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Stuck In A Mental Rut...

Question:

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p>I am a 21 one year old male and have felt depressed from round about the age of 16/17. I have been on and off various medications including cipramil and efexor although ive never really felt that much better on them. Ive noticed that when ive stopped taking them for awhile and then take them again I feel good for a few days, i feel like myself which is very very rare but then after a week or so my depressive mood comes back. I find it very hard to concentrate on things and carry out normal day to day tasks. My energy levels are also very low, i usually get eight hours sleep a night but still feel like i havent even slept when i wake up and this continues throughout the day. I also find it hard to understand how i feel emotionally and im constantly analysing everything i experience. I know what i want from life and what makes me happy and i know that i can achieve it but this overwhelming feeling i get or ‘depression’ gets in the way of me being able to just live my life. I find it very very hard to talk about how i feel perhaps probably because most of the time i dont know what im feeling just that its making me unhappy. I dont know if much of this has made much sense to you but if you could give me your opinion it would be greatly appreciated.

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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:

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p>You are providing everyone with an excellent example of why medication, by itself, is not enough to treat depression. Studies demonstrate that the best possible outcome for the treatment of depression is a combination of anti depressant medication with psychotherapy.

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p>You are not alone in finding it difficult to talk about what you are feeling. This is sometimes referred to as Alexithymia. That is why Cognitive Behavioral Therapy (CBT) works better for many people than the more traditional psychodynamic “talking therapy.”

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p>The way CBT works is that the therapist asks you to keep a log of what you were thinking just prior to experiencing an episode of depression. The log includes not only what you were thinking but where you were and what you were doing at the time. Together, you and the therapist examine the log and identify your patterns of thought that result in depression. The next task is to learn how to alter these thoughts so that they become more realistic. The problem is that depression is often caused by exaggerated or unrealistic thoughts that cause us to feel despair and hopelessness. For example, if I happen to trip while I am walking I may tell myself “what a jerk I am and what a jerk I always am.” This is what we call an Automatic thought and it makes me feel worse. What I need to do is learn how to do an assessment of that thought and come up with a more realistic conclusion. So, I do the assessment which results in something like this: “people trip all the time, even young people like me. Perhaps it’s a result of not watching where I was walking or a result of thinking about something while I was walking or it was just an accident like happens to everyone. I am not a jerk, just a human being like everyone else and all of us trip and even fall sometimes. Therefore, I am not a jerk.”

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p>This is a very simple example and CBT is much more complex than this. All the studies done on CBT for the treatment of depression show excellent results. In fact, some studies show that CBT can work even better than medication for some people.

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p>Find your self a good Cognitive Behavioral Therapist to help you reduce your depressive symptoms.

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