[Merlin]

My bipolar disorder has been very unstable lately and I am plagued by the thought I am a failure and feeling of shame and despair. I'm withdrew from university due to my failure and have to acknowledge that, as this is the second time I was "required to withdraw," it is unlikely I will ever be able to successful complete a degree. Until very recently I have been in a very deep depression that has impaired my ability to work; truthfully, it has impaired my ability to function at all.

I am starting to come out of the depression and function again, albeit not at my best. I had stopped taking my meds. When I get depressed, I inevitably begin to believe that either the meds will not help, I don't deserve to be well, or if my depression gets severe enough, I will be able to escape the pain by suicide. I stop seeking support from friends, family and my psychiatrist. I stop answering my phone and sometimes evening cancel plans and appointments.

I've started to recover from my depression. Episodes don't last forever, at least not for me, and I am left with regret from how I handled the most recent one, all of the ones in the past as well to be honest. I decided to see a therapist, and was lucky to get in within two days. The only negative to going through Employee and Family Assistance is that it is short term, three sessions only. I suppose I'll need to contact my psychiatrist before they are finished, although I am taking the meds he prescribed for me now.

I decided that the most important thing to talk about with the therapist is my belief that I am a failure and that I will always fail. I know that these are irrational thoughts. I have failed in the past, and I will fail in the future; but I have also succeeded. A "failure" is an idea, not an object like a table or a tree. We acknowledged that I will likely have these thoughts for the near future, if not for the rest of my life. However, the thoughts can only affect my choices and actions if I let them.

His strategy is to acknowledge the thought "I am failure," verbally if possible. Immediately following tell myself, "I am having the thought 'I am a failure.' And finally, "I am noticing I am having the thought 'I am a failure.' Distancing myself from that judgment, that label, helps to ease the unpleasant physiological symptoms. With that relief, it is easier to confront the cause of the thought than avoid it. Then I can accomplish the goals I am aiming for. My therapist asked me what I would do if I was not impaired by the thoughts and feelings. I said I wanted to find a profession I believed to be satisfying work in that field. I also want to advocate for the things I believe in. I am tired of my thoughts and feelings preventing me from accomplishing my goals.

[Rive.]

It’s really good you managed to get a T so soon & yes, please search for a longer-term prospect when/if things end with this one. Could T advise you? Maybe referral of some potentially good Ts?

I get the negative thoughts and that is what he seems to be doing i.e. have the rational 'you' question the validity of these (irrational) thoughts/beliefs.

I will gently challenge these assumptions as well (done gently, *not* to judge etc.): e.g. you say you had to withdraw from Uni but you say you are feeling better. So there is hope. Which means, you could try again at a later date. It is hard to focus on Uni when one is going through hell... So, try not to be too hard on yourself. Likewise, you saying you “will always fail” is not really validated to date. You acknowledge that you did succeed at some stuff. So, again, the future is undecided and you are not doomed to fail. Things *can* get better. But definitely, look for a T to work longer-term.