Therapy’s not helping my depression

After 15 years and no progress, I'm ready to quit it for good

Topics: Since You Asked, depression, Psychology, psychotherapy, Alcoholism,

Therapy's not helping my depression (Credit: Zach Trenholm/Salon)

Dear Cary,

I’ve suffered from pretty serious depression — laced with a good dose of anxiety — for more than 15 years now. It’s never been incapacitating; I always get up out of bed and bathe and work, but the lows, and darn-close-to-suicidal thoughts, are getting lower and coming more frequently.

I’m on antidepressants — four. I also self-medicate with booze — I’ll make no bones about it, I’m an alcoholic. I  know it’s a depressant, but it’s also the only thing that gives me any sort of respite.

For most of these 15 years, I’ve been in therapy. And I want to give it up forever, period.

I’ve had six therapists for stretches of time from a few months to three years. None of these stretches has ended well. One was good but I moved away; one put me on major drugs that wrecked me; two were pleasant enough, and talking to them helped sometimes, but they never brought any special insight to the table.

Two others have been ruinous. One insisted, through my worst depressive episode, on reminding me of all the reasons I had to be depressed (his favorites were the death of my father several months prior, and my mother’s long-term incapacitating illness), and pointing out what a long hard road back lay ahead for me, and how much work it would take. Every session was worse than the previous, and I would find myself sobbing uncontrollably as soon as I got home afterward.  (My partner took to referring to this one as “Dr. Mengele.”)

My most recent therapist spent half of our last (and final) session exploring the fact that I often forget to write down the times of our appointments, and have to email him for confirmation. “Why did you forget to bring your calendar today? Well, why do you think you forget to write things down? Will you put this on your calendar for next week?” I’d had a terrible week, and was sitting on the couch in tears at the end of this.

Neither of these guys tried to comfort me, or make me feel better in the moment, or the week that lay ahead. The first guy made sure I knew that I could always check myself into a psych hospital, but never listened when I asked him to please stop saying things that made me feel worse, week after week. The second sat there in a room with me — another human being — looked at me with tears running down my face and said nothing to express any sort of compassion or concern. Nothing. Never went back to him, of course (that was a few weeks ago).

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I’m sick and fucking tired of this. I go see these people, and pay them as professionals to provide a service: helping me feel better. Yes, I know that you have to go into painful areas in therapy. I’m willing to do that, and have. And I know their job isn’t to make me “happy.” But if it isn’t to help me feel better, and cope better with those painful feelings now rather than sometime in the distant future, then what the hell are they doing there?

I don’t get it and I don’t want to be involved in it anymore. Frankly, I think there’s something inhuman in this — who spends their day watching humans suffer terribly, while proffering little more than handkerchiefs and banal questions? I don’t want to work these things out alone, I want help. Instead, I find myself consistently talking to people who, to my mind, border on the sociopathic in their ability to disregard suffering. (I’m looking at you, Dr. Mengele.)

The day I “fired” my most recent therapist, I felt better than I had in months. I knew I didn’t have to go back there and ruminate yet again.

Unfortunately, in America, if you’re not happy and well-adjusted, everyone from you to Dear Prudence to Dear Abby to my sister proffers therapy as a necessary component of maintaining mental health. Well, I’ve done it, I hate it, it’s damaged me, and I never want to go back. I especially don’t want to go back into that hellish process of trying out new therapists and spending multiple hours laying out my troubles.

But, there’s still the nagging feeling that I might be wrong — obviously, or I wouldn’t be writing to you. What would you do if you were me?

Thanks for letting me ramble.


PS: Don’t suggest cognitive-behavioral/mindfulness therapy; that last guy specialized in that and didn’t do jack shit.

Dear Jeff,

I feel for you. I wish you could find some relief for your pain. I don’t know what I would do if I were you. I guess if I were you I’d keep looking for some kind of solution. I’d keep looking for someplace I could go and just leave all my problems for a while. If not through therapy then some kind of group.

All I can say is I totally hear you when you say you want to quit therapy, and some of these therapists sound like real jerks. Maybe there are some sociopaths who are therapists. I hadn’t really thought about it before, because I’ve been very lucky with the therapists I’ve had.

I just went through the worst depression of my life, in the spring, summer and fall of 2011. That was awesomely bad. So what was I depressed about? Loss, I guess. I was grieving. But I was fighting it. I was fighting my own grief, and I was angry and heartbroken over things that happened in my family and in my own life. But I got a good therapist and I’m working through it and most days I’m pretty good. Of course, I haven’t been drinking for a long time, so that helps. I think when I was drinking I was depressed but didn’t even know it.

Where the hell are you living? It sounds like you’ve had some real cold therapists! Out here in San Francisco there are lots of really caring people. I mean super caring people. There are people out here full of love, and when you’re down really low you can feel it and they’ll pull you out of it. I’ve been pulled out of it by people with extraordinary gifts, extraordinary wellsprings of love. Where does that come from? Hell if I know. I came out here, though, because I sensed there was a lot of love out here, and love was what I needed. You know, like the song says, “If you are going to San Francisco, be sure to wear some flowers in your hair.”

Seriously. I was a lonely, cold, frustrated kid down in Florida, and I needed people who could be warm, and luckily the therapists I found were that way. They didn’t just sit there and stare at me. They helped me.

You know, one thing I’d do, is contact that one therapist who was good, and see if you could do sessions by phone. Or at least just talk and see if he or she had any ideas about what to do.

It would probably feel good just to get in touch.

This thing about therapists not being kind is interesting. The idea, I think, is that by observing you in a neutral way the therapist lets you have your emotional experience and then hopefully guides you through some kind of process where the sadness ends up meaning something. It’s compassion for yourself that you need, but the therapist can model that for you by showing compassion for you. Now maybe this being within you who is deserving of your compassion has surfaced but the therapist hasn’t helped you successfully identify this being and connect with it. Or maybe, just maybe, you haven’t been able to process and integrate what you’re encountering in therapy because afterward you self-medicate with alcohol. If that were true, it would make perfect sense that therapy’s not working — because you’re not able to really solidify what you’re learning.

But if drinking’s the only thing that gives you any respite, well, that’s a tough one. Not to bring you down any more, but the alcohol and the antidepressants together sound like a dangerous combo. So at the very least, please get some solid medical advice about drug interactions. And find out how much alcohol it’s safe to drink with these medications. That’s really not something to fool around with.

Look, I’m just another drunk, and a depressed person to boot, but I’ve been able to quit drinking, and I’ve been helped by therapy. And I don’t know if therapy would have worked if I was drinking. I never would have gone to therapy when I was drinking, because I was afraid of therapists and also angry with anyone who tried to help me. I did think they were a bunch of jerks — but that was before I tried it.

So if therapy isn’t working here’s my suggestion: Try Alcoholics Anonymous. Just start going to meetings. At the very least, you’ll find some people who are compassionate. You’ll hear some stories of other people who are having a hard time.

That’s what I would do if I were in your shoes. See if you can quit drinking. That really might help.

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