Excuse me for diving into something a little heavy for a Monday morning, but it’s on my mind and I want to talk to you all about it. Therapy. Counselling. Psychotherapy.
Being open about my own journey in and out of Depressionville has had many benefits, and one of those is the privilege of having others share their own story with me, both in my private life, and online. It’s not easy for most of us to talk about our dark places, our traumas, our struggles, our pain, and when someone does open up to you, it’s a humbling experience, and one that you both benefit from. One of the truly frightening things about mental illness is how isolating it is. You get cut off from the world, and your mind tricks you into thinking that no one else is going or has gone through what you are. That breeds desperation, hopelessness, and adds distress on top of distress. When we are able to talk, to share our experiences, it lifts that burden of aloneness off our chests. We feel less broken, less freakish.
This is why it is so important to be as open as you can about depression and other mental illnesses. Together we can lift that burden, and clear the fear and ignorance and stigma away.
I’m going to continue to push for that, at every opportunity, with every person I can. I hope you will too. But I’m digressing from my main topic.
Something that I keep coming across in my fellow depression sufferers is a deep fear of therapy, and I want to address that. It seems to be a common theme for those of us with depression/anxiety issues, and it’s very understandable, so if you identify yourself with this situation, please don’t feel picked on or criticised. I have been where you are. Which is why I want to help.
Every person has the right to make their own choices about treatment, whatever the illness, and as with most illnesses, there are a number of treatment routes you can go down with mental health issues. Of course, “mental heath issues” covers a pretty broad spectrum, and I am by no means an expert. So let’s just focus on clinical depression for now, since that’s where I have first-hand experience. (But bearing in mind that this information will also apply in principle to most other mental health issues, such as anxiety, phobias, OCD, eating disorders, etc etc, all of which have common factors that tie them together.)
There is a complex path that brings us to depression, a combination of biochemistry, life experiences, personality, genetics, and other factors. Both the body (physical) and the mind (psychological) are involved and affected. This means that successful treatment of clinical depression (and by successful, I mean remission from depression, and prevention of recurrence) has to tackle it from two angles – biochemical and psychological. We are fortunate to live in a time when there is a range of very effective antidepressants available to us, and that is usually the first step in any treatment programme – finding a medication that works for you, and getting your symptoms stabilised on it. Ideally, this gets you to the point where you are able to take the next step towards full recovery – tackling the psychological side of the issue.
This is MUCH easier said than done. Nobody ends up in a state of clinical depression from a blissful life – whatever our present, there are painful spots in our past that have brought us to where we are. For some that pain is so profound, so terrifying, that they have spent their whole lives constructing a watertight wall around it, shutting it in, closing down, and fighting off anything that reminds them of that pain. Their ability to cope with life is precariously balanced on that knife edge of denial and deliberate forgetfulness. Asking them to go into therapy and open up that pain is like asking them to press the self destruct button – and that at a time when they are at their most fragile, most broken. They have just clawed back an inch or two from the edge of the precipice, and now you want them to jump right down into it………………. ARE YOU CRAZY??????
My friends, I have been there. I understand. I get it. I went into therapy and back out of it, and back into it, and back out of it, because I couldn’t face those demons. I didn’t resist it outwardly (because I was afraid that if I said no to any help, I might not get the help I needed when I needed it), but I resisted inwardly. It took three lots of therapy, and a very talented, very perceptive therapist, to break those walls down. I learned so much.
One of the most valuable things I learned is this. Our pain, our fears, our distress, our hidden horror stories, the things that keep us bound up and locked away, these are usually things that relate to our childhood, to times when we were vulnerable and unable to deal with issues and unable to protect ourselves. When we shut that bit of ourselves down, it becomes frozen in time. When you tentatively approach those memories, and then shy away in fear or pain, it’s because that bit of you is still that child emotionally. You still feel vulnerable and unable to deal and unprotected. But you’re not. Really. Truly. You have the strength in you to be able to take that child by the hand, metaphorically, and lead it out of that dark place. You, and your therapist. Don’t you want to do that??
The other thing I learned is that most of us have serious trust issues. Especially for those who have had their trust betrayed and damaged at the deepest level, by those they should have been able to trust above all others. This turns us into control freaks, hanging on for grim death to our issues and way of seeing the world. We barely trust ourselves, we definitely don’t trust anyone else. This makes it incredibly hard to let go, to put yourself in the hands of someone else, to open up those locked doors and explore the dark places. There is no easy way around this. Because trust grows very very slowly. You won’t walk into a therapist’s office and immediately trust them. It takes weeks, months, maybe even years. But there are two good places you can start:
1. Trust your friends, who have been where you are, and come through. Trust them when they tell you that this is the best route out of your darkness. Trust them when they assure you that you will survive this, that you can become happier, more at peace than you ever dreamed. Trust their experience.
2. Trust that any therapist/counsellor has been trained specifically on how to treat people like you. Broken people, people with trauma, people with dark, frozen wastelands inside them, people who are terrified and fragile and desperate. These are experts, they know how best to help you, how to get you through the process without further traumatising you, how far to push you to make progress without pushing you so hard that you spiral down further. They know what they are doing. Your problems are unique to you, but not entirely unique in the sphere of human suffering. They know how to help you, if you’ll let them.
It’s also good to bear in mind that there are levels of psychotherapy. You don’t have to jump into the deepest end first. You can still be in control of what direction your therapy takes. It may be advisable to start with something that has a gentle and immediate effect (especially if you have high anxiety levels), such as cognitive behavioural therapy. Learning to manage your feelings can be a very useful starting point. It can also help you to develop trust in your therapist, before you start to reveal anything very deep or disturbing. Many people will stop at this point, and if you only get this far, it’s something. But if you have serious issues to work through, such as abuse, post-traumatic stress disorder, or other severe trauma, your future mental health will be affected by how far you are prepared to go to deal with these issues. CBT may help with your symptoms, but psychotherapy will help address the roots of the problems. In some cases it is absolutely essential, life saving.
Having depression is like carrying around a bucket with a large hole in it. You can keep filling it with water, but it will keep emptying through that hole. You need to plug up the hole AND fill the bucket back up with water. Medication can ‘fill’ you brain chemistry back up, temporarily, but it doesn’t fix the leak that is causing the problem in the first place. Addressing the issues that have made you who you are, and brought you to this place, is the only way to plug that hole up, so that the medication can properly level out your brain chemistry. Medication and therapy work hand in hand, and together can be more than the sum of their parts.
Once you have experienced depression, you will always be vulnerable to it. Recurrence is distressing, frightening, discouraging, frustrating. It is tempting during times of remission to refuse to think about it, what has been, what might be, to enjoy the sunshine and deal with the storm when it next hits. But trust me, it is much wiser to do all in your power to keep well, stay well. You can use each period of recurrence to equip you to fight the next. Identify your weak spots, your triggers, and rather than ignore them, deal with them. You can get stronger with each episode of depression, instead of weaker, more broken.
Your inner demons will continue to shout if you ignore them, and their voices will get louder each time. The only way to shut them up is to listen to them. To get really quiet and still, and to hear the message they are trying to get across to you. Most of us, in order to accomplish that, need the help of a professional. If you have that opportunity, grab it with both hands.
Don’t be afraid. You are so strong, to have got to where you are – yes, I know you don’t feel strong, but you are, or you wouldn’t have survived this so far. You have fought this long, hard, bloody battle, all alone. How much easier it will be if you have someone fighting alongside you. You don’t have to do this alone any more.
You don’t have to do this alone any more.