Feeling Worse Every Day

The weekend was full of ups and downs. Friday was kind of nice, I went to my parent's house after work to visit with my mom. I ended up staying long enough that my brother came to visit too, and we were still there when my dad got home from work. Then they were all going shopping together, so I went home to my bf so we could do our own shopping. I guess Saturday was pretty good as well. A friend of ours came over a couple times to hang out, and then later in the day another friend came over. It was cold and nasty out, so I was happy to not leave the apartment.

Yesterday was bad though. I was agitated and restless all day, but couldn't figure out anything to do. I tried some cross-stitching, and video games, but they got boring quickly. BF helped me make bread, which is something I had really wanted to do this weekend, and that left me drained. I just couldn't stop crying all day. Today hasn't been much better. I was super anxious when we got up this morning, and I still felt anxious when I got back up for work later. I was fighting tears all the way until I got into my office, and I'm still fighting some. I just feel like there's this dark cloud over me today and I just can't shake it. I'm anxious about my appointment with t Wednesday morning.

What do you fear about Wednesday's appointment?

I'm worried about nothing getting done. Last week when I went I felt like we didn't get any work done, and I just felt unsatisfied after I left. I don't want this week to be the same.

What might you do differently this week during the session?

I already told t last week that I'd started journaling again and had written a list of things I wanted to cover, but that doesn't mean anything. We could go over it Wednesday and still not talk about anything on it, or anything of importance.

Thanks. Therefore journaling is not by itself the means to more meaningful sessions. What do you think might be useful to try on Wednesday, so as to speak consistently about things of importance during session?

I don't know, I don't even know what's important. Right now it feels like nothing is.

What might be important, what might be worth speaking about?

Anything but coping skills. I'm so sick of talking about deep breathing and distraction and muscle relaxation. Ok, I guess that was important last week because I called in crisis over my anxiety, but I just feel like there has to be more to it then that.

Today is turning out to be a very bad day for my depression. All I can think right now about Wednesday is that I don't want to walk out feeling the same way I did last week.

It sounds like your depression got worse at the thought of another session like the last one.

I think you are saying that you need to get deeper than simply focusing on how to cope. It sounds like that was the problem last week. You didn't feel any closer to being understood, to getting a senses of the causes of the problems, and/or to making progress on them. As a result, the session seemed pointless and made you feel hopeless.

What one or two topics might be entryways to getting a little deeper? Or maybe: What one or two topics are most on your mind?

dang.. you still arent feeling any relief?
it took the antipsychotics to work on my depression... didnt take it all away but improved.. more often than not i wouldnt really feel anything though

That lack of understanding was one of the things on the list I wrote for last week. I just didn't bring up my journaling until the end of the session.

So that's probably one. I'd like to explore my diagnoses further too. I feel like there could be something more going on, something deeper than the generic labels I have. PTSD is one thing I want to explore. I, at one point in the past, felt like I fit the criteria for it. Plus the panic attacks I was having a couple of weeks ago felt traumatizing, or like reactions to being traumatized, or something like that.

I do feel more depressed thinking about having another session like last week. There's more to it then just that today, but it's still there.

Not from the depression. It has only been 2 1/2 weeks on the wellbutrin, so I'm trying not to get discouraged with that. I more feel angry at myself for waiting so long to ask for help. If I hadn't waited I might be feeling better now.

Okay this seems good to me. You have two main topics: your need to be better understood, and your desire to explore the possibility of having a PTSD diagnosis.

Now to me the next question is how to get to these two topics, stay on them, and get to greater depth with them. If you see things similarly, what is your thinking about this question?

Well, now that t knows about my journaling and that I wrote a list of topics I wanted to discuss last week, she said she will ask about it at the beginning of our next session. So that takes care of getting to the topics. Staying on them might be more of an internal struggle for me, I tend to wander at times. I'm already taking the time to write out things I want to talk about, so maybe I can write more about what I want to achieve with each topic the day before, so I have a bit of a script already laid out. Or I could ask t to help me not stray by saying something if I start to.

Getting to the depth of these topics is causing me a bit of struggle. I'm hoping maybe t has some ideas. I'm really not sure how to go about that.

oh only 2 ½ weeks, feels like its been months
my time perception is horrible

sometimes these things take little more time, in therapy.. gotta take nibbles at it and make little small progress before it builds up to a big progress

it sucks, wish i knew how to help more...
im a mess right now though, not on this planet - cant seem to return so i cant think very clear...

just gotta take each step with patience... sometimes we cant take a step just yet...
but with persistence we can learn to walk on our own right..?

Okay this all sounds like promising material to me. You have stated a way to get to your key topics and then two ways to stay on them (bit of a script; ask t to help). It might be hard in one session to get all of the way to the depth you need. But I think that a relevant suggestion for you to consider is to say what you know you need to say but are afraid to say. This is a way to open new depths. If you can say the scary thing(s), t will be in a position to help you to understand and explore them.

For example: it might be hard to say that you don't feel understood. You might fear that t will judge you for thinking that you are not understood, and/or for wanting to be understood more. If you don't say it, though, at the end of the session I expect you will be feel that desolation of not having gotten closer to the core of your concerns with regard to that topic. When it is hard to summon the courage, remember why it is necessary to do so.

I was thinking about that earlier. I was reading another thread that someone wrote about not getting what they needed from therapy, because they were trying to not rock the boat. I've said it before, I never expected my depression or anxiety to get this bad, and I've kept things pretty surface level with t. I've even talked about the homework she's given me in terms of how she feels about me doing or not doing it. I'm trying too hard to be a good client and make progress. And it is scary to go deeper into these things.

Maybe a deeper kind of progress comes when you open the scary topic(s) rather than trying to be a good client and make progress.

I wonder if something specific comes to mind that you definitely know you need to say, and is deeper and scarier than you have gone in the past--but not too much deeper and scarier.

Being misunderstood is one. When I was going through the panic attacks a couple weeks ago, I felt like no one was listening to how I felt or understanding how bad and scary it was. That was #1 on my list of things to talk about last week, but I couldn't say it because I didn't want to make waves. I don't feel like all of it is directed at t, more at my pdoc, but I didn't want to make her feel bad by saying anything. And it's not something that just came up during that week, it's an old wound. I don't open myself up enough to people in my life, so when I need something I feel like my needs are downplayed because no one thinks they are that important.

It is her job to manage her feelings. It is also her job to hear your feelings and make you know that you are understood and accepted. By speaking you give her the chance to do her job. How much confidence do you have that she is up to the job?

You might even come to resent others in your life for not recognizing the severity. How much confidence do you have that if you told the true severity, they would be accepting, nonjudging, and helpful?

I'm not sure it's a problem of my confidence in t, but our relationship. I feel like I can't let go of my role as a therapist in session, and I see t as more of a colleague. That topic may have to take some priority at my next appointment.

I don't want others to know the severity of my problems. I'm afraid of worrying them. Then I feel guilty for not being honest with my loved ones, but I regret telling them my true feelings.

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It sounds like you might feel shame at being a t who is also a client.

I agree that your view of t as a colleague would be good to discuss at a future session.

You do seem able to speak quite freely here, perhaps the anonymity helps. Did you know t personally before becoming her client?

I think that you have covered a lot of good material here. What are you thinking and feeling about tomorrow now?

All the crazy things I told the old clinic you shouldn't worry about telling the true severity f symptoms especially if you trust them... I still have a problem with it but I'm trying to get better at that too... but they deal with cases more severe than us even right ... they should be used to hearing these things...
Hope you feel relief soon...

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Yes, I do feel shame about it. I feel like I can't fully be a client, because I'm not in my regular life. There have been times when I have wished that I could just start over and not tell my t that I do the same thing.

The anonymity does help a lot. I feel much more able to be honest about what I'm thinking and feeling here. I didn't know t before I started meeting with her. I've been to the same clinic before, but I made sure to be assigned to a t who I did not know. I didn't like my old t there much anyway.

I'm still feeling a little anxious about tomorrow. Discouraged, as well. I felt like I could be ready to start tackling some deeper issues this week, but now it seems there is so much more work that needs to be done first. I think we need to address our relationship first, because I can't get into what I need to work on if I don't feel comfortable with her. But that feels like so much work, and I feel like we will be wasting a session having to work on this issue.