Or were you in the recent past?

I've been in therapy for a number of years. It helps with some areas of my life, but it's not helping with depression, which has gotten much worse. It seems like the longer i have it, the worse it gets.

I hardly read posts about depression here, so i was wondering how people are helped by therapy with depression. Depression as in clinical major depression (as opposed to being lonely, not living a full life, relational problems, social anxiety, etc, or one aspect of life. Depression as in cognitive problems, under/over eating, under/over sleeping, lack of enjoyment/interest, no motivation, hopelessness, spending hours in bed, etc.

I think some components of my depression are psychological, and i have a childhood history trauma, but i wonder sometimes how much of this is more related to physical problems such as the effect of years of stress, including hormonal imbalance. I feel like i have brain damage. Alcohol and drug addiction also runs in my family, so i think there are some physical components to that as well. Like it seems there are endorphins missing from my brain.

So, I'm trying to pull myself out of this and feel so incredibly hopeless and it's making me feel worse because i get overwhelmed and start thinking-why even try when keep failing? I am wondering how therapy helps or has helped, or even things that you have done for yourself that have pulled you out of depression.

[unaluna]

Meds help me. Deadlines help me, like "clean up your apartment or the city will evict you" - its making me move past psychological barriers, having to choose the lesser of two evils. I hate to admit it, but i am grateful i am being forced to take these actions (to get healthier, to clean the apartment). I have always been deadline driven in school and work. Not a good thing really. It helps that both my parents are dead now and nobody is moping if i do well for myself. I can clean my apartment and not anticipate criticism from the family. That its not good enough, that im not good enough.

[ruh roh]

Yes, and it's hard to pull apart how much is physiological and how much is life, because life experiences create physical changes that manifest as depression. At this point, my therapist believes I would do well to tend to both ends of it. Since I have been messed up by meds, I no longer take them. So, to ease the physical influences of depression, I go for walks, stay away from sugar, eat whole foods (no animal products for ethical reasons, but it has helped me be healthier and calmer), and take supplements. I have a b-12 deficiency (from before I went vegan), so I take supplements for that, as well as Omega 3's, D, etc.

All those things do not eradicate the depression, but my body has more energy than it used to, and that's helpful. For one thing, I'm not making it worse.

I sometimes talk about diet and nutrition in therapy. My therapist is a good sounding board and we share similar values on the diet/nutrition front.

This is a long way of saying that both approaches are important--the physical and psychological.

I also watch a lot of animal videos and can ease the depression just by watching a guinea pig eat a slice of carrot.

My therapist encourages me to find anything to do, watch or read that lifts even 2% of the heaviness. Approaching it in that small way feels less overwhelming.

That's really interesting Unaluna! Only minutes before i posted this, i was looking at an article that spoke about "catastrophe motivation" that explains exactly this.

I've always had high stress, high demanding jobs, constant deadlines and having to 'do' something, living in fight or flight. It does seem that now that my life is even keel, calm, and relatively predictable, kids are grown, less stress....i cannot get motivated. Even growing up, from the little i can remember, i was always afraid or worried because of my parents and sibling.

So I wonder if my motivation structure, as in the chemical processes, is just damaged, and if this is something that has to be fixed physically or if it something i can "will" myself to change? I've been struggling with this for too long.

[atisketatasket]

I've been diagnosed as depressed after an awful fall last year. I have medication, which has done little so far. But the big things that help me are connecting with other people (often difficult for the depressed) and exercise. For instance, I decided to stay in bed today and not exercise, which only made things worse. I've been shutting people out, which also only makes things worse.

Ruh Roh, those ideas are great!

I never thought about watching pet videos. Unfortunately, my cognitive problems prevent me from reading. I just can't focus enough to read anything but short paragraphs.

So the mental and physical combination always seems sensible to me. It's just an enormous struggle with the lack of motivation. Maybe i should try harder to focus on the small steps, like your therapist said.

I have boxes of supplements that I've tried and gave up on. But i think motivation is the worst, and feeling physically blah. You know, I did go downhill with my eating lately at about the time things got worse. My depression got so bad, then i got too tired and unmotivated to prepare healthy food, so I'd order out and get pick up food and screwed up my good habits.

I was screwed up from medications too, for several years. Now i think it may be too late. The last one caused me to gain 15 pounds in about 2 months (i just stopped taking it) and i was constantly hungry. I'm back to preparing healthier foods, but now still crave sugar and fats like when i was on the medication, as if it caused permanent damage. I don't understand, I've never had these constant cravings and have quit taking the medication.

Atisketatasket-I'm so sorry about your fall. Do you think you had traumatic brain injury?

i also tend to shut people out when I'm depressed. That is one reason i stay in therapy, to have the connection.

Exercising is one thing I really really have to revive, to make it a priority again. Like you, I didn't have luck with medications, and that is the one thing that I need to do again. But, when i was exercising a good bit every week, which ended not that long ago, i was still pretty depressed. This is because, I think, I've had depression for so long. That's what worries me. I've read that prolonged depression can make it iretractable. I don't feel i ever got the proper treatment from the beginning.

I have fibromyalgia too, or that's what my doctors said.

[awkwardlyyours]

I am really sorry to hear what you're going through ex_vivo.

I was severely depressed for more than a year before starting therapy.

My therapist didn't officially diagnose me with depression (mostly because I get the sense that she thinks it would've done more harm than good) but she did once say when I was going on about my 'deep sadness' that she thought I was depressed.

We discussed it for a bit and she suggested that given my family history and how long I'd always had this persistent sense of deep-rooted sadness / emptiness (basically all my life), she thought it was likely biological by this point.

In response, I told her that I never wanted to get on to meds (bad experience earlier) and so, she suggested something like acupuncture.

I didn't want to do that either and so, then she asked me this question which really baffled me -- what did I want to do with the depression? Did I want it to go away? Or did I want to just manage it?

She went on to explain that people can and do have different responses in how to deal with it as opposed to the straightforward one of doing whatever it takes to get rid of it.

I think for me that forced me to look at how I defined myself and what role my depression played in that -- I guess I said something to the effect that I did not want to do anything to actively make it go away (knowing how my brain works, I was sure it would backfire) but if it did disappear organically, I would be pretty pleased.

I know I was / am in a super privileged position to have been able to say something like that (as in I was functional and things were not totally out of control) and so, I don't know how much it translates outside of my experience.

A few weeks later, I honestly don't know precisely how or why it lifted but it did -- that despite the fact that materially, I ended up having a lot more stressors in the rest of my life which should've actually made me collapse pretty quickly.

So, it's not like it's completely gone but at least for now, the worst of it is gone -- I'm still not totally 'normal' but rather just 'not sad' and things seem much more manageable now.

I think a big part of how therapy helped me was that it forced me to talk about stuff that I'd never talked about -- as I did so, I realized that the depression in my case was largely a deep-rooted sense that I didn't have the right to live the life I wanted to live, have the feelings I had and so on.

This sense of not having a right to my life was so ingrained that I didn't even realize I had it until it came up again and again and again in therapy with my therapist patiently pointing it out in a dozen different ways.

Just showing up every week then to talk to someone who was trained to be empathetic -- I can't honestly say I have a great connection to my T but she's competent -- and helped me reframe my thoughts, I think made the difference in how I felt about myself.

And, so now, I can at times catch myself before I slide back down that dark and scary road.

At the same time though, I can't say I'm completely rid of the fear that it won't occur again but hopefully, I feel like I have a little more strength / resilience in me to tackle it rather than just succumb to it fully.

Not sure if this helps you at all....take care.

[Myrto]

I've been in therapy for two years now.
And I've been severely depressed for maybe 6 or 7 years.
Therapy hasn't helped with depression I'm sorry to say. It helps with other stuff, it helps me focus on the things I want to change in my life in order to achieve some semblance of happiness. Thank god I have antidepressants or I wouldn't be able to achieve anything.
So meds help.

The apathy and lack of motivation is such a downward spiral because the less you're motivated the less you'll do sth and the worse you'll feel. I've noticed that when I force myself to go outside, do some sports, run errands, anything. It gets better because it feels like I've accomplished something even if it's small;

Awkwardlyyours, thank you so much for sharing that. I'm so glad for you that the worst is gone.

Yes, i have questioned whether or not i have a secondary gain.

I didn't have the right to live the life I wanted to live, have the feelings I had and so on.

That is something i can identify with.

I think the physical overlaps so much with the emotional, it's hard to tease it out. I do have major self-worth problems, so that is something there.

what did I want to do with the depression? Did I want it to go away? Or did I want to just manage it?

I'll think about this too, and keep talking about it with my therapist. I think one problem is that my therapist and i have been in a long rupture, like several months long. It seems over now, so maybe i can focus more on this rather than our relationship. Thankfully he stood by me, and even told me where he was wrong in some regards. This is the 2nd time we had a major rupture. After the first one was solved, things got much better for me.

Thanks for all of the responses. It's encouraging to hear your strategies and stories.

[unaluna]

Ex vivo - thx for this. Yeah cuz i recently told my t that my stress button is broken. You can keep pressing it and pushing it, but nothing happens anymore.

Myrto-really glad to hear that medications have helped you. They helped me years ago, but no longer now that the depression is so prolonged. I sometimes wonder if they have contributed to the damage for a mere short-term gain.

The apathy and lack of motivation is such a downward spiral because the less you're motivated the less you'll do sth and the worse you'll feel. I've noticed that when I force myself to go outside, do some sports, run errands, anything. It egts better because it feels like I've accomplished something even if it's small;

Yes, that is so true. This is what i struggle with now. I read before that your motivation muscle can decline, but that it can be strengthened again. It's hard for me to believe, but maybe it is true. I think i run in to problems when i set out to do something like you mentioned, such as go to the gym, then i end up not doing it. As a result, i feel worse. Now it has spiraled-several months of not doing these 'little' daily things. So it all spiraled into how badly i feel now. It didn't help that my therapist and i were in that rupture. Perhaps things will go uphill from here.

It's also really interesting to hear your responses. For the therapy forum, people don't say much about clinical depression overall.

[atisketatasket]

Originally Posted by ex vivo

Atisketatasket-I'm so sorry about your fall. Do you think you had traumatic brain injury?

I didn't have a brain injury, though I lost my oxygen supply briefly during a surgery gone wrong,

By the way, there is a Depression forum on PsychCentral too, which has a subforum about Depression Success Stories that you might find useful.

Sorry to hear about your surgery.

I'm going to look at the depression success stories too. I'm interested in the therapy component of depression treatment, as most elsewhere on the forum do not mention therapy.

________________________________

One thing is clear to me, that i just thought of after reading all the responses. I once had confidence and self-worth, but when i got the depression, my confidence and self-worth somehow declined really badly. I think because the cognitive problems greatly impacted my career and i ended up being in a job for which i was overqualified and my salary was less than it was many years before that point.

I used to always excel at everything academically and at work, but when depression hit, i could not read, focus, or concentrate. I had memory problems, especially short-term and really struggled with work. I brought it up to my doctors, and they kept giving me antidepressants that made things worse. I was also told by doctors that i was getting older. (WTF-i was only in my 30s!) A psychiatrist did give me ADD medications at one point, they helped much more than the antidepressants, but they just fizzled out and stopped working.

So it had a domino effect. I didn't realize how much this impacted me at the time, but it's like years of confidence were zapped by the depression. Oh, and i really value a good internist. Mine left when she went to another practice, and there is no one helping me in that area. Western medicine isn't good for this type of thing, and no longer have anyone helping me in that area.

[Chummy]

I have/had severe depression. From the end of 2013 until October 2015 it was really really bad. I didn't went back in therapy until the start of 2015.
Before that I've also had periods of depression, but not as bad as it is now.

What helped me was medication. It took about 10-12 months to find the right med combination. It made me feel a little less low. SI thoughts became much less. This helped me to focuss more on my therapy. I was convinced it was all hopeless and useless. But because I didn't feel so low anymore, I started to think that maybe things could be better and I could be helped.
In my therapy I've done some EMDR sessions. We talk, we do CBT, I have a workbook to help me improve my self-esteem.

I'm still not happy. I wonder if I'll ever be happy. Or just glad to be on this world.

Thanks Chummy. Sorry about your struggles.

From what i understand, happiness isn't an end point, it has to be incorporated into your day-to-day life. So if you make your expectations low, it might not feel so bad?

I'm at the point where i don't care about happy at all. I just want to be able to do what the average person does (or can do)-open mail, tend to personal tasks, read a book, don't isolate/keep in touch with family and friends, wake up from sleep feeling like i slept, etc. Simple things.

That's another thing that seemed to impact my self-esteem. My social life really declined, i lost friends from isolating from the depression for so long. Year after year, i turned invites down. Now i am alone a lot, and it feels like i am an 'outsider'. In the rare event i go to a social occasion, i feel alone yet surrounded by people.

Real glad that medications worked out for you. Were the antidepressants, or did you have undiagnosed bipolar or something else?

[ScarletPimpernel]

I have suffered from depression since I was a teen. Recently, I have found myself in a different type of depression for me. Normally, I suffer from atypical depression and the episodes last about 5-14 days. Right now my depression is melancholic and I've had it for 3 months. It's not fun. I'm really struggling with the hypersomnia. I can barely muster energy to do anything. Showering is even difficult. I'm falling asleep on the drive home from my T or Pdoc. I'm just so tired.

Normally, medication helps me. I'm usually very stable on my meds. It has even, basically eliminated my SUI and SI thoughts. My art has also helped me a lot.

Right now my T has me doing basics. My hw is to spend 10mins a day doing something out of bed which doesn't include TV. So it could be a shower, cleaning, sitting outside in the sun, going for a walk, art, etc. My Pdoc wants me to sit outside in the sun for an hour everyday... T reduced it for right now to once a week for 10mins.

[with or without you]

I am. (Various thoughts):

I've been going through a tough time for the last 2 months. I had been doing well since a radical med change I made in the fall (dropped everything and switched to a MAOI). But the dose I was on was too activating, and by the beginning of December I got insomnia that raged on for 2 months. And the insomnia made me depressed all over again. Since I am depressed again, it makes me not very receptive to any suggestions or advice on how to make myself feel better. When medication is able to "crack the door" just a nudge, only then am I more willing to try things.

I have had more difficulty doing everyday tasks more than ever before. Since this is the therapy forum, I actually showed my T a photo on my phone of the current state of my living room. I had told her many, many times what a wreck my place was - and she believed me - but I felt it was time for her to actually see it. She said after seeing the picture that she was truly able to see what I was struggling with so much. "I see you have to make a path to sit down, that must be so frustrating."

About a month ago, I threatened to quit therapy the same day of the session because I had just had it - my mantra was "I don't care anymore." I just felt so defeated and like my depression wasn't even an illness on its own...rather, I felt like it had become my personality. She got harsh with me and raised her voice a little bit towards the end, but she wasn't yelling at me. "DON'T do this to yourself. You've had too many unsatisfactory endings in your life. If you want to leave therapy, of course that is your decision, but we need to discuss it over several sessions." I decided not to leave ultimately.

I seem to get the most benefits from a therapist who works with a psychodynamic orientation rather than CBT. I am quite a complicated person (but aren't we all?) with a rather unusual life story, so there's much more going on there than some sort of situational depression. Events that happened over 25 years ago are still behind the steering wheel of my life.

Sent from my iPhone using Tapatalk

Originally Posted by ex vivo

Or were you in the recent past?

I've been in therapy for a number of years. It helps with some areas of my life, but it's not helping with depression, which has gotten much worse. It seems like the longer i have it, the worse it gets.

I hardly read posts about depression here, so i was wondering how people are helped by therapy with depression. Depression as in clinical major depression (as opposed to being lonely, not living a full life, relational problems, social anxiety, etc, or one aspect of life. Depression as in cognitive problems, under/over eating, under/over sleeping, lack of enjoyment/interest, no motivation, hopelessness, spending hours in bed, etc.

I think some components of my depression are psychological, and i have a childhood history trauma, but i wonder sometimes how much of this is more related to physical problems such as the effect of years of stress, including hormonal imbalance. I feel like i have brain damage. Alcohol and drug addiction also runs in my family, so i think there are some physical components to that as well. Like it seems there are endorphins missing from my brain.

So, I'm trying to pull myself out of this and feel so incredibly hopeless and it's making me feel worse because i get overwhelmed and start thinking-why even try when keep failing? I am wondering how therapy helps or has helped, or even things that you have done for yourself that have pulled you out of depression.

I could have written your post. I was hospilised for my depression in the past. Several od's on top of that.
I think therapy is what I hold onto. It keeps me from going under.
It's not always bad, though therapy has help je grow stronger inside I probably can tolerate some of the depression now.
I'm not sure it will ever go.
Like you my mother was an addiction and used whilst pregnant. Adoptive mother was abusive. Plus other traumas in my childhood, I guess the question is.....why wouldn't I feel like this given the equations

[Duckling000]

Thanks for this thread. I've been treated for moderate/severe depression for the past two years and seen three Ts in that time. Two of the three have helped, but in both cases it's been a fairly slow burn. I've managed to turn things around due to a mixture of meds (firstly citalopram, then when that stopped working, sertraline), running, better diet, omega 3 and vitamin d pills, supportive friends and boyfriend, and therapy.

I couldn't honestly tell you how much of a role therapy has played, all I know is that when I was seeing the second (ineffectual) T, I was severely depressed and felt I was getting worse not better. I went back to my GP and she was very firm that if it wasn't working at all, I needed to change.

For me, the thing that makes it helpful depression-wise is having a place to be heard, to talk about the things I had repressed and not spoken of in many years and to feel free to say exactly how I feel without fear of upsetting the other person - ie suicidal thoughts. I wish you the best of luck and hope that you can find peace from your depression, whether it's from therapy or in other ways. Keep trying, what works for some people won't work for everyone.

[PinkFlamingo99]

I, like you, have suffered from severe "treatment-resistant" depression for as long as I can remember.

I had also given up on meds ever helping. A little over a year ago I was referred up to a specialized clinic in outpatient psychiatry at the local looney bin. Something had happened (a really bad, unethical therapy relationship actually), I aldo had just had gastric bypass surgery and lied (I admit it) about my mental health in order for them to do it, and then 2 gallbladder surgeries, a painful ending to a job I'd worked at part time for a long time (grad student), and my depression/self harm tendencies had gotten so bad that I ended up there, which (embarrassingly) is where the worst cases end up. Anyway, the first positive thing in all this was finding a really smart, competent pdoc, also trained in psych pharmacology.

At this point I figured I had tried everything in the universe medication wise and decided antidepressants were just placebos. But I agreed to try again, expecting him to haul out one of the few SSRIs I hadn't been on. Instead I ended up on Parnate (an MAOI, like mentioned above). As badly as I am still doing, I don't think I would have survived without the Parnate.

Have you tried anything luke this? I know MAOIs tend to be the final thing pdocs will try because they have dangerous food interactions and side effects (even after a year, I get very dizzy when I stand up quite often). I don't mind these, although most people do. But have you ever tried anything like a tricyclic (Amitriptyline?), or something like Abilify? SSRIs did absolutely nothing for me in the almost 15 yrs I was on them (I'm 33, so my entire adult life).

Another thing that really did help was finding a therapist willing to work very slowly from the "bottom up." We made an eating plan and schedule, a list of cleaning stuff to do, daily tasks (dishes, etc), and she helped me learn to forgive myself for getting that way in the first place. Deptession and guilt really go hand in hand, the way we speak to ourselves.