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Depressed and (slightly) functional seems to be a tricky combination


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Things are going fairly poorly with both my pdoc and todc. They don't seem to understand what I'm trying to tell them about my experience of depression and many of their comments and reactions are off the mark because of this. My pdoc defined disorder as something which interferes with ones life and then listed areas of my life that it doesn't interfere with. I agree with the definition, but it interferes significantly with the exact areas he listed and more. What I'm trying to tell him isn't getting through. I tried emailing him with a description of the problems it is causing me. I'm not even sure if emailing is allowed, but I didn't want to let that inaccuracy sit for the next 2.5 months.

In some ways it feels like I get penalized for working so hard on my own to help my mental health. I can get out of bed because I spent 2 years practising getting out of bed. It didn't make me feel better, it just made me better at getting out of bed. Same with sleep, exercise, food, work, better thought patterns, some social contact. It took 10 years to get to the point where I can (barely) do those things, but having reached this point is used as proof that I'm fine now. I don't believe I'm fine when I still have the same set of symptoms as I did before.

I'm running out of ideas for how to actually feel better, and my medical professionals often feel like an additional obstacle. I'm frustrated, and I don't know how to move this situation forward.

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This sounds... scary and depressing. You worked so hard to use the techniques most therapists spend months training their patients and you're still depressed. It would make me feel hopeless.

Some psychiatrists and therapists work in a "textbook" fashion, where they see you as a list of symptoms they've studied, rather than an individual. They feel like they're doing their job when someone is presenting obvious symptoms of a mental illness. When a case like yours comes along, it starts to get difficult and I feel they're insecure because they're humans too and ultimately get defensive when you try to explain to them how they're wrong because they feel like your undermining their years of training, experience, as well as their authority. If your psychiatrist and other doctors can't understand how your condition has changed then maybe you should look for a different doctor. It sounds like you generally are just finding life extremely meaningless and pointless and that you're living through the motions and functioning autonomously while you engage in monotonous daily activities that you've trained yourself to carry out because it's "productive" 

 

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I appreciate the reply. I'm not sure if switching pdocs is an option, but I think I know where to start looking for that info. I don't know if switching is the best option, but knowing my available options will help, I think. It would also be good to have a back up plan in case he decides to stop treating me.

I'm not trying to speak badly about the things I've tried so far. I'm still doing them. I think they're things that are good for everyone, and I imagine there are plenty of people that would emerge from depression under that routine. I seem to have done things a bit backwards by doing those first. I regret waiting this long. I didn't want to bother anyone, didn't want to take up health care resources.

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  • 3 weeks later...

As I was reading your post I thought about something that really sucks...

And that is after doing all the things like getting life back together, diet, work, exercise, social life, I often wonder if the best I have to look forward to is only being mildly depressed for a little while instead of severely depressed like I usually tend to be...I try to tell myself I've stepped up and out of the hole before...

My PDoc is so overwhelmed that I literally see him for like 5 mins now in which he just tells me to go up on something, he couldnt depersonalize his practice any more I don't think unless he was just emailing me the prescription.  The only reason I stay with him is I have a long history at his office.

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On 07/01/2018 at 4:48 AM, BrianOCD said:

And that is after doing all the things like getting life back together, diet, work, exercise, social life, I often wonder if the best I have to look forward to is only being mildly depressed for a little while instead of severely depressed like I usually tend to be...I try to tell myself I've stepped up and out of the hole before...

I don't want to discourage anyone. Even with all the things I've done I still have more things to try. I really think that I can get to a place of actual remission if I stick with it , and I hope that you can, too

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8 hours ago, Ion said:

I don't want to discourage anyone. Even with all the things I've done I still have more things to try. I really think that I can get to a place of actual remission if I stick with it , and I hope that you can, too

Does remission even exist? I mean I'm starting to think that, this is all I know and will know for the rest of my life. 

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2 hours ago, protectmepls said:

Does remission even exist? I mean I'm starting to think that, this is all I know and will know for the rest of my life. 

I feel that fear and doubt, too. When I'm doing worse the possibility of remission can feel a long way off and very foggy, but I believe remission exists. Partly this is because I've had periods where the symptoms lifted completely and I remember that I'm capable of feeling that way, even if it didn't last very long that time. When I'm looking through studies for info about treatment approaches I see plenty of different approaches for treatment resistant depression. They only help a portion of the people in the study, but there are many different approaches each helping some of people who hadn't been helped before.

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I couldn't help but read your posts. I am someone who has suffered since my early 20's with at the time they wanted to call "situational" depression. I would go on meds for months at a time to help me so call function and get back on track with life to where I felt somewhat like a human and then I would go off the meds. I did this for years and years, up's and downs.  In 2009 I was finally diagnosed with major depressive disorder but they continued to start and stop the meds as before. I imagine that i was okay with doing this and that I felt as though I could get by during the times I was off of the meds. However in late 2011 I hit a bad low and decided that the ups and downs were not helping and that going on and off the meds didn't seem very ideal. I have now been on meds consistantly with no breaks. I can't say that I'm doing any better. I used to sleep all day and was not functional at all. No energy or motivation for anything. I do get up now and I do go to school and complete tasks but as the first writer (Ion) mentioned, it has been years of training and of forceful acts of which I give credit. I still feel no energy in my body, no motivation or desire to want to do anything or go anywhere. It is just a get by day by day ritual for me. Does it ever get better? I am now 45 (next month) years old! 25 years is an awful long time to be waiting and to still be where I started off if not worse....i have been to Drs in 4 different states, individual therapy, group therapy, counseling, you name it. I am still hopeful,  I continue to press on and am always willing to try new approaches. Over all, I am a strong believer that my life situations are a big contributor to my depression. Change that, maybe lessen some depression. I don't really know?  One step at a time! 

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That's what I take. SSRI's do not work well with me. I have always been on Wellbutrin. I have tried them all and  always go back. Recently tried an increase to maximum does which seemed to help but there were side effects that were not good so dropped back down. Going to attempt higher dose again at a slower pace. Thanks for the response and input. 

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4 hours ago, aandrews73 said:

That's what I take. SSRI's do not work well with me. I have always been on Wellbutrin. I have tried them all and  always go back. Recently tried an increase to maximum does which seemed to help but there were side effects that were not good so dropped back down. Going to attempt higher dose again at a slower pace. Thanks for the response and input. 

I've been doing a similar thing recently. Going up to the higher dose on bupropion had very difficult side effects, but it didn't help more, so I'm hoping to try abilify next

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13 hours ago, Iceberg said:

There are also off label meds that are stimulating like strattera and Provigil. Depends on how brave your pdoc is. Also an aap add on of rexulti/abilify/ seroquel are indicated for depression 

I take the abilify as well in admiring to the welbutrin. I'm already there! And the anxiety meds, and the sleep meds!!! I'm at a loss with medication. Rexulti was horrible. 

 

I couldn't help but read your posts. I am someone who has suffered since my early 20's with at the time they wanted to call "situational" depression. I would go on meds for months at a time to help me so call function and get back on track with life to where I felt somewhat like a human and then I would go off the meds. I did this for years and years, up's and downs.  In 2009 I was finally diagnosed with major depressive disorder but they continued to start and stop the meds as before. I imagine that i was okay with doing this and that I felt as though I could get by during the times I was off of the meds. However in late 2011 I hit a bad low and decided that the ups and downs were not helping and that going on and off the meds didn't seem very ideal. I have now been on meds consistantly with no breaks. I can't say that I'm doing any better. I used to sleep all day and was not functional at all. No energy or motivation for anything. I do get up now and I do go to school and complete tasks but as the first writer (Ion) mentioned, it has been years of training and of forceful acts of which I give credit. I still feel no energy in my body, no motivation or desire to want to do anything or go anywhere. It is just a get by day by day ritual for me. Does it ever get better? I am now 45 (next month) years old! 25 years is an awful long time to be waiting and to still be where I started off if not worse....i have been to Drs in 4 different states, individual therapy, group therapy, counseling, you name it. I am still hopeful,  I continue to press on and am always willing to try new approaches. Over all, I am a strong believer that my life situations are a big contributor to my depression. Change that, maybe lessen some depression. I don't really know?  One step at a time! 

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23 hours ago, aandrews73 said:

Over all, I am a strong believer that my life situations are a big contributor to my depression. Change that, maybe lessen some depression. I don't really know?  One step at a time! 

This was my big focus in the years I wasn't working on meds, and I think the changes I made were helpful

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On 12/19/2017 at 12:34 PM, Ion said:

Things are going fairly poorly with both my pdoc and todc. They don't seem to understand what I'm trying to tell them about my experience of depression and many of their comments and reactions are off the mark because of this. My pdoc defined disorder as something which interferes with ones life and then listed areas of my life that it doesn't interfere with. I agree with the definition, but it interferes significantly with the exact areas he listed and more. What I'm trying to tell him isn't getting through. I tried emailing him with a description of the problems it is causing me. I'm not even sure if emailing is allowed, but I didn't want to let that inaccuracy sit for the next 2.5 months.

In some ways it feels like I get penalized for working so hard on my own to help my mental health. I can get out of bed because I spent 2 years practising getting out of bed. It didn't make me feel better, it just made me better at getting out of bed. Same with sleep, exercise, food, work, better thought patterns, some social contact. It took 10 years to get to the point where I can (barely) do those things, but having reached this point is used as proof that I'm fine now. I don't believe I'm fine when I still have the same set of symptoms as I did before.

I'm running out of ideas for how to actually feel better, and my medical professionals often feel like an additional obstacle. I'm frustrated, and I don't know how to move this situation forward.

dude i went to an IOP, the PDOC i wennt to after sat there and told me how he didnt understand me, and that my past is fine(its not) and that he doesnt get why anythings wrong. THat im functional, IM great at putting on a face, meanwhile i have a passive deatwish. I totally get you.

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16 minutes ago, looking for answers said:

dude i went to an IOP, the PDOC i wennt to after sat there and told me how he didnt understand me, and that my past is fine(its not) and that he doesnt get why anythings wrong. THat im functional, IM great at putting on a face, meanwhile i have a passive deatwish. I totally get you.

The validation is helpful. I have such a strong tendency to try to deal with things on my own and with the pdoc telling me I don't need help I have to push back against him and my own personality to keep believing that I deserve help.

I had a good development, though. I talked to my primary care about a backup plan if the pdoc wants to stop treatment or if we can't fix up our working relationship. In that case I will go back to working with my GP on meds and if necessary later they can refer me to a different pdoc. My GP and I work really well together, so I'd be happy to work on psych meds with them and just knowing that I have another option is a big relief

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10 minutes ago, dancesintherain said:

I'm glad you have a back-up plan.  Depending on how things go at your next pdoc appointment, it might even be worth pulling out that option pre-emptively.  Why wait for it to collapse officially if it has already collapsed in spirit?  Just a thought.

I agree with this. Give it one more go n see what happens .

24 minutes ago, Ion said:

The validation is helpful. I have such a strong tendency to try to deal with things on my own and with the pdoc telling me I don't need help I have to push back against him and my own personality to keep believing that I deserve help.

I had a good development, though. I talked to my primary care about a backup plan if the pdoc wants to stop treatment or if we can't fix up our working relationship. In that case I will go back to working with my GP on meds and if necessary later they can refer me to a different pdoc. My GP and I work really well together, so I'd be happy to work on psych meds with them and just knowing that I have another option is a big relief

Im

sorrty your not having good luck iI’ve been through doctors doctors doctors and doctors. Sometimes it just takes a long while till you find one that works for you. I myself am on five  Long  year journey I’m still trying to find the right doctor. Things are slightly better but I’m nowhere near where I need to be. My new P dog doesn’t understand me very well.He told me this about 7×1st time we met. It’s obviously very discouraging but I’m gonna give it another shot. I tried countless meds countless doctors countless therapies, stay strong

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