[objectclient]

It's been 6 months since I was last in therapy. On leaving (which was my choice but not on my terms), I was advised by my therapist to see how life goes without therapy as I seemed to be over analyzing myself and focusing on therapy too much. She also said I'd been in therapy quite a while (4.5 years by that point with various therapists, 6 months with that therapist) and it would be an idea to take a break from it.

6 months later, my symptoms still persist and are starting to worsen recently. I struggle to manage my feelings and understand what they mean (though I am much better at it than I was pre-therapy!), every day is a struggle, I enjoy nothing, I get anxious for no apparent reason and I struggle to know who I am. I also don't find anything meaningful or have any sense of purpose, even though I work. I spend a lot of time with family, though I wouldn't describe my relationship with any of them as being close or healthy, I have no friends, I'm not in a relationship and I don't have any hobbies anymore due to lack of enjoyment of them. In fact, I'm not passionate or enthusiastic about anything anymore.

When I saw a mental health nurse this week and described my symptoms, putting forward my argument that I think I require further therapy, I was advised against it as it is a case of depending on someone else to help me manage whereas I can apparently do that for myself.

In the last 6 months, I have done everything I possibly can to help myself, eating a healthy diet, taking my prescribed medication, volunteering, practicing strategies to help manage my emotions like breathing exercises, mindfulness, rationalizing thoughts etc. I cannot go on living this way. I need therapy. It's the only thing that has helped me make progress but now I am left doubting the whole idea of therapy. I don't know where to go from here. I get that it's not good to have a dependent relationship in therapy and that it should be about the therapist helping the client to become independent. I also am aware that I am prone to dependency and attachment to authority figures which affects me in more than one area of my life and this is something I want to change. I thought therapy was the place to do this work.

[lucozader]

It sounds to me like further therapy is definitely something you could benefit from at the moment. The mental health nurse's response to you seems odd... is it a case of an oversubscribed waiting list, so that only those who are in absolute crisis can access help? I don't know where you are in the world but certainly that seems to be the case with the NHS in the UK at the moment. She might have to discourage people from seeking therapy because there just isn't enough access to it...

Are there other ways in which you might be able to access therapy? Could you perhaps seek out a therapist in private practice and finance it yourself?

Sorry you're having such a difficult time at the moment, I hope things work out for you and that you get the help you need.

[BudFox]

Originally Posted by objectclient

taking my prescribed medication

Part of the problem? It's what jumped out at me.

The nurse's response seems like a throwaway statement.

[AllHeart]

Originally Posted by objectclient

I cannot go on living this way. I need therapy.

Seems pretty clear to me you know what you need. Maybe tell any new potential therapist outright that you tend to get caught in over analyzing and focusing too much on therapy and see what they have to offer to you? Just don't deprive yourself of therapy since you know you need it.

Just wanna throw this out there quick - have you had your nutrients/vitamin levels checked at all? Deficient levels of Vitamin D, B12, magnesium, etc. can be playing a role in your inability to stop struggling. So can high levels of cortisol (from chronic stress/PTSD), or, low levels of dopamine.

[unaluna]

Well dont get into another breeding witches coven like the last one! how about a nice man, do you talk to men? Where do you find your ts? That seems to be part of the problem here. Is there a university nearby? I am seeing a child psychologist with a college major in philosophy - he understands attachment AND existentialism. What would you want in your perfect t?

[CantExplain]

Originally Posted by objectclient

When I saw a mental health nurse this week and described my symptoms, putting forward my argument that I think I require further therapy, I was advised against it as it is a case of depending on someone else to help me manage whereas I can apparently do that for myself.

This is a strange and unconvincing recommendation.

[satsuma]

I think a T can give recommendations of what they think would be best, but in the end you are in charge of the decisions on your life. Also it sounds like you have tried out not doing therapy before coming to this conclusion.
Getting access to therapy through a Public Health Service is a different question though, as Lucozader said.

[objectclient]

Originally Posted by lucozader

It sounds to me like further therapy is definitely something you could benefit from at the moment. The mental health nurse's response to you seems odd... is it a case of an oversubscribed waiting list, so that only those who are in absolute crisis can access help? I don't know where you are in the world but certainly that seems to be the case with the NHS in the UK at the moment. She might have to discourage people from seeking therapy because there just isn't enough access to it...

Are there other ways in which you might be able to access therapy? Could you perhaps seek out a therapist in private practice and finance it yourself?

Sorry you're having such a difficult time at the moment, I hope things work out for you and that you get the help you need.

I don't like to say my location as I'm afraid of being identified but I can say that I am unable to finance private therapy myself. There are other options but due to my financial circumstances, they are limited and might not be the right treatment or for the duration I need. Without a diagnosis, it seems harder to access treatment here.

Originally Posted by BudFox

Part of the problem? It's what jumped out at me.

The nurse's response seems like a throwaway statement.

That's an interesting perception...so do you mean to say that the medication may be contributing to my symptoms??? If so, I understand where you're coming from. Against medical advice, I decided to ween myself off of one of my regular meds last year because of the side effects. The withdrawal symptoms were terrible but my doctor was adamant that I must have a virus, it couldn't possibly be the meds but once I got through that stage, I realized that there was no change whatsoever with regards to my mental health and it's been that way ever since, which is getting on for a year now. The meds were making no difference! And I had been on the max dosage as well!

Originally Posted by AllHeart

Seems pretty clear to me you know what you need. Maybe tell any new potential therapist outright that you tend to get caught in over analyzing and focusing too much on therapy and see what they have to offer to you? Just don't deprive yourself of therapy since you know you need it.

Just wanna throw this out there quick - have you had your nutrients/vitamin levels checked at all? Deficient levels of Vitamin D, B12, magnesium, etc. can be playing a role in your inability to stop struggling. So can high levels of cortisol (from chronic stress/PTSD), or, low levels of dopamine.

I haven't had my vitamin levels checked at all. It's not a routine practice over here for doctors to consider before prescribing meds. I would love to know but I wouldn't be able to get the doc to do it.

Originally Posted by unaluna

Well dont get into another breeding witches coven like the last one! how about a nice man, do you talk to men? Where do you find your ts? That seems to be part of the problem here. Is there a university nearby? I am seeing a child psychologist with a college major in philosophy - he understands attachment AND existentialism. What would you want in your perfect t?

I have never had a male T before, only male psychiatrists and mental health nurses (including the one who advised me not to seek further therapy!) I don't know how I feel about having a male T...I would give it a chance but my experience of men in the mental health profession so far leads me to feel that they are lacking something...I find it difficult to feel a connection I find my the best Ts I've had have been through college and private practice and the worst through the health service over here. That is probably why I am getting a bad experience.

Originally Posted by CantExplain

This is a strange and unconvincing recommendation.

Glad to hear I'm not the only one who thinks so!

Originally Posted by satsuma

I think a T can give recommendations of what they think would be best, but in the end you are in charge of the decisions on your life. Also it sounds like you have tried out not doing therapy before coming to this conclusion.
Getting access to therapy through a Public Health Service is a different question though, as Lucozader said.

I think that mental health professionals within my health service make me doubt my own judgement because they are the so-called "experts". Outside of the health service, I have never had this experience...strange

MH people are wrong a lot!

Five different nurses or doctors could give 5 different opinions as to what they recommend. Can you get a second opinion? The nurse you spoke to had just one opinion-he could be wrong or overly biased. Personally, I've found find that my psychiatrists are usually in agreement with my own personal assessment as opposed to other MH people such as my therapist, but I've been fortunate to have open minded MDs over the past few years.

Allheart had a good idea, about getting checked for medical problems.

I just wanted to say that some of the things you mentioned here really, really stand out as clinical aspects of depression as opposed to emotional aspects:

I'm not passionate or enthusiastic about anything anymore.

I'm not in a relationship and I don't have any hobbies anymore due to lack of enjoyment of them

I enjoy nothing

I think therapy is the best way to improve relational issues, but I don't think it really 'cures' depression of this sort, especially when it's chronic-years gone by. If it were me, I'd try another antidepressant or combo (like adding Wellbutrin). I, too, have gotten worse from anti depressants and so I've tried to avoid them for the most part. Your doctor attributing your reaction to a virus sounds like a nightmare, but really, it is true the longer you go, the harder it is to treat.

In the clinical world, I think people who take medications are shown to have similar depression remission rates as those who are not treated at all. But if time doesn't cure, I think the longer you go without remissions, the more cumulative your symptoms become.

Clinical depression can mess up your reward system in your brain. Not having pleasure in things goes hand in hand with not being motivated to do things, such as be in relationships and make new friends as pleasure is what triggers your brain to be motivated. I consider those 2 to be to ends of the same thing. Even if you feel you want to do things, the switch in your brain that allows you to get up and go do something is broken.

I've been in long-term, depth therapy for almost 7 consecutive years, but it wasn't until I did TMS (a magnetic brain stimulation treatment) recently that my motivation and enjoyment came back. I am so much more the person I was years ago, before the depression came. And I have PTSD too, but that is not as bad as the clinical symptoms, although it waxes and wantes.

The main symptoms I had-lack of motivation/not experiencing pleasure caused immense anxiety as everything in my life piled up and not being able to do daily tasks. This really impacted my self esteem as I have been in a state of 'not being able to do x, y, x', which brought feelings of helplessness daily. My concentration problems ruined my self-esteem too, as I lost my ability to speak articulately and to do other than average or sub-par work, also resulting in career failures when I was entering a new field. The fatigue and lack of sleep left me feeling like I had brain damage, which left me without the physical capacity to do 'normal' everyday things. And this led for me to lose many of my friends and avoid romantic relationships and things I enjoy, like travel and reading. It also led to underemployment, which helped crush my self-esteem. I could go on and on. I mean, all this stuff went on for years and it really changed who I was.

But now that the physical component of depression was treated successfully, which fixed the fatigue/motivation/ability for pleasure, all the other stuff is improving on it's own. I feel pleasure at simple things, like music, again, which erased the hopeless feelings. And my reward system is 'fixed', which made the helpless feelings vanish. My sleep improved. My motivation came back, and I am doing stuff like putting up the hooks in my closet that have been sitting in the hardware store bag in the corner for over 8 months. Feeling like volunteering and dating again. Improving my job outcomes which is already leading to increased responsibility and better assignments. etc. The successes are cumulative as well.

Just saying, for you or anyone, consider all the possibilities, don't put all your eggs in one basket (therapy). Even my therapist of 3+ years thought my problems seemed to be more emotional than they were physical, and he has 40 years of experience. (But I have huge attachment issues too so that skews things when I have an intense attachment with him that he experiences on a weekly basis).

Those clinical aspects of depression can really change you though, so I'm just putting another view out there.

Why can't you get a diagnosis?

[chihirochild]

Yeah I agree with the folks who are saying that second opinion might be helpful. There's a saying that if you submit the same question to 10 psychiatrist, you'll get 12 different opinions...

And testing your vitamin levels (and your TSH/T4 etc.) certainly wouldn't hurt; any GP/primary care doctor should be able to order those tests for you.

I really, really agree with Skies. Experienced the same thing earlier in my life and it impacted everything and caused a lot of destruction. I will add that the impairment in reward system functioning can easily lead to seeking out and clinging to very unhealthy things, sometimes obsessively and desperately, as an attempt to still find the motivation/momentary pleasure - in my case it was substance abuse, among other things, which just made everything much worse in turn.

I don't view the emotional and clinical aspects of depression as separate, emotional dysregulation is pretty much an organic thing, not something mysterious. But it's a broad spectrum and can be progressive both in the good and bad sense.

I also relate to Skies' experience that therapy alone did not make huge difference for me. It was almost always an interesting intellectual endeavor but sometimes actually distracting when it took too much space in my mind. What therapy could achieve was small changes, often unexpected ones, to increase my motivation and discipline to address my issues in a more holistic way. It took me some pretty dramatic lifestyle changes, sometimes in spite of not having any motivation, with a leap of faith that things will improve on the go. And that's exactly what happened: it took quite a bit of time sticking with the effort before I felt any significant improvement. There are now so many different treatment possibilities, I agree that therapy is only one, often not the most effective, but it can boost the efficacy of a complex regimen. What I do not think good is to cling to one single thing too excessively and expect it to change the entire world - that is rarely the case with mental health problems in the long run.

[AllHeart]

Originally Posted by objectclient

I haven't had my vitamin levels checked at all. It's not a routine practice over here for doctors to consider before prescribing meds. I would love to know but I wouldn't be able to get the doc to do it.

It's bloodwork testing done by your general practitioner. It doesn't seem to be routine here in the US either. Typically the patient has to make the request.

[velcro003]

Originally Posted by AllHeart

It's bloodwork testing done by your general practitioner. It doesn't seem to be routine here in the US either. Typically the patient has to make the request.

my doctor regularly does bloodwork tests for me, does vitamin count come as a normal panel doctor's do?

[AllHeart]

Originally Posted by velcro003

my doctor regularly does bloodwork tests for me, does vitamin count come as a normal panel doctor's do?

It doesn't in mine. I had to ask specifically for Vit d, b, magnesium, iron, etc.

[velcro003]

Originally Posted by AllHeart

It doesn't in mine. I had to ask specifically for Vit d, b, magnesium, iron, etc.

good to know, i may ask next time.

[BudFox]

Originally Posted by objectclient

That's an interesting perception...so do you mean to say that the medication may be contributing to my symptoms??? If so, I understand where you're coming from. Against medical advice, I decided to ween myself off of one of my regular meds last year because of the side effects. The withdrawal symptoms were terrible but my doctor was adamant that I must have a virus, it couldn't possibly be the meds but once I got through that stage, I realized that there was no change whatsoever with regards to my mental health and it's been that way ever since, which is getting on for a year now. The meds were making no difference! And I had been on the max dosage as well!

Medication contributing to symptoms... oh god yes, if not causing them directly. Iatrogenic illness due to psych med-induced toxicity and pathology is apparently an epidemic. I don't know your history, just the general state of affairs.

People with many symptoms and afflictions need real and comprehensive help. Pharmacological psychiatry solves nothing. Their drugs treat no known disease. They create abnormality in the brain and in the gut and other organs and disrupt normal functioning and homeostasis, that's what they do.

I found therapy palliative (but highly addictive) at best and damaging at worst.

Standard GP lab testing is not comprehensive care either. Could be useful, but most of them are too ignorant to even know the right way to test for nutrient deficiencies or thyroid problems or other conditions.

I believe part of getting well is walking away from mainstream healthcare and never looking back. Get off the poisonous drugs, get away from their bats**t crazy advice, their invasive procedures, their circa 1950s diet ideas, etc.

Seems to me the challenge with depression, etc is to investigate possible physiological and environmental factors using modern methods, and then not medicalize the rest. A depressed mood is not a disease (though obviously a real thing). And it cant be fixed with magic pills.

This is not advice, just my opinions, feel free to disregard.

[thesnowqueen]

"I believe part of getting well is walking away from mainstream healthcare and never looking back. Get off the poisonous drugs, get away from their bats**t crazy advice, their invasive procedures, their circa 1950s diet ideas, etc.

Seems to me the challenge with depression, etc is to investigate possible physiological and environmental factors using modern methods, and then not medicalize the rest. A depressed mood is not a disease (though obviously a real thing). "

Could you say anything more specific about what you have found to be effective? As we all know, there is plenty of alternative quackery so how does one find the valid stuff?

[Ididitmyway]

Originally Posted by thesnowqueen

"
Could you say anything more specific about what you have found to be effective? As we all know, there is plenty of alternative quackery so how does one find the valid stuff?

Sorry to interject. The question was not for me, but I thought I could share how I found some bits and pieces of valid stuff in the area of alternative medicine since you are absolutely right, there is just as much alternative quackery as there is traditional.

My answer is simple. I do extensive research, I educate myself on various alternative practices, I use my intuition, which I have grown to trust over the years, I allow myself to experiment with things at home if I believe the risk of harming myself is very low, I see alternative practitioners from time to time after researching them thoroughly and looking through their patients reviews, and, just like with therapists or traditional MDs, I always put myself in the driver's seat and don't allow their "expert" opinion to supersede my intuition and my common sense.

[CantExplain]

Prozac helped me.

[thesnowqueen]

Originally Posted by Ididitmyway

Sorry to interject. The question was not for me, but I thought I could share how I found some bits and pieces of valid stuff in the area of alternative medicine since you are absolutely right, there is just as much alternative quackery as there is traditional.

My answer is simple. I do extensive research, I educate myself on various alternative practices, I use my intuition, which I have grown to trust over the years, I allow myself to experiment with things at home if I believe the risk of harming myself is very low, I see alternative practitioners from time to time after researching them thoroughly and looking through their patients reviews, and, just like with therapists or traditional MDs, I always put myself in the driver's seat and don't allow their "expert" opinion to supersede my intuition and my common sense.

The difficulty - as I see it - is that alternative practices do not have the funding to set up large scale trials with controls, etc. I know that in the medical realm these are influenced and open to distortion by way of pharma, etc. However, I'm not sure of any other method that seems even marginally reliable.

[campervanman]

Hi objectclient .

I don't` know where you are in the world friend! `BUT` if you are in the UK somewhere!
Why don't` you go to your doctors`, and ask him about TALK LIVERPOOL! (These are T`s that deal with Bereavement, mental and physical abuse) `And they are good` (Also very empathetic, as they have gone through some sort of abuse themselves`!!) Just think about it and give it a go!!

Just a thought my friend..............Take care

Originally Posted by AllHeart

It's bloodwork testing done by your general practitioner. It doesn't seem to be routine here in the US either. Typically the patient has to make the request.

Concur with this.

I've had my thyroid ridiculously checked about a dozen times, but there are a lot of things that were never checked when they should have been, and many things I know most doctors don't check, and they are supposed to rule out other causes for symptoms.

It's difficult because depression symptoms overlap with so many other things, but they don't take or have the time and don't listen. Also, I find the psychiatrist assumes the GP ruled everything out already, and the GP assumes the psychiatrist rules everything out. They just don't bother.

Years ago, I had anemia but was given antidepressants for treatment. They did not listen to me, which is consistently one of the problems I've had with getting appropriate healthcare. I kept insisting the shortness of breath was not anxiety but they did not believe me. I had other anemia symptoms too,, but diagnosis only requires a simple blood test. If you know medical terms, they often treat you like a hypochondriac.

I think not getting treated for anemia for over a year really contributed to my depression that started years ago. Being fatigued every day and not being able to do anything outside of getting through the workday, ruined my life at the time, in addition to not being believed by medical people, leading to feelings of hopelessness.

And most blood tests are cheap, so there's really no excuse. It really irks me how doctors don't want to order blood tests aside from thyroid, and instead just prescribe SSRIs.

[BudFox]

Originally Posted by thesnowqueen

Could you say anything more specific about what you have found to be effective? As we all know, there is plenty of alternative quackery so how does one find the valid stuff?

My situation is complicated, I have oppressive situational stuff and huge range of health challenges. Long, slow process. Seems like correcting sleep/wake cycle is huge. All the artificial blue light from screens, esp at night, plus lack of sunlight, is a death sentence. Addressing this has improved my sleep some, which has improved all aspects of my health.

Have heard from people who've had dramatic turnaround with psych disturbances by addressing parasites, Lyme, and other infectious disease. Also, restoring healthy gut flora can have big impact on brain function. The bugs outnumber our human cells something like 10-1. They are sort of in control.

Orthomolecular psychiatry claims large numbers of successes, even with psychosis, with targeted nutrient therapy.

Simple things like replacing all the refined carbs with healthy fats (ghee, coconut oil, fatty fish, etc) can be helpful.

I think most egregious quackery is in mainstream medicine. Any system that emphasizes synthetic drugs over basic nutrition is surely insane. As someone said, your Dr is the person in your life most likely to kill you. For me first priority is avoiding those most likely to harm -- psychiatrists, conventional dentists, conventional MDs, and I'd put therapists in there too though people need someone to talk to sometimes so what you are gonna do.

This is a bit of a digression from OP's original post, and the psychosocial stuff is a whole different thing obviously.

[BudFox]

Originally Posted by thesnowqueen

The difficulty - as I see it - is that alternative practices do not have the funding to set up large scale trials with controls, etc. I know that in the medical realm these are influenced and open to distortion by way of pharma, etc. However, I'm not sure of any other method that seems even marginally reliable.

True, and since much of mainstream published medical science is fraudulent and corrupt to the core and since drugs are mostly poison, and since many other interventions lack large-scale well designed trials, I think we have to look for other forms of evidence and other methods.

There is a big "biohacking" movement taking off. It's sort of grass roots, internet-based, crowd-sourced, personal experimentation based on existing and cutting edge science. Will likely topple the healthcare system eventually. Also some plant based medicines have been around for hundreds or thousands of years and have a lot of empirical evidence behind them, even if they are not published in top journals. Plus some herbs have been studied extensively. Functional/biological medicine is evidence-based.

There shouldn't be a need for doctors in the first place. But modern people are isolated, living indoors in toxic environments instead of outdoors, and eating fake food.

[thesnowqueen]

"This is a bit of a digression from OP's original post, and the psychosocial stuff is a whole different thing obviously."

Yes it is, so apologies to OP, and thanks for the additional info!