Sunday, May 04, 2008

4000th visitor "My Psychiatrist Won't Give Me Counselling..."

Just a today I had my 4000th visitor to this site. Thanks for visiting everyone. I am always so interested to hear from others and to discover other people searching for some of the answers to the questions I ask. I feel less alone knowing other people exist and are trying to work through their lives while struggling with mental illness. I also appreciate those visitors who may not be mentally ill, but support and search for help for those of us with these illnesses.

I thought I'd address the question Visitor 4000 googled to get to my blog because I found it especially poignant given how much support I receive from my psychiatrist. It saddens me that people are being left to fend for themselves when they think they need more support.

Visitor # 4000 googled: "my psychiatris[t] wont give me counselling i need more than 20 sessions".
In my experience I have seen so many people whose psychiatrists offer no therapy, but are simply there to provide medication and biological treatment advice. In some cases, where a person takes an antidepressant, it works wonders and the person is off and returning back to a normal life, I think this might be a good approach.

My question is...and this is a big one...Does this EVER happen? I have met so many people in the last 10 years or so with depression and honestly, I cannot think of a single one whose illness was that easily treated.

I don't believe depression is simply a biological illness. There are so many factors involved in why someone becomes depressed and why one person gets better while another struggles. 15 years ago I would have told you all I needed was 5 or six therapy sessions when I was depressed and I got my life back and became well...but DID I BECOME WELL?

Would I have been in a better situation now if my depression had been taken more seriously when I was having short Major Depressive Episodes. I addressed this before in my post "Early Medical Intervention for Major Depression" . There are no easy answers, but I really believe I needed the support of a psychiatrist, and especially a psychiatrist who works longterm with his or her patients in therapy as well. Twenty therapy visits would not be enough for me, even before this episode.

Why do I believe this??
  1. I believe Major Depression is complex and has complex triggers...environmental stressors, the person's family history, the individual's history, the individual's coping mechanisms. whether abuse has been involved, whether there are other psychiatric problems like anxiety disorders, or OCD problems, or alcohol or drug abuse problems, whether genetics is a factor, how much, or how little support the depressed person has, whether or not medication, or medications work....the list goes on. No one can convince me that all these things can be addressed in 20 sessions or less.
  2. What if medications don't work, or work for a while and then stop, or are not optimal and as such are leaving the depressed person at risk of another depressive episode, or more problems in their life due to the side effects, or ineffectiveness of the medication. Long term support is crucial.
  3. By long term support I mean a psychiatrist you have the opportunity to learn to trust. A psychiatrist who is there for you when it's black and dark and life is not worth living, a supportive psychiatrist who listens and cares and believes they can help you, a psychiatrist who does not falter when mistakes happen, or when the patient gives up hope, or even when the patient feels distrustful of the psychiatrist in spite of the doctor's consistency. My experiences in life have left me scared and scarred and afraid and distrusting of other people. No medication takes those fears away without a combination of therapy. Certainly, 20 therapy sessions cannot eradicate a lifetime of lessons in anxiety, fear, intimidation, helplessness, hopelessness and sadness.
  4. I know the reason I have survived the last few years is because my psychiatrist offers therapy. Without his continuing support, without there being an understanding that I can see him until I am well, and even after I feel well, I would not have the courage to keep trying.
Dear 4000th visitor...there are psychiatrists who offer therapy. If that
is what you want, or think you need, please listen to yourself and look for a different doctor. You have one life and it is so important to get the care you need to make your life manageable, and, hopefully one day, delightful. I wish you all the luck in the world.


The Silent Voices in my Mind said...

Great post! Congrats on so many visitors. It is comforting to not be the ony one in a particular boat.

You asked a question that was maybe rhetorical, maybe not. Does anyone get better with meds alone, poof all better. (Not how you put it but that's how I interpreted it.)

My hubby is on meds for depression and they do the trick. I honestly can't picture him in therapy. It wouldn't be a pretty picture. Still, he needs to be monitored and every few years we need to get him different meds.

On the other hand, his dad went through a spell of depression that had us pretty worried. He finally went to a doctor and got on an antidepressant. Six months later and without any counselling, he weaned off the antidepressant. That was 7 years ago and he hasn't needed anything since then.

So, yeah.... I think there are some people like that. Just not most of us. I've been struggling with this my whole life, with meds and without, with therapy and without, with support and without.

I hope that some day everything will be alright. Right now, I take it a day at a time and convince myself to get out of bed every single day.

Aqua said...

Hi The Silent Voices in My Mind,
Thanks for your comments. I am glad to hear that medications do "poof" work for some people (that was my original meaning). I wish that were the case for you and I. I hope..."some day everything will be alright"...for you too. I, like you, struggle everyday to get out of fact one of my paintings I am doing right now is titled "my own private hell"...and it is a painting from the perspective of my eyes in bed, staring at the same thing I always stare at while trying to coax myself to "live" that day by at least getting out of bed.
Take care,

Anonymous said...

I am a trainee looking for a psychiarist position after graduating. I cannot find any jobs that will allow a psychiatrist to do therapy. I think I will have to open a private practice, but that is nearly impossible for a new graduate. The system is screwed up.

Henry Cisneros said...

There are a number of stressful medical conditions affecting many of us today. One of the broadest topics is anxiety disorders, with millions of people suffering to some degree or another. Specific symptoms vary greatly from person to person. As anxiety disorders grow progressively worse without treatment you should see your doctor immediately if you suspect that you may be suffering from one of these illnesses.