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Am I Always Going To Feel Like This?

Question:

For the last 3 years I have been treated for Bipolar Depression but I still feel deeply depressed. I feel stuck and feel like I am faking it. I am not happy and do not feel that I will ever be happy. There was a time I felt happy but even then my life was up and down and now it is always down.

I work part time in a job I really hate and have come to despise it. The job is in housekeeping. I have recently quit drinking and smoking pot. That was over 3 months ago. I go to AA to be around people and to work the program but nothing seems to help. I hate my life and what I have become. I feel like an empty and shallow woman. People don’t really want to hear how bad I feel, and I am tired of talking about it. So mostly I just keep my mouth shut.

My doctor increased one of my meds. Which I do take quite a few medications for my illness. I am tired of taking pills that doesn’t seem to really help. I am tired of being a guinea pig for the meds. Now I have a hard time getting to sleep at night and the sleeping meds do not work.

I just feel like a flat human being wasting space. I just don’t think I will ever be happy. I am tired of trying. What can I actually do? Am I always going to feel like this?

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  • Dr. Schwartz responds to questions about psychotherapy and mental health problems, from the perspective of his training in clinical psychology.
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Answer:

What I suspect is happening with you is that you are experiencing the limits of what medications can do. You are not alone in this, if my assumption about you is correct. We have come to expect that taking a medicine will help us feel better without making any other effort. While there is no doubt, in my mind, that medications for Biplar disorder as well as for the other mental illnesses have, have been incredibly beneficial, people must do more to feel better.

For one, attitude is important. If you doubt that you will never feel better then there is a chance that you might not. There is someting called the “self fulfilling prophecy in which, if we believe something strong enough, we will make sure it turns out that away. Specific to you is your comment that you are tired of trying. That is not just your depression speaking but a very negative attitude that you must work at changing.

That brings us to my next point and that is the necessity that you be in psychotherapy so that you can learn how to modify unrealistic thoughts and begin thinking in a more grounded way. This is called Cognitive Behavior Therapy (CBT) and it has proven to be enormously effective in helping people reduce the symptoms of Bipolar disorder. For example, your notion that you are being used as a guniea pig with medications is sumply not true. The doctors are trying to find the right combination of meds to help you.  

There is now evidence that psychotherapy actually improves brain function. That is important because Bipolar disorder is known to result from chemical imbalances in the brain. There is a version of cognitive behavior therapy called Dialectical Behavior (DBT) that includes learning how to reduce stress, among other things.

In addition, it’s important that you take a more activist role in regulating your mental health. Activities such as regular exercise, yoga, meditation and regulatng the kinds of food you eat are all helpful in reducing depression.

Your psychiatrist can refer you to the psychologists who provide these types of psychotherapy. Exercise and yoga you can learn by going to place like the community center or the Y because they often provide those types of classes.

Never give up hope. Yes, you can feel happy and you can feel free from the crushing types of depression you are experiencing.

By the way, congratulations on giving up the pot and alcohol. Those only deepen depression, especially for those with bipolar disorder.

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