Saw the doctor today
Mar. 8th, 2005 08:02 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
xiphiasDr. Sagov is very difficult to make appointments with, so I saw Dr. Altman, who's the other physician in the practice. I'm starting to really like him. Not as much as I like Dr. Sagov, because, well, Dr. Sagov has been my doctor since I was a wee tot, but Dr. Altman has many of the same traits that make Dr. Sagov a good doctor.
Anyway, the upshot is he upped my dosage of Lexapro, with the comment that it looked like the medication started failing about when the days started getting shorter, so we'll revisit the dosage in six weeks, and, if things are getting better, possibly cut back to the original dosage, with a note to go back up to the higher dosage in November.
And we also talked briefly about therapy as a possibility. I said that, while I wasn't resistant to the idea in principle, I wasn't enthusiastic about it, because I've seen maybe a dozen therapists of one stripe or another in my life, working with six of them fairly extensively, and had really nothing to show for it.
But Lis and I were talking about it further, and I'm trying to figure out if it's time to re-open the question and maybe start again.
And, well, as my friends list is chock full of 1) therapists 2) medical personel of various sorts 3) generally wise people 4) people who've benefited from therapy (with lots of overlap between categories), I figured I'd ask here.
The problem is that, well, therapy has mainly been a great waste of time and money for me. I don't know how to judge if I'm making progress, and I CERTAINLY don't want to hurt a therapist's feelings by saying that I feel like I'm NOT making progress, and, anyway, if I'm depressed, I'm feeling enough inertia that I don't want to make changes like changing therapists. . .
Also, this livejournal is the only forum I've ever found in which I'm comfortable talking about myself. I mean, the ONLY forum. Writing a private journal seems pointless, because who am I writing it for? Talking about myself in person feels egotistical. And while writing a livejournal IS egotistical, definitionally, it doesn't bother me, because I feel certain that y'all can just not read it if you're bored. Which means that I feel free to be boring, because I know that, no matter how boring I am, I'm not going to bore anyone who doesn't freely choose to be bored. Since there's no way you'll offend me by NOT reading this, I know that, if you ARE reading it, it's because, for whatever reason, you're interested.
So, in person, in therapy, I feel awkward. I understand that I'm paying the therapist for his or her time, so I should feel free to talk about myself. But I'm also pretty skilled at drawing other people out, so I've also managed to get them to talk about themselves. Which I am more comfortable with, but which kind of defeats the purpose of therapy.
And, in general, I can't figure out what I'd be trying to DO with therapy, anyway. I mean, I get depressed. The ability to feel happiness sometimes gets sucked out of me, so quickly and violently that I get a physical sensation of it draining out of my feet. There's not much I can DO about it. Talking about it doesn't help.
I can certainly see that, if I was to get some of the depression under control, I'd need to learn how non-depressed people do things, and that might be useful -- I remember that, when Lis and I were seeing a coach, that had some value for me. But I don't see how therapy would help for me.
I wish to stress that this is not intended as any sort of general dismissal of therapy -- I think therapy is a wonderful thing, and I'm actually a little proud I can list so many therapists among my friends. I just don't see how it would help me.
But I'm also aware that I could well be wrong. So I guess my question is -- how do I know if I'm wrong about this, and that I actually SHOULD give therapy of some sort another shot? It's not like we've got unlimited money, and I'm a bit resentful about the money and time I've wasted in it so far. . .
Anyway, the upshot is he upped my dosage of Lexapro, with the comment that it looked like the medication started failing about when the days started getting shorter, so we'll revisit the dosage in six weeks, and, if things are getting better, possibly cut back to the original dosage, with a note to go back up to the higher dosage in November.
And we also talked briefly about therapy as a possibility. I said that, while I wasn't resistant to the idea in principle, I wasn't enthusiastic about it, because I've seen maybe a dozen therapists of one stripe or another in my life, working with six of them fairly extensively, and had really nothing to show for it.
But Lis and I were talking about it further, and I'm trying to figure out if it's time to re-open the question and maybe start again.
And, well, as my friends list is chock full of 1) therapists 2) medical personel of various sorts 3) generally wise people 4) people who've benefited from therapy (with lots of overlap between categories), I figured I'd ask here.
The problem is that, well, therapy has mainly been a great waste of time and money for me. I don't know how to judge if I'm making progress, and I CERTAINLY don't want to hurt a therapist's feelings by saying that I feel like I'm NOT making progress, and, anyway, if I'm depressed, I'm feeling enough inertia that I don't want to make changes like changing therapists. . .
Also, this livejournal is the only forum I've ever found in which I'm comfortable talking about myself. I mean, the ONLY forum. Writing a private journal seems pointless, because who am I writing it for? Talking about myself in person feels egotistical. And while writing a livejournal IS egotistical, definitionally, it doesn't bother me, because I feel certain that y'all can just not read it if you're bored. Which means that I feel free to be boring, because I know that, no matter how boring I am, I'm not going to bore anyone who doesn't freely choose to be bored. Since there's no way you'll offend me by NOT reading this, I know that, if you ARE reading it, it's because, for whatever reason, you're interested.
So, in person, in therapy, I feel awkward. I understand that I'm paying the therapist for his or her time, so I should feel free to talk about myself. But I'm also pretty skilled at drawing other people out, so I've also managed to get them to talk about themselves. Which I am more comfortable with, but which kind of defeats the purpose of therapy.
And, in general, I can't figure out what I'd be trying to DO with therapy, anyway. I mean, I get depressed. The ability to feel happiness sometimes gets sucked out of me, so quickly and violently that I get a physical sensation of it draining out of my feet. There's not much I can DO about it. Talking about it doesn't help.
I can certainly see that, if I was to get some of the depression under control, I'd need to learn how non-depressed people do things, and that might be useful -- I remember that, when Lis and I were seeing a coach, that had some value for me. But I don't see how therapy would help for me.
I wish to stress that this is not intended as any sort of general dismissal of therapy -- I think therapy is a wonderful thing, and I'm actually a little proud I can list so many therapists among my friends. I just don't see how it would help me.
But I'm also aware that I could well be wrong. So I guess my question is -- how do I know if I'm wrong about this, and that I actually SHOULD give therapy of some sort another shot? It's not like we've got unlimited money, and I'm a bit resentful about the money and time I've wasted in it so far. . .
(no subject)
Date: 2005-03-09 02:07 am (UTC)Because he's been depressed for so long, Ian seems to have disassociated his emotional state from any external stimuli. I can't ask him *why* he's feeling a certain way, because he doesn't look for causes as I tend to. It's all neurochemical to him.
Just something I've observed...
(no subject)
Date: 2005-03-09 07:03 pm (UTC)I'd call, "emotional states disassociated from external stimuli" a mental illness or disablity, separate from depression. The skill of determining the (usually external) sources of my emotions is THE most important skill I have. So it floors me that you can function without it, and, apparently don't consider the it's lack to be a major problem.
Well, it's your life. If you aren't bothered by it, and want to spend your time and energy elsewhere, that's your decision.
On the other hand, IF you want to change this...
1) Take Lexpro... because when you don't, your emotional state IS disassociated from external stimuli. (I'll assume that when you're taking Lexpro it replaces the false emotional state "depression" with the healthy state "emotions respond to external stimuli" rather than the equally false emotional state "always happy".)
2) Determining why you feel the way you do is a skill. Learn it. I can't say that therapy is the best way for you to learn this skill, but it is the most common, the most polite, and, for most people, the fastest. Therapists are the only professionals that I know of who teach this skill, and it is a good part of what most of them do, one way or another. (and, BTW, you are not the only one in this boat. Why do you think there are so many therapists?)
You shouldn't judge the usefulness of therapy with medication by the uselessness of therapy without medication. Several people have said that therapy with medication can help retrain bad habits that were established by depression. The dissassociation of emotions from external stimuli looks like that kind of bad habit. The tendency to avoid long term commitments (a couple LJ posts ago) could be another.
In case you haven't guessed, I'm strongly in favor of therapy. I think it would make you more functional, and possibly happier. And it would decrease the frustration of the people around you who often WANT to know why you feel a certain way and find "biochemistry" a... frustrating... answer.
Kiralee
(no subject)
Date: 2005-03-10 01:17 am (UTC)And (this is why I'm responding, actually) it /can/ be fairly mild-- as when you try not to pay attention to what's going on with you in the dentist's chair, say. It's one of those continuum things.
(no subject)
Date: 2005-03-10 12:36 am (UTC)If you have a relationship with a therapist that isn't working for you and that you can't fix, it's the therapist's fault. You should get a new one, and feel no guilt about doing it. (This might be obvious. But some people blame themselves when their therapy isn't working. They should blame the therapist and move on.) At the same time, if you are deliberately sabotaging the relationship, you need to stop. Getting therapists to talk about themselves, for example, qualifies as sabotage.
The dissociation thing is really important. I certainly do it. It's a coping mechanism, and one that our society generally teaches men to have. That doesn't mean it's a healthy coping mechanism, though. It's a problem for me when I'm suddenly angry at everything, and even when I can figure out what the event that made me angry was, I don't know why it made me angry. It's also a problem when I have to explicitly stop and ask myself how I'm feeling. Being surprised by my own emotional state isn't a good thing.
Two questions for
A book I recently read on male cultural programming and depression is "I Don't Want to Talk About It" by Terrence Real. It's not great, but I found I related to it far more than I was happy about. It's worth looking at for info on how depression expresses itself in men and why. (Part of the argument of the book is that our culture defines depression in terms of how women express it. But our culture also teaches men and women to manage emotions in different ways, so men express depression in different ways than women.)
Talking about emotional dissociation reminded me of the book, so I figured I should mention it.
Reply to Juliansinger
Date: 2005-03-11 06:41 pm (UTC)I am particularly thinking of his post from 9/9/04, "So, what is depression like for me?" To quote:
"Because my depression is primarily biocheical in nature, I have gotten used to thinking of emotional states as being entirely distinct from outside events. I rarely think of questions like 'why am I unhappy,' because I've gotten used to there being no cause..."
"I'm beginning to learn that that isn't true. There are times that I get unhappy because bad stuff happens, or happy because good things happen. But I'm not used to thinking that way, so I don't look for causes like that. If someone insults me, or attacks me, and I become upset or depressed, I'm likely to think of those events as entirely unrelated..."
....
One of my first lines of defense against emotional pain is knowing when/where/how/why it happened and working to avoid or prevent it in the future. Xiphias is, apparently, not even aware that unhappiness is the result of an event that could be prevented. It's like watching someone you care about (since I care about Xipias) spend their entire life wandering around a construction site without a hardhat.
I know, or at least I can intellectually deduce, that Xiphias has protection that I can't "see". But it still gives me the emotional willies. And it floors me that Xiphias does not respond to this as a five alarm crisis.
It floors me even more that HE DOES NOT HAVE TO. He can, in fact, function reasonably well without a "hard hat". If I had not seen it I would not have believed it, but I guess nothing is impossible.
On the other hand... given that Xiphias asked what we thought, and that Lis brought up exactly this point... I thought it was appropriate to say that I see this as a problem, and that I think therapy would/could help.
Although I also agree with Mrmorse, when he says, "Two questions for Xiphias: Are you unhappy being dissociated from your emotions? And if not, what can you do about it?"
I know that Xiphias doesn't feel about this the same way I would. And I think he should make his decision based on what works for him. Being dissociated from his emotions is only a problem if he thinks it is... Although I'm aware many people would consider the state he decribes above to be a problem, it's still his choice.
Kiralee