At what point do you give up

What do you do when nothing seems to work?
I suffer from depression and anxiety and at the moment I am just trapped in a vicious cycle: I sleep really badly and am constantly exhausted, which makes the depression and anxiety worse, which them makes it even more difficult for me to sleep.
I have tried CBT which didn't work - the therapist thinks it is because I am not sleeping well, meaning that I can't consolidate the learning bits of CBT. I am not sure I agree with this, I think that it's because CBT is based on changing my core beliefs about myself and so is based on the assumption that the beliefs are wrong - but what if they're true? There don't seem to be any alternatives to CBT, other then group therapy (which makes me anxious just thinking about it). I am in the UK so am limited to what the NHS in my area offers as I can't afford to go private. The psychotherapist suggested counselling and gave me a list of numbers to try, but most of them deal with trauma or abuse which are not relevant to me (and just makes me feel ridiculous for asking for help when there are so many people who need and deserve it more than me)

I have tried several different antidepressants, but none of them have had any positive effect on my mood, and for each one I just end up with a different list of side-effects. I am seeing a psychiatrist about medication and even she says we are running out of options. I get the feeling (from the letters she sends my GP) that she doesn't think it is particularly serious as I am well-dressed, not showing any signs of self-neglect and can hold a conversation.

Right now, I feel like I am running out of options and I just want to give up

I'm so sorry you feel this way. I can't really give any advice as I'm not in your area, but please know that your problems ARE important, just as anyone else's. Don't let anyone, professional or not, tell you otherwise.

I am sorry to hear that you are struggling and feeling hopeless.

When medication wasn't working for my depression, we tried ECT and it brought me out of the deepest depression I ever had. Mind you, I was not functioning well (in the hospital, not showering, not eating, etc). It might be worth bringing up as a last resort option but generally it's saved for when you are no longer functioning well. There are also the memory-related side effects to consider, but when you are at rock bottom, the side effects are worth it.

I know this may sound like a trivial (or even insulting) question, but do you exercise? I find exercise helps my mood tremendously. It's pretty much a natural anti-depressant without all the side effects. I am on an anti-depressant and would venture to say that exercise has done me more good than the medication.

Are they working? I find myself constantly changing or fine-tuning core beliefs about myself, life, God, other people and whatever else.

Im sorry you are having such a tough time. Keep going. You never know what is just around the bend. I hope you start feeling better soon.

I'm also in the UK

I do, though probably not as much as I should. I walk my dog twice a day, which I used to really enjoy, but now it just gives me too much time to think. I should do more, but it takes all of my energy to get through a day at work pretending that everything's fine.

Not sure about working, but they are frequently reinforced. Apparently most people have a mixture of positive and negative beliefs and mine are all negative.

Sadly, mental health services seem to be somewhat lacking here. I am very grateful that we have an NHS, and for the help I have had so far but I had to wait for nearly a year to even be assessed by the psychological wellbeing service and then when I started CBT I was told that I had 12 sessions which made me feel even worse because there was this time pressure - and now I feel like even more of a failure because I couldn't even do the CBT properly

Feeling like more of a failure after NHS treatment is sadly all too common

My guess is that the core beliefs are not true

Never, never, never give up.

I was suicidal just a few weeks ago. Electroconvulsive therapy, meds and counseling are helping tremendously. Don't be afraid of ECT if they offer it to you. I wish I had done it sooner.

Don't ever give up. We need you here.

dont give up, i know its hard im in a similar situation sending you big hugs#

(((hugs))) from a fellow UK 'er...

Lack of decent sleep and a feeling of constant exhaustion will certainly make any depression worse.

I have similar thoughts about CBT insomuch as I feel it is very blaming, 'your thoughts are wrong, that's why you are depressed' 'if you could change your thoughts and beliefs, everything would be ok' .... er No..!
We have our core beliefs for a reason (quite often a protective factor) and no one has the right to diminish or invalidate them because they don't conform to what society deems as normal.

I too am in the UK and while like you, am glad that we have an NHS, the meagre variety of therapies available, the exceedingly long waiting lists and time limited therapy are absolutely shocking.

A lot of counsellors deal with a wide variety of issues, not just trauma. You could maybe try contacting one or two of them and asking exactly what they deal with. Another possibility is to search the Counselling Directory (just Google it), and then narrow down by area, speciality etc. Some offer lower fees or sliding scale for people on low incomes. Alternatively, MIND sometimes offer free counselling - contact your local branch.

As for feeling that you don't deserve the help because there are "others who deserve it more than you " - there is no hierarchy of need, if it's important to you, then it matters, if it's causing you problems functioning in your daily life, then you deserve to get help.

Unfortunately can relate to the issues with antidepressants and especially the side effects.
Just because you 'present well ', doesn't mean your problems are any less serious, or that you are coping any better.
I work full time and am also a carer with health issues of my own. Yes I can hold a conversation, appear well dressed, together and professional when required... But people don't see the enormous effort it takes to keep that mask in place every day. They don't see me crying my eyes out when I disappear off to the ladies, or sit in my car because I can't face an office full of people right then. They don't know how many times a day I have suicidal thoughts, they don't know the effort required just to get from one week to another.

I can't offer you any guarantees, because there are none in life. But I can offer you my support and a listening ear.

Kind thoughts
E.

Hi. I started a NHS CBT course awhile ( maybe 5 years ) ago but wasn't impressed with the therapist and we mutually ended it early. I remember it seemed to need a lot of work; activity diaries, thought diaries etc . If you've got absolutely no motivation how are you supposed to do them. Where I am in the uk there is now an online NHS course you can do and I might do that.

I also think that exercise is at least as good as medication for moderate depression. Have you got a local sports centre. If you have see if they have any special membership deals. If not consider getting a treadmill or crosstrainer and exercise while watching tv. Go for longer walks. see if there are walking groups locally. You need to force yourself past the inertia and lack of energy until the endorphins from exercising kick in and exercising becomes as much of a habit as brushing your teeth or going to work.

As always feel free to pm me.

Ok, you are asking us "when do you give up?"

If a friend or family member you felt close to asked you the same, how would you answer? That's a good guide.

Next, you said your therapist or doc said you are running out of options. Mine told me that a few years ago. So... I took it on myself to figure out how to get better.

Have there been any pieces of advice your therapist or anyone has ever given you that has been healthy and helped you? If so, continue to use it when you can.

Sunshine helps with depression. Get as much as possible.

Look online, find out what foods and vitamins you may be able to add to your diet.

Lavender essential oil has helped me with anxiety.

Simply taking a walk can help with both anxiety and depression.

Listening to calming music like nature sounds, bamboo, or classical can help both anxiety and depression because it engages the entire brain causing you to focus in on it rather than the anxiety or depression.

Other relaxation and coping techniques are helpful as well.

Journal if talking helps you bc that still gets it "out" which is what talking does.

If someone else or some event in your past causes your depression, write a letter to the person or about the event. Outline how you were before what happened, detail what happened n how you felt during it, detail how you feel now, n state what you would like to happen in order to help you "get over it".

I hope that helps.

Thank you for this. I think I am so used to just trying to get on with it and not let people see how I feel that I really struggle when I see the psychiatrist. I only see her really to try and sort out some medication that works, but I get sent copies of the letter she sends the GP after each appointment and they all start by saying that I am well dressed with no signs of self-neglect and am able to have a coherent conversation with appropriate eye contact. The problem is that I hate talking about myself and I get very anxious talking to her and I can't make her understand how bad I feel most of the time.

Thanks. I actually do a lot of walking as I walk my dog twice a day. Usually I have to force myself to do it but I have to as it is not fair to make him suffer because of me. I do feel less stressed when I am walking but then I get back home and it all just hits me again.

Thank you for your post, there is a lot in there to think about. I have to admit that this bit made me laugh - there has been a joke going round this week in the UK: I don't know why Americans are making so much fuss about the eclipse - we haven't seen the sun since June!

I'm in a similar cycle right now, awake at night, constantly napping through the day. Exercise does help me. Even the simplest things like walking in place for two or three minutes.
Don't force the CBT exercises, don't do them because "you have to." Sometimes you will feel stronger and it will be easier to pick up on the lies and re-frame them.

Lack of sun could be part of your depression actually, try Vitamin D supplements. My doc told me to do that n it helped tremendously. He knew about natural meds. That funny though about the eclipse joke

Many people often have these kinds of thoughts. You just need something that can inspire you and motivate you.

You have to communicate to your pdoc how you really feel. Tell yourself, and believe, that you cannot control what she thinks of you, and that it's not your job to, anyway. Your only reason to see your pdoc is to get the help you need from her so you can be stable and mentally healthier.