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Recurrent Depression

Question:

Recently, I had a bout with a mild depression, which I can’t seem to shake yet. I was diagnosed with clinical depression at 16 and took two years to recover. I found that I have severe sleep disorder, not being able to get a good night rest and staying up all night till the wee hours in the morning. I become irritable, fight with my boyfriend who is very sweet to me. I have failing grades in school now, and it was the thing I really wanted to do in making a career change. I feel awful, I know I’m a perfectionist, and the anxiety is getting to me. I had a therapist when I was young and was with her off and on for 4 years. I was the one who decided to cut off therapy five years ago. I feel embarrassed that I should have changed my patterns again, but I didn’t. I know my therapist can help me a lot, but I’m so embarrassed to go back to see her. I should be well now. Do you think I should see my therapist again ?

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

You know – it’s a common mistake to think that depression is something you can fix once and forget about. While some people do experience only a single depressive episode in their lives, a large number of people find that they go on to experience multiple recurrent depressions throughout their lifespan. In fact, there is good evidence to suggest that some people are genetically predisposed to have problems with depression. It may be helpful (and more accurate) if you think of depression as you would a chronic illness disposition – something that can be managed, but not entirely eradicated. I certainly can understand and sympathize with your feeling of embarrassment – but keep in mind here that there is little to be embarrassed about. You wouldn’t be embarrassed to seek professional help if you had recurring episodes of a ‘physical’ chronic illness like Diabetes or Multiple Sclerosis; don’t be embarrassed about seeking professional help for a recurring depression. If you are experiencing a problem with depression, by all means get yourself back into a situation where you can get some help for that problem.

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p> You have at least two general treatment options; medical and psychotherapeutic. Medical treatment of depression has made major strides in the last decade. Today’s anti-depressant medicines are pretty safe and generally quite helpful in reducing depression symptoms. They do sometimes have side effects (sexual arousal difficulties, etc.) that most people don’t enjoy – but not everyone experiences that. Medicine is certainly worth a try.

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p> Psychotherapy for depression is also a very useful way to get help. For the best bang for your buck, seek out a therapist who is up on one of the scientifically supported protocols for treating depression efficiently; either Cognitive-Behavioral Therapy for Depression, or Interpersonal Therapy for Depression. Cognitive-Behavioral Therapy for depression generally takes place over 3-6 months (not years) and has been shown to be as effective as anti-depressant medicine in the short-run, and more effective than anti-depressant medicine in the long run.

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