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Question:

I am a young professional woman. My problem is that I am feeling a total lack of purpose for waking up in the morning. This is not new because its been going on for years, perhaps since my teenage years. However, I am now really concerned. I just threw away a very promising career opportunity because I felt depressed.

Sometimes everything is fine and I have a good mood but I always end up feeling sad and lonely and clueless about what I want.

It has also been very hard for me to find and maintain a relationship with a man. Also, alcohol abuse has been a constant since I was very young.

I really cannot handle my life anymore. I have a lot of issues that I know cannot be answered or solved by email.

What I would like to know is what to expect from psychological therapy? Can I be fully functional and happy? How long does it take? How do I know if a psychologist is good? Does it work for everybody?

This Disclaimer applies to the Answer Below
  • Dr. Schwartz responds to questions about psychotherapy and mental health problems, from the perspective of his training in clinical psychology.
  • Dr. Schwartz intends his responses to provide general educational information to the readership of this website; answers should not be understood to be specific advice intended for any particular individual(s).
  • Questions submitted to this column are not guaranteed to receive responses.
  • No correspondence takes place.
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  • Always consult with your psychotherapist, physician, or psychiatrist first before changing any aspect of your treatment regimen. Do not stop your medication or change the dose of your medication without first consulting with your physician.
Answer:

You are asking excellent questions that I will do my best to answer. First, its important to focus on what you are trying to cope with.

First, you state that you feel depressed a good part of the time and going back, at the very least, to your teen years. Second, you admit to having an alcohol problem since you were very young. Finally, there are some serious relationship problems.

Depression and alcohol often go together. The reason is that alcohol is an attempt to relieve the painfulness of having depression. In the end, it only worsens depression. In psychotherapy it will be important for you and the therapist to address both the depression as well as the alcohol abuse. The therapist, such as a Clinical Psychologist, may ask you to join a self help group such as Alcoholics Anonymous or Smart Recovery, among other choices.

There are many types of depression and it is impossible to know which kind you are experiencing. There is Dysthymia, Major Depression, Bipolar Disorder, among others. It will be the job of the psychologist, with your help, to figure out the type you may have.

The causes of depression can range from a chemical imbalance in your brain to a history of being abused or traumatized during childhood. There could be a combination of both chemical and non chemical causes.

Now, to the questions about psychotherapy:

What you can expect from psychotherapy depends upon the type of therapy and therapist you select. There are two main types of psychotherapy:

1. Psychodynamic therapy, also called “talking therapy” in which you and the therapist engage in an in depth discussion of your past and present so you can gain insight into the causes of your problems and the possible solutions. Usually, this type of therapy takes a long time, such as a few years.

2. Cognitive Behavioral Psychotherapy is more structured than the psychodynamic kind and takes much less time. In this therapy, the automatic thoughts or beliefs that cause you grief are identified. Once that is done, more realistic and helpful thought replace the automatic kinds. The premise is that our automatic thoughts cause our depression. This is also used to deal with addictions.

3. Medications, such as anti depressant medications, are used in conjunction with psychotherapy to help relieve depression. If you need medication the aim will be to use it only temporarily until you can function without it.

There is no type of therapy that works for everyone but it certainly helps a great many of people. The fact that you are young is strongly in your favor and that is why its important to get started now.

Yes, in my opinion and experience, psychotherapy helps people fully function in their live and experience a normal amount of happiness, along with other normal emotions.

You can find a good psychologist by asking your medical doctor for a referral or by speaking to friends and neighbors who have been in therapy and can recommend someone.

I hope this helps and, in my opinion, there is no doubt that you should start therapy.

Dr. Schwartz

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