[kraken1851]

Hi everyone,

I'm currently in psychotherapy for reactive depression. I left a very stressful job in mid-2012, developed quite bad food intolerance issues following that and have been suffering from fatigue for about a year. The latter means I went from being a very active person who used to exercise a lot to couch potato pretty much. Sometimes I feel like don't have the strength to climb the stairs anymore. So for a year I've been feeling more and more depressed and desperate about my situation. The fatigue won't budge. I've had more check-ups than I can count, and although a few things have come up (nutrient deficiencies for the most part) and were addressed, I'm not doing better. I don't know how to get out of bed in the morning, I drag myself to work, and I perform poorly there.

So last fall I decided to see a therapist to help me cope, to help me find ways of accepting the situation and to stop pushing myself to go on and on and on (although my body is clearly telling me it can't perform on the level I want it to anymore).
I like my T and I think we're on the right track. He has helped me understand a lot of things - the mechanisms kicking in when I keep pushing myself and possible reasons behind this. I think we have peeled away some "layers" there, and for a while I felt like I was able to deal with my situation. But for a few weeks now, things have really been going downhill. The fatigue seems to be getting worse and so does my depression. I think about suicide so much. I'm not at a point where I would act on these thoughts, but they use up so much energy regardless. I "confessed" this to T in the session before last, so he knows what's going on with me. He was good about it and supportive, and the session was very helpful, but I'm so uncertain as to where I am going from there.

My feeling is that things are moving too slowly - this partly has to do with the frequency of sessions I think (I have a session every two weeks, sometimes every week - it's difficult because of my work). And by too slowly I mean I don't know how much longer I can hang in there. We have started talking about me going to a psychosomatic clinic. The thing is, I'm so scared of this (partly because I know they won't be able to accommodate my food intolerances, partly because I'm worried I'll lose my job, which I love). So my dilemma is, I feel like the clinic might be my only option I have, but I'm too scared of it to even consider it. I don't know what to do and I'm also not sure where therapy is or should be moving.

Sorry for this wall of text and the jumbled thoughts. Not sure I'm making sense , but any ideas or suggestions you have are highly welcomed.

[Leah123]

I suggest you do need more support but definitely recommend more therapy sessions before doing something drastic that would cost you your job.

Therapy every two weeks is very very difficult.

Can you try two sessions per week for a while?

That might seem hard to manage with your job, and expensive, but if the alternative is some sort of inpatient program, wouldn't two sessions a week have less consequences?

[Leah123]

As far as where therapy is going, sounds like you need the focus to be on coping strategies, distress tolerance, etc. if it's not already. If you had two sessions a week, one of them could focus on traditional emoting and receiving support, just being able to express yourself, discussing what pains you, and the other one could focus on concrete skills and planning to help you manage during this difficult period.

[wing]

You might need a short-term course of anti-depressants too.

[peaches100]

So sorry to hear you're feeling so discouraged. My thought was. . .could you possibly have a second session per week after work hours (evenings or weekends. . .or even phone sessions)? That way, you could increase the level of support you are getting without being afraid it will affect your job.

I understand somewhat the discouragement that sets in when you find you are no longer able to do and keep up with all the things you used to. Before I was struck with clinical depression, I had much more energy than I do now. Even with anti-D's and therapy, I have never bounced back fully. I've had to accept that while I've definitely improved and am coping much better, my physical health just isn't what it used to be. I don't have as much stamina, I don't cope as well with stress, I need more rest and sleep. But as they say, "it is what it is."

I'm glad you were honest with your t about your sui feelings. Let her know you need more support than you currently have. If you aren't on any meds, have an evaluation with a psychiatrist to see if that is necessary. Remember too, you can come here for support.

By all means, hang in there! You are not alone!

[HazelGirl]

Have you had your thyroid checked? If not recently, I highly recommend getting it checked again.

[kraken1851]

Thanks for all your thoughts and encouragement

Originally Posted by Leah123

I suggest you do need more support but definitely recommend more therapy sessions before doing something drastic that would cost you your job.

Therapy every two weeks is very very difficult.

Can you try two sessions per week for a while?

I think two sessions per week will not be possible, but I will try and make it one session per week. Part of me is worried how T will react, I have a very strong fear of being rejected and left alone. I don't think this is likely, but then fears aren't rational.

Originally Posted by wing

You might need a short-term course of anti-depressants too.

Meds is another of my issues I suffer from a condition that means my body doesn't detox and I have really strong and often quite bad reactions to any meds. I've had one bad experience with an anti-d. and want to avoid this if at all possible. But I will consider them if things don't improve.

Originally Posted by peaches100

I understand somewhat the discouragement that sets in when you find you are no longer able to do and keep up with all the things you used to. Before I was struck with clinical depression, I had much more energy than I do now. Even with anti-D's and therapy, I have never bounced back fully. I've had to accept that while I've definitely improved and am coping much better, my physical health just isn't what it used to be. I don't have as much stamina, I don't cope as well with stress, I need more rest and sleep. But as they say, "it is what it is."

Thank you peaches100 - I'm sorry that your physical health isn't what it used to be either. I find it so hard to accept, especially since the cycling was such a big part of our (i.e. my husband's and mine) life.

Originally Posted by HazelGirl

Have you had your thyroid checked? If not recently, I highly recommend getting it checked again.

Thank you, yes I have. I have hypothyroidism (it's also not 100% certain that I don't have hashimoto's, I need to have this checked again). Some things have improved slightly since I've started substituting levothyroxin, but it wasn't the breakthrough.

Thank you again everyone. I think what I'll do for the next session with my t is trying to address session frequency. I hope that's a first step I can manage. Although even this scares me .

[HazelGirl]

Could you have it retested and increase your levothyroxin? I know that's not the only cause, but the way you describe your symptoms point to an out of whack thyroid.

[kraken1851]

I tried to increase earlier this year and it didn't work out. I went back to my last dosage but have an appointment to have an ultrasound made and blood works done. The appointment is in mid-July, so it'll be a while before I know what's going on, but this is the soonest they could offer me.

[HazelGirl]

Originally Posted by kraken1851

I tried to increase earlier this year and it didn't work out. I went back to my last dosage but have an appointment to have an ultrasound made and blood works done. The appointment is in mid-July, so it'll be a while before I know what's going on, but this is the soonest they could offer me.

I am sorry about the long wait. That has to be really hard.

[kraken1851]

Thanks, it's OK. I'm getting used to waiting .

[Leah123]

Why can't you do two sessions a week? It does seem like a cheaper, easier alternative to putting yourself in a clinic and losing your job? Just curious because it sounds like you really need the support.

[kraken1851]

Originally Posted by Leah123

Why can't you do two sessions a week? It does seem like a cheaper, easier alternative to putting yourself in a clinic and losing your job? Just curious because it sounds like you really need the support.

It's a good question and I started thinking about this. So my first response was: it's never going to work with my work schedule and T's (he works in some kind of clinic two half days per week). T works close to where I live, which is not close to where I work, so having a session means I have to leave early.

But the real problem seems to be that I feel I can't ask for more sessions, for fear of rejection but also for fear of making myself (even more) dependent on T. So now I'm assuming there are some transference issues are at work here as well. In "real life" I often feel this way when there is some sort of perceived power imbalance (which may not in fact exist). I'll have to discuss this with him in the next session. So thanks for making me realize I need to address this . I suppose I knew this was an issue before, but I didn't see it as clearly.