I’m yet again in a bout of depression. Depression is such a broad term. It represents chaos, melancholy, feelings of hopelessness, and inability to change.
A first session with a therapist usually consists of niceties, getting to know each other, questions about sessions, about the methods a therapist uses, rules of conduct, etc.
I’ll skip it. Use your imagination.
Mos is the name of myself as a therapist. A ‘she’. You can read about the players in this game here.
My lines are in plain, non-italicised letters, Mos’ lines are italicised.
my life is chaos. I feel like drowning in everything I should be, should do, and, trying to do everything, I end up doing nothing properly.
I cannot focus, I feel overwhelmed by everything, by what I should do, all at once, I cannot prioritise. Everybody else is better off. I hate myself. At least when I’m depressed, I really deeply hate myself. When I’m not too low, I don’t hate myself, but I’m just low. I feel it’s hormonal – in my “normal” state I have my cognitive processes fully running, but feel chemicals do their (wrong) job so I feel unhappy. Or indifferent at best.
I don’t know whether I need a psychoanalysis, or CBT, or NLP, or just going out more. I just oscillate between ‘can’t-stand-it’ and ‘let’s-survive-another-day’.
we’ll sort it out. Let’s find a thread with which to start untangling these feelings.
You may just need to talk about it. To say it out loud. To give your thoughts structure, cohesion.
I don’t know where to start. I wish to have a beginning and a clear goal. Then I could tell you what’s wrong with me.
That’s why we are here. We wouldn’t be here if you knew everything.
You are also at the beginning, so why put yourself under pressure for later problems?
I know myself quite well. I know everything how I should act, what to do to be better, but I don’t do it. I know my depression types and all.
I don’t do feelings. They’re complicated, so I just ignore them. I know I should tackle them now and then, but …
I came here to tackle them, but I don’t want to.
It’s only natural to feel the fear of unknown. If you’ve never dealt with feelings, you don’t know them. So you fear them. We’ll start small, and grow from there. All right?
Tell me of the things you feel sure about.
You feel depressed, you said you know your types. Do you mean major depressive disorder as opposed to dysthymia? *
Yes —. No. The types of depression are so confusing. I just say I have depression. It probably means major depressive disorder (MDD), or dysthymia, or melancholic depression. I would settle for minor depression, too. I can’t judge how severe my form is. And it doesn’t matter. If someone said I had major, or minor, would it change my feelings? No, I suffer as I suffer.
What I meant was, I know my symptoms, and I know what causes my depression.
Then you have a good starting point. There’s something you already know.
Yes. There are three types of my depression, I categorise them by possible causes. The first is the guilt induced. I feel guilty of something all the time.
The second is triggered by my low self-esteem, which mostly stems from my inability to do tasks which others do easily. Or by anything others can do which I can’t. Or by what I should / shouldn’t do. Here I might also put my constant underachievement. I don’t finish a task or a project, be it on a daily or long-term basis, and then I’m depressed.
And the third type is my fear of responsibility. I’m not afraid of admitting I’ve done something wrong. I’m afraid deciding, for fear the consequences of a decision might be devastating.
These are your triggers? Usually, the triggers for depression episodes are a loss of a loved one, job, or a divorce, big changes. What you are saying is, your depression is triggered by daily events. How do you experience your episodes? How long they last?
Guilt for the past, low self-esteem for the present and fear of responsibility for the future. I’ve covered them all. [I can smile :)]
I don’t believe in episodes. I don’t know of a state without depression. Even if I am well, without depression, it’s usually of a short duration – a day or two.
No, wait,– I know of an instance, a period without depression.
It was when I was pregnant with my first child. I felt ok. Not happy per se, but I said to myself, “Oh, so this is how it’s like to be without depression!”
This is how I know my depression is mostly hormonal. If I was in a different hormonal state then, then it’s the normal (depression-ist) state also hormonal. I must just figure out how to balance these hormones.
But I’m talking about the triggers, yes. Those that can’t be avoided.
Triggers cannot be avoided, no, but we can develop mechanisms to be less sensitive to them. Maybe we can even become immune to some (or all) triggers after the process.
Well, I doubt I can do this. I fail at all the things. And I’m not able to meet deadlines. And I’m always late. We’ll have many problems before I can start dealing with depression. And I procrastinate. And I don’t want to do it myself because I’m lazy. I want someone to do it for me–
Please calm down. We have all the time in the world to tackle what’s stressing you. We’ll pick one and work on it. And after that, we’ll pick another. And so on.
I must point out it’s harmful to talk or think in absolutes like you did just now. Always do this, never do that … Because your self-image is then distorted. Because sometimes things are different. You can change. I’ll talk about this another time.
It’s been enough for one session.
I have a homework for you. We’ll go specific.
Take notice, make a list of all the triggers for your guilt-induced depression occurrences. You can do it in real time this week or remember past examples. Describe the fashion in which feelings of guilt lead to depression. We’ll probably see a common denominator and tackle that manifestation of depression there, at the root.
Uhm … I have homework?
Yes. You need to work on your issues every day. By homework, you do it, you don’t just mull over.
Good luck. See you next week.
See you. [Disconcerted by the early end. Don’t all sessions end too soon?]
*We don’t do a diagnosis, we just assume there’s one.
P.S. It’s hard to write of being depressed in a state when you aren’t. But then, this is what writers do. They write regardless of the mood. Some writers, at least.
P.P.S. This post is updated in a new post, ‘The flavours of my depression‘.