From the U.S.: Hi. I am a young woman suffering from treatment-resistant atypical anxious depression. I know my brain is lying to me when it feels like I am going to be depressed for the rest of my life– I can be suspicious of this thought. Of course, the fact that successful treatment eludes me weighs on me, making me feel hopeless.
In addition, whenever I ask clinicians and therapists for encouragement related to my prognosis, they never fully reassure me that I’m going to emerge from atypical anxious depression. I wish they would authoritatively say something encouraging like “Something WILL work for you. You ARE GOING to feel better” But they are always hemming and hawing, saying things that seem more concerned with managing my expectations. “Well, there’s reason to be hopeful…Maybe this will work…”; “It’s not the end of the world, It’s just something you’re going to have to manage.”
These statements, which may sound encouraging from their non-depressed points of view, enter my pessimistic brain and morph into further proof that I’m never going to be satisfied with my mental well-being. ALL I WANT IS TO FEEL WELL AGAIN. Is that too much to ask? Is it too much to ask my helping professionals for more effective encouragement?
A: It’s not at all unreasonable to ask to feel well again. It may be unreasonable to ask other people to encourage you exactly the way you want them to. Even if you ask them to say the words you want them to say, you will probably be unsatisfied because you want them to come up with the exactly right statements without a prompt from you. From what you shared, it seems to me that your helpers are doing their best to be honest as well as encouraging. The honest truth is no one ever knows for sure how responsive someone will be to treatment.
The good news is that atypical anxious depression usually does respond well to a combination of talk therapy and medication. I would need to know a whole lot more about you to venture an opinion about your prognosis.
What I can do is remind you that what really matters is that you be an active member of your treatment team. That means doing your share to get better regardless of what you think others think. That means eating well, getting outside for some exercise and fresh air several times a week and making sure you keep a reasonable sleep schedule as well as attending therapy and being as honest with yourself and your therapist as you can be. It’s a tall order. But your health is worth being your own best team member.
I wish you well.
Dr. Marie
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