Counseling (Depression)
In some ways, talking to a psychologist was even harder than starting antidepressants. In both cases, I was admitting to a problem that comes with its own baggage of shame and stigma and perceived weakness. But with counseling, it felt harder. This was more than hitting my doctor up for a prescription. I would be walking into a stranger’s office and spending hours explaining how I’d lost the ability to deal with things in my life, how I needed help to figure out things I feel like I should already know how to do.
That’s what it all comes back to. I feel like I should be able to handle this stuff. I should know how to be a good father and husband, how to balance the demands of writing and the day job, how to maintain my emotional balance in times of increased stress, and so on. I know how deceptive and nasty the word “should” can be, but that didn’t stop all the crap from swelling back through my brain when I thought about making that first appointment.
I made it anyway.
Eventually.
I’ve had three sessions so far, and while I’m not going to go into as much detail about them, I’ll say it’s been helpful. The first session or two were mostly a get-to-know-you sort of thing. I got an official diagnosis of dysthymia. As I understand it, this is a milder form of chronic, long-term depression. I.e., I’m in a lousy mood most of the time, but I’m not jumping off the Mackinac Bridge.
The funniest moment came in the first session: I was describing my life, the jobs and the writing, taking care of the kids after school, the work I did around the house, and so on.
Doctor P: What do you do for fun?
Jim: …?
Doctor P: When do you take time to just get out and enjoy yourself?
Jim: …I’m sorry, I don’t understand the question.
I was amused, but it was a good catch on her part. She gave me homework to do something fun just for me. I actually managed to do it, too. The trick now is going to be incorporating that lesson into my life on a more regular basis.
Doctor P has also pointed out some areas where I could improve things at home. We both recognize there’s a lot I can’t change — realistically, I can’t quit the day job; I can’t magically improve my wife’s health so that she can do more at home; and so on — so we’re concentrating on things where I can make changes for the better.
This whole process scares me. Eventually, I’d love to get off of the antidepressants, and I think counseling is one of the things that will help me do that. But given how helpful the pills have been since April, I’m also terrified of losing that crutch and slipping back into the swamp of who-gives-a-crap-about-anything. I guess I’m not yet completely trusting that it can help — or that I can change enough to really make a difference — in the long run.
This experience has also made me recognize once again how fortunate I am to have decent insurance that covers most of the medications and my weekly sessions. As hard as it’s been to admit I need help, how much worse must it be to realize you need help and have no way of getting it? [Rant about U.S. healthcare deleted because the goal is to not depress myself further.]
I’m cautiously optimistic. I like my counselor. She feels pretty genuine, and seems to get me. The first few sessions felt a little open-ended, but we’re talking about more concrete goals this week. Apparently we’ll also be doing a bit more cognitive work, teaching me how to win at some of my head games. I’ve had some speed bumps at home and at work, but overall, so far so good.
My thanks once again to everyone who’s been so encouraging and supportive.
LJ Cohen
June 18, 2012 @ 9:44 am
As a fellow traveler (have dealt with anxiety and depression my entire life) ,I know that terrible sense of shame that can come with admitting you need help. I wish you well on this journey of discovery and am glad you have found a therapist with whom you can work.
I do think there is something to the link between depression and creative types–it may come from a certain kind of sensitivity — I’ve often felt I was the canary in the coal mine for strong emotions, even ones that aren’t necessarily mine.
Seeking help is an act of bravery and strength, not weakness.
WIshing you all the best.
Angela Korra'ti
June 18, 2012 @ 10:04 am
Good luck to you and I hope this’ll continue to prove helpful!
JRVogt
June 18, 2012 @ 10:11 am
I always admire your being willing to share such personal details and struggles, Jim. As someone who has been working through counseling for the past few years, I definitely understand how it can start out scary. At the same time, looking back, I’d be more scared to see where my life would be at right now if I had never gone. If anything, a lot of the depression and related feelings would’ve gotten stuffed deeper down until they blew up bigger and more disastrous further down the road. We develop a lot of weird mental twists and turns as we grow up, which can keep us going in circles as adults. Straightening those out, or at least recognizing they’re there so you can work through them, is difficult but freeing (or has been for me).
It’s also funny. Your counselor’s question about what you do for fun and your response is almost identical to one my counselor offered during our first year.
I hope this continues to be a positive experience for you!
Mishell Baker
June 18, 2012 @ 10:26 am
Disclaimer: this is based on my own experiences and may not reflect every depression under the sun.
It is possible that you can go off the meds at some point later on, so if that’s a goal for you, I say go for it, and don’t worry that it will tank your progress. Just be sure you’ve found some sort of a replacement for their effects first. By that I mean, even when you’re on meds, you’ll be able to start identifying things that give your serotonin a boost, be it exercise, sunlight, certain foods or even certain people. Then you can use those things assertively when you’re beginning to feel “down” to keep you from sliding back into a ditch you can’t pull yourself out of by your bootstraps. I feel that meds are useful for those times when depression has worsened past a certain point, but that with time most people can learn to keep it from getting that bad in the first place.
It does require a lot of self-knowledge, though, and this is where therapy helps. I went to therapy for 2.5 years or so, and it has given me invaluable tools to monitor myself. My depression was not caused by some hardwired chemical imbalance (I can’t really speak to the ins and outs of that type), but by a lifelong habit of thoughts and self-concepts that gave me a constant hounding feeling of failure, inadequacy, and futility. I had to retrain myself to reinterpret the messages the world was sending me. It’s still hard for me sometimes, but I can at least recognize when the script I’m feeding myself is b.s.
I know that guilt and shame and feelings of inadequacy can’t be cured by near-strangers telling you that you’re okey-dokey, but just know that you are by no means alone or even in sparse company. I think almost everyone of a creative nature is more vulnerable to being beaten down by life’s destructive influences. If you weren’t open enough to the world to let yourself be beaten down by it, you wouldn’t be open enough to observe it and express it in a way that resonates with others. But it also doesn’t mean that you must accept pain as the necessary payment for creativity. You can and will find happiness, true happiness. I believe it with all my heart, because if a complete failure like me can feel good about herself, so can you! Sorry, bad joke.
Jim C. Hines
June 18, 2012 @ 10:45 am
“It’s also funny. Your counselor’s question about what you do for fun and your response is almost identical to one my counselor offered during our first year.”
You’re the second person to say this. I’m starting to think this question is something they all learn to ask in Counseling 101…
And thank you 🙂
JRVogt
June 18, 2012 @ 10:49 am
Oh, I’m sure there’s some cross-over.
My answer basically was, “Well, I sit in a room by myself most of the day and write. Oh, and I play video games in a room by myself most of the evening. Yeah.”
The writing certainly hasn’t gone away…in fact, I find a lot more joy in it…but my world has expanded a decent bit since.
J.Swan
June 18, 2012 @ 12:28 pm
I think it’s also important to note that “happy” is not the default human condition. Happy is something that does come and go a bit, and takes work for most people. So what you are working at is something the entire human race struggles with, in different ways and with different amounts of denial. Happiness, meaning, contentment, fulfillment–they’re worth working for, but you do have to work at it, and our brains are programmed to generally always want “more!” It could be a lot worse: you could be accepting it and wandering through life in a depressed haze. Which is, you know, a really depressing thought.
Best wishes for you. And thanks for speaking out.
Janice in GA
June 18, 2012 @ 12:51 pm
I’ve had that same diagnosis in the past.
One thing that helped me was cognitive behavioral therapy. (see http://en.wikipedia.org/wiki/Cognitive_behavioral_therapy for an example.) FOR ME, it helped me see how the things I was telling myself about myself made me feel bad. But that’s me. ALWAYS do what works for YOU, not what some random stranger on the internet says. 🙂
Exercise also helps me. But OTOH, I don’t have kids or a full-time + a part-time job to deal with, so my plate is less full than yours.
Just hang in there. Many of us understand what you’re going through, and wish you all the best. And we’re proud of you for speaking out about this. You’re awesome. 🙂
Tim Moore
June 18, 2012 @ 12:52 pm
“This whole process scares me.”
This is the same thought that kept me away from counseling for a long time. I’ve had a few traumas and always just buried everything psychologically, not realizing what it was doing to me.
All I can say is: stick with it. A good counselor is worth her weight in gold, I think, and I’ve found the experience to be enlightening and life-altering, in very good, healthy ways.
Good luck to you. I hope things look brighter for you as time goes on.
Alice K.
June 18, 2012 @ 2:02 pm
You may be able to go off your medication. If you have a low-level version of depression where the day-to-day is easier to deal with than medication side effects, it’s worth your while. But only once you feel ready to handle it.
For me, I knew I was ready to wean off the meds when I tripped and fell and, instead of running back to my room to hide and feel like an idiot, I laughed and brushed myself off. I still had to go to therapy while I slowly reduced my medication dosages, and I still saw the prescribing doctor after the meds were out of my system, so it was kinda like having mood training wheels.
Jim C. Hines
June 18, 2012 @ 2:07 pm
“…it was kinda like having mood training wheels.”
I like this analogy 🙂
Jim C. Hines
June 18, 2012 @ 2:08 pm
Thanks, Janice. And yep, we’re going to be doing some CBT work as we go forward.
Mishell
June 18, 2012 @ 4:07 pm
I can vouch for CBT, and it has helped me be a better parent too!
Kathryn
June 18, 2012 @ 4:31 pm
This is a good timed post, Jim. I have my first psych appointment in two weeks’ time, and I’m beginning to get a bit more nervous 🙁
It’s for issues deeper than ‘just’ depression, though.
KatG
June 18, 2012 @ 6:21 pm
There’s this guy at Salon who isn’t a therapist. He’s an artist, writer and recovered addict. And he does an advice column, natch. But he’s pretty good at it most of the time. And he did this answer to a woman who was in Germany and planning to try to stay there and who was overwhelmed, and I kept his response to her first of all because it was a very funny piece of writing, but second of all because it’s a really good reminder for the problems in my life — times I’m being depressed, times I’m dealing with the demands of being a mommy, times I beat myself up, haven’t managed to do the things I need or want to do, etc. So maybe it will be helpful to you too. Don’t know, but here’s the link:
http://www.salon.com/2010/10/14/too_stressed_out/
Basically, the things you have to do, you’ll get to them. You won’t be perfect, you’ll always be behind, and you already know that the “shoulds” are dirty, unreasonable words. I hope you keep going to the therapist — it was an enormous help to my mother in her time, to my sister and her kids, and it’s definitely going to help out your wife. 🙂 And if you have to take some drugs for awhile to help with all that, this is an excellent thing that there are medications that can help you deal with this illness. It’s a very, very good thing, and your kids will so appreciate that you did it for them and for yourself. As always, we’re in your corner, we hope to hear your stories, and we really, really wish you the best.
Steve Buchheit
June 18, 2012 @ 9:15 pm
Good luck with the therapy, Jim. I’m glad your insurance covers it (here in the backwaters of Ohio, we only get 3 visits a year). And I so hear you on that question.
Jenny
June 18, 2012 @ 10:20 pm
I’m glad the counseling is helping. My husband has dysthymia too–has had it for ten years or so now. He’s been on and off his meds and has done poorly every time he goes off. Now he sees them as something he just needs, like his epilepsy medications. –Which is not to say you won’t go off them, of course; just offering the point that not going off them is not a bad thing, either. He’s happier and more productive when he’s on them. I’m happier and more productive when he’s on them. He’s also a good model since I’ve recently gotten on them myself, for anxiety, and am feeling a bit of a failure even though (a) I studied psychology too and (b) I have this guy in the house to show me that sometimes the little brain chemicals need some gentle guidance to get their act together.
Heather
June 18, 2012 @ 10:24 pm
I think “crutch” is a scary, and thus not terribly useful, analogy for the medication. When a crutch is gone, you only have two legs, and you’re never going to grow a third one. But that’s not really how learning new coping techniques, or maintaining your support systems, works.
My favorite counselor once described it to me as a chair: you need more than one leg for it to stand on, to support you. One could be the medication, but you also need a leg made out of your family, and a leg made out of spending-time-on-yourself, and maybe one made of going-for-some-exercise, or another made of whatever-mental-tricks-work-for-you-to-stop-yourself-dwelling-on-something-terrible, etc. The more different things you do to support your sanity, the more legs you have on the chair, the less disastrous it will be if one of them fails. Counseling is a workshop in which you’ll build a lot of chair legs.
When you think you’ve built enough of them, you can try to remove the medication-leg, slowly and carefully, and see how badly the chair wobbles. If the chair wobbles a lot, OK, put it back on; try again when you have more legs. If it’s not very wobbly at all, awesome, mission accomplished.
I guess the chair is not really a good analogy either, since we generally think of those having only four legs. Make it a giant tentacled robot beast instead. You can never have too many legs on those.
Daniel D. Webb
June 18, 2012 @ 11:26 pm
I think it’s brave of you to be willing to post your experiences publicly like this. I didn’t leave a comment when you first made an entry about your depression in this blog, but that was actually a very helpful thing to me. It prompted me to start talking to my own loved ones about my depression, and begin actively researching the condition and seeking out ways to deal with it rather than simply letting it wash over my helpless self.
I lack insurance and am part of the economic class in America for whom health care of any kind is an unattainable luxury. But still, there are things you can do on your own, and I’ve been making the effort. There are very few blogs I actually follow, and I’d not have expected this one to touch on the subject, but I’m glad it did, and I wish more authors and others who have a presence on the Internet would reach out the way you did. Just seeing that someone else, someone who’s actually successful in the field I aspire to enter, went through the same things was deeply encouraging.
Part of depression as I and many others experience it is a feeling of futility, which inhibits one’s ability to reach out and communicate. I mention that because I think it’s very likely that you have other readers whose lives were helped by your willingness to talk over this scary subject, who simply haven’t managed to lift their heads enough to respond yet. I can’t speak for them, but on my own behalf… Thanks.
Jim C. Hines
June 19, 2012 @ 9:02 am
Hi Daniel,
I’m really glad to hear this. I know exactly what you mean about that sense of futility. I remember feeling rather isolated, but not doing that much to try and change the feeling, because what was the point? There was too much else going on, and in a way it was just easier to accept the momentum of the depression, if that makes any sense at all.
Reaching out takes guts. Good luck!!!
Jim C. Hines
June 19, 2012 @ 9:07 am
It’s been really nice to see that not only have I been happier since I started the meds and the counseling, but as far as I can tell, so have my wife and children. (Which also makes me feel guilty about making their lives less pleasant in the pre-medication days, but I’m trying to focus on the positive.)
I’d like to get off the meds if it works, but we’ll try it and see what happens. If it the counseling and such don’t help me get to a point where I’m happy and functional without the pills, then I’ll keep ’em.
I was a psych major in college, and did some crisis counseling and such. It’s amazing how we can look at everyone else and recognize that there’s no guilt or shame, but seem to cling to that double-standard when it comes to ourselves.
Jim C. Hines
June 19, 2012 @ 9:20 am
Thanks, Steve. As for the insurance, if I started talking about the state of health care right now, it would undo all the gains I’ve gotten from the meds and counseling 😛
Jim C. Hines
June 19, 2012 @ 9:21 am
Nervousness is totally normal. I’d be more worried if you *weren’t* nervous.
Good luck!!!
Writers and Depression Revisited | M.H. Lee
June 20, 2012 @ 5:59 pm
[…] Jim C. Hines on Counseling (Depression).
Kerry D.
June 23, 2012 @ 5:09 am
I have what is called atypical depression (I think because it doesn’t necessary make me cry all the time); I’ve had it for nearly 20 years (now under control with meds) and had counselling for a number of years. I never believed just talking could make a difference – until it did. As a long time reader, perhaps I should have had more faith in words than that. I don’t know. But for me, it helped immensely.
I applaud you, Jim, for putting this out for the public to see. I know how hard it is to do and, if it’s appropriate for a total stranger to be proud of you, I am. I suspect your blog reaches a huge number of people, and your honesty may help them in ways you’ll never know.
Keep on taking care of yourself as you are doing. I wish you all the best and thank you for being willing to take the risk of sharing your experience with the rest of us.
Jeri Lynn
August 22, 2012 @ 11:39 am
Thank you for posting. It takes guts to publicly talk about mental health issues.
Therapy made it possible to keep going when I had to go off my anxiety meds. On the one hand, I’m glad to know I can function without my meds, but, on the other, I also kind of look forward to the time when I can take them again… 🙂