about how to act in any given situation, etc.." -
Europerep, I can relate to this awful feeling of loss. I once had similar confidence, productive, was free-spirited, easy-going, traveling and going out all the time, and had alot of fun. That was me for a large part of my life. But that changed, and over the past 2 years--it slowly eroded and got worse-to the point where I lost a lot of friends because I felt I could no longer be my 'self' and didn't want to hang around anyone in that state because it was more than disappointing. Once spontaneous, I felt like I had to think about what I was going to say, felt self-conscious at times, and just wasn't comfortable being my new, depressed, self.
So I also never got back to my former 'self'. One of the toughest things I recently had to come to terms with was the loss of this former self. It feels like a great loss-I understand what you are going through. You mourn that loss, and keep searching to regain it. It's only natural.
Although it was difficult to grasp and accept, I came to realize that my old fun and confident 'self' really wasn't 'me' after all. That self had adapted to be happy to ignore and mask all the underlying pain I never adequately dealt with. Eventually, that pain trys to emerge in your conscious and wears you down. It sucks up your mental energy. It causes depression, lack of confidence, social anxiety...which leads to lack of interest...which spirals and eventually becomes ahedonia and dysthmia.
Upon this realization, I stopped searching to regain my 'old self' back and finally realized, that was never me. Both the good and bad experiences are part of who we are-and if you split off the bad stuff, the stuff that makes you uncomfortable, you really are not a 'true self'.
The stuff that contributed to my feel badly about myself was there all along. The bad stuff eventually overcame the good stuff because I had not dealt with it adequately...it just wouldn't let me ignore it anymore. Now, after beginning to integrate that bad stuff, processing all the stuff I had been repressing, the dysthmia has eroded. No, I'm not great, and I still have major anxiety problems from time to time, but I no longer feel in a depressed state. And I find anxiety to be alot better than anxiety and self-loathing.
And I am for the first time in a couple years, beginning to realize that some of my old self is actually still with me-confidence, being playful, having fun, feeling comfortable with me. I am very hopeful to be well again and fully content in the future. I realize since it took me a while to get in that state of feeling badly, it won't happen as fast as a medications. I've been at it for a year and I'm slowly getting there. The difference now is that I am starting to see how my wellness is becoming permanent. I did not see this before. It's something you have to experience first to truly identify with.
I'm just hoping you will give that PDocs opinion another thought. Because if you have been depressed since you were age 16--you might not know who you true self actually is. And-I don't want you to be chasing after a self that perhaps was never true to begin with--and end up in the same place as you are now when you become middle aged-my age.
I wished that years ago, a PDoc had told me 10 times what I needed was psychotherapy. And yeah, they knew all about my past childhood experiences. Would I have listened? Maybe not, but I don't know because I was never advised to do what this PDoc has told you what he feels is in your best interest. Maybe I would have have a similar reaction as you-being preoccupied with getting back to my old self without realizing that what I really needed to do was find a new self, a self that accepts the old after all, instead of masking it, but also integrates it into a content, happy-with-myself, new self.
Best wishes to you.
poster:violette
thread:953367
URL: http://www.dr-bob.org/babble/20100628/msgs/953677.html