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.