Is there any way that people who are mildly depressed can become better without taking anti-depressants? And how do you know whether it is in your best interests to ask for help? My mother has mild paranoia schizophrenia. She had me when she was 15. My parents divorced when she was 18. When I was 5 my mother’s brother who was studying medicine, committed suicide in his final year of studies. I can remember my mother before that being happy, carefree and silly; like you’d expect of a young woman. For years after that I remember things like hopping into bed with her at night so she would stop crying, her following cars with hers because she thought she recognized someone who knew her brother, her throwing a radio through a glass window, her getting the phone cut off because the phone company was putting voices in her head etc. I found it hard because I got teased at school for having a crazy mother. For months at a time she slept in the attic complete with cobwebs on a mattress on top of ceiling beams. I couldn’t have friends stay over and she was ten yrs younger than most of my friends mothers so i was also ostracized in that way too as she was never friends with any of them. I ended up shoplifting and drinking at around 12. When I left home at 18 I went through another rebellious stage (like when I was 11-14 when my Mum was out of control) where I drank a lot, smoked pot and several times took LSD. Now I am working full time, living with my mother and still have one subject left of my degree and feel as though I am such a failure and want to become happy but am scared of so many things. I don’t trust my ability to make major or even minor life decisions anymore because of all the “mistakes” I have made in the past. I have ostracized a family member my age because I am not good company to be around. I have gotten drunk several times and cried and yelled at her and generally behaved appallingly. I want to take responsibility for my life but I find it hard admitting that I have problems because I have always liked the idea of being the one who can help rather than the one who needs it. I have never even had a car license because a car accident on my learners license made me too terrified to keep driving. I know from my Mum’s experience what the stigma is like having a mental illness which is why I never wanted to have one. I myself was bullied at school for several years because of it and had no close friends until I went to Australia to escape that. In the last year I just feel so much anger because there have only really been several years in my life that I was truly happy, in high school. I had a stable home, friends, excellent grades, played sports and a job. Now I just feel like I am the product of my life, a failure because I wasn’t given the chances I deserved. Like I had potential but all the knock backs have finally drained all the goodness out of me and that I have thoroughly wasted my 20s and will never be good happy or successful again. How do I change without causing my family further pain and/or shame like they have already experienced through my mother’s illness, uncles suicide and grandmother’s death? I need help but nobody has the energy to give me that as they have their own problems and cant shoulder mine. Any advice for me?
- Dr. Dombeck responds to questions about psychotherapy and mental health problems, from the perspective of his training in clinical psychology.
- Dr. Dombeck 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.
- No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Dombeck to people submitting questions.
- Dr. Dombeck, Mental Help Net and CenterSite, LLC make no warranties, express or implied, about the information presented in this column. Dr. Dombeck and Mental Help Net disclaim any and all merchantability or warranty of fitness for a particular purpose or liability in connection with the use or misuse of this service.
- 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.
Depressions can be caused by many different conditions including biological, psychological, emotional, developmental, and some would even say spiritual causes. It is often a complexly caused illness, and the growing dominance of the exclusively medical/biological vision of depression promoted by the drug companies has obscured this fact. In your case, with your detailed life story, you have some inkling that past events have caused some of your current suffering, and in fact it is likely that this is the case. There is rage and anger in your history and you may were cohersced into a caregiving role for your sick mom when you should have been ideally protected from this responsibility you were too young to comprehend. Children make lousy caregivers for their sick parents because they are not psychologically mature enough to comprehend the meaning of their actions, prone to magical thinking and exaduration as they are. You also come from a family which is at least partially ‘loaded’ for schizophrenia, and possible related mood dysfunction (psychosis and mood problems can be linked sometimes). So you may have gotten it from both ends, lucky you. However it is arrived at, there are several ways that depression can be treated. The pharmacological route is not a bad one, and I’m not sure why you would reject it out of hand. If a pill can help you to manage your life better, and there are no substantial side effects to it, and you can afford it, and you aren’t worried that the Medical Information Bureau will tag you for life as a depression risk (and that because of this record you’ll be denied health insurance in the future if you try to purchase it as an individual – an actual risk in the United States! – shame on us!) then you’re not helping yourself by not taking that pill. In addition to antidepressants, there is psychotherapy. Really, there are psychotherapies because there are different kinds, and they work differently. Cognitive-behavioral therapy for depression is well studied and known to work to help people to become less depressed. It is a very practical and present-time centered approach; teaching you to recognize depressogenic thoughts that make you depressed and learn how to bend them to your rational will. There are also the psychoanalytically oriented psychotherapies which are more past-centered. They try to resolve problems you are having in the present by untying the knots from the past. Doing work on past traumas and troubles is valuable, but sometimes doesn’t really help you to cope better in the present, so if you go with this approach (sometimes called psychodynamic psychotherapy) focus the work on how remembrances of past traumas make you feel right now – remember that you are working to resolve your depression today – not years ago. The past is a trigger for what is happening right now. It helps you to bring the past into the present, but once you’re feeling it deeply, work on resolving it now. There is also anger management therapy, and anxiety-resolving sorts of therapy (behavioral approaches are generally best for fear-based treatments), etc. Whatever type of therapist you select, try to find one you can relate to and trust. Finally, there are various practices you can explore that can help, including vigorous exercise, meditation, yoga, social groups, volunteer experiences, etc. It is often a combination of these approaches that works best. Often the best way to think about untying developmental traumas like you’ve described is that it will be a life-long project. Do some therapy work for now, see how far you can get, and then stop to digest it for a while. Then go back a while later and work on it some more when life events trigger new waves of difficulty. You cannot erase your difficult past, but you can learn to come to terms with it, and to find joy in the present.