My Mental Health Treatment Journey
Adventures with therapy, meds, and beyond
Welcome to the third installment in a series of posts about the journey I’ve been on over the past three years. Previous posts: Part 1, Part 2. This one discusses depression and its symptoms and treatment. Though I’ve tried not to make it too heavy, be forewarned that some sensitive subjects are touched upon.
In July of 2020, I was losing it. “It,” in this case, being my will to live.
I hurt everywhere—mentally and physically—to the point where I could barely function. There was an intense weight in my chest; it took a lot of energy just to hold my body up. Though I’ve always been an anxious person and prone to depressive thoughts, I had been able to manage them in the past. But everything suddenly felt like it was spiraling out of control. And I couldn’t imagine that it would ever end. I started fantasizing about ways I could make the pain stop (none of which, to put it mildly, were healthy options).
Even so, it was not easy to reach out for help. Now, I can look back and realize how much I was suffering, but at the time it just felt like the stupidest thing to say, “My book flopped—partially due to my own inability to promote it—and now I’m having trouble convincing myself that life is worth living.” I knew I should toughen up, dust myself off, and move on. Because in the grand scheme of things, did that book really matter?
Well, maybe not. But inside my personal universe, it mattered a lot. My writing had become deeply entwined with my own identity, and with the way I’d hoped to make a mark on the world. I felt like I’d failed as an author, and this cut very, very deeply.
But I wanted to get better. For my family. I didn’t want to remain this empty husk of a person who snapped at the people I loved (or withdrew from them entirely) because I hurt so much inside.
Starting Therapy
One day I finally mustered the courage to call my insurance provider to find out about my mental health care options. It turned out that they cover the cost of a mobile app that allows virtual visits with therapists, psychiatrists, and wellness coaches. All of which sounded great to me... but, due to high demand, I had to wait a month to see a therapist. Which felt like FOREVER when it was such a struggle to get through each day. Weekly chats with a wellness coach filled the gap somewhat, though. I started doing yoga daily, listening to guided meditations, slowing down, pushing back book-related deadlines and focusing more on self-care.
Then I had my first session with my new therapist. And it did not go well.
She seemed impatient and disinterested in me, and I came out of it feeling like even more of a loser than I had before. Who was I to be taking up this person's valuable time, when so many others undoubtedly needed therapy more than I did? Who was I to claim being "depressed" (and a depressed writer at that—how cliché!) when I had so many privileges and a supportive family? I felt like an annoying whiner who was making a big deal out of nothing.
With some distance, I recognize now that this therapist was probably just burned out. Which, of course, had more to do with her own life and the demands of her profession than it did with me. But it still really hurt at the time. I had put a lot of trust and hope in the expectation that therapy was going to cure me. And when it just made me feel worse, I wondered if I had made a mistake. Maybe therapy wasn't right for me after all? And if it wasn’t… what was I supposed to do instead? How was I going to get through this?
I had to wait six weeks before my next session. And it didn't go well either. At this point, I wasn't sure what to do. Should I seek out a different therapist? I didn't want to "reject" my current therapist by going with someone else. At the same time, I had come to dread therapy sessions and felt I was getting more help from my wellness coach than from my therapist.
In the end, the problem solved itself. That therapist ended up leaving the platform and I was assigned to a different one. Our first session was much better—more like what I thought therapy would be. I got the sense that she cared about me, so that was refreshing. But while she had some great insights, we stayed solidly in the cognitive/intellectual realm. After a while, I felt like this wasn’t getting me where I needed to go.
It was strange to realize that trying to use logic to get my thoughts “under control” just was not working for me. It was so frustrating! My whole life, I’d put most of my energy into cultivating my mind, especially its rational and scientific side. Why wasn’t it coming to my rescue now, when I needed it most?
Welp, turns out depression is not rational. You can’t just think your way out of it, because it isn’t solely a condition of the mind. (My body had been trying to warn me about this for a long time, but I kept ignoring its signals because they didn’t “make sense.” If only I’d paid attention to it sooner!)
When my second therapist told me in the spring of 2021 that she too was leaving the platform, I decided to search for someone who I could see in person, and who would take a more experiential, creative, and body-centered approach to therapy. My sister had gotten me interested in Internal Family Systems therapy (a huge topic that I’ll be covering in more detail later), which isn’t exactly a mainstream approach, so I started looking outside my health provider’s network. Through the Psychology Today directory, I was able to find my current therapist, and she is AWESOME. What a difference it makes to work with someone who not only "gets" you, but is willing to engage with you in the way you find most helpful!
Real talk, though: I have to pay out of pocket to see her. It was really hard to bite the bullet and make that budgetary commitment, but fortunately we've been able to make it work. And it's important to my family that I take care of my mental health, so it has definitely been a worthwhile investment.
Not everyone can go this route, unfortunately. I hate that there are so many personal and institutional hurdles involved in getting this kind of support. I wish it was easier for people who are less resourced to find help that actually works for them. But that's a rant for another time, I suppose.
On Meds… and Off Meds
One good thing came out of my relationship with my first therapist: she referred me to a psychiatrist. After thinking through the pros and cons with him, I began taking antidepressants. This was a tough pill for me to swallow at first (har har). I was doing all the "right" things, therapy and yoga and meditation and reaching out to friends, and I wanted so badly for all of that to be enough! Why should I have to add chemical intervention to the mix?
Then the following truth dawned on me: Depression is a life-threatening disease. We all know of someone whose battle with depression ended in tragedy. So why not acknowledge this condition with the gravity it deserves? You wouldn't treat cancer with yoga alone. I had to grudgingly admit that perhaps there was a role for pharmaceuticals in my treatment plan.
Once I resigned myself to taking them, they weren’t so bad. And both my psychiatrist and therapist brought up an important benefit I hadn't considered before: they often allow you to go deeper in therapy. They take the edge off, allowing you to deal with painful topics you might otherwise avoid (sort of like novocaine for dental work). The hope is that if you're able to get to the root of your issues and process them in a safe environment, you'll eventually get to a place where you no longer need the meds.
Something like that happened for me last fall, when I went through a major metamorphosis. After a ton of difficult inner work and over a year of trust-building with my therapist, I'd finally been able to face some things that had haunted me for decades. This was unspeakably scary, but also incredibly freeing. I felt like a whole new person! The next step, I decided, was to slowly taper off the antidepressants I’d now been taking for two years (under the supervision of my psychiatrist, of course).
I regretted the decision almost immediately.
For months, I felt like I was right back where I had started. Those two years of what I’d thought was “healing”? Somehow, they had been completely erased. I worried that the meds were the only thing that had caused improvement. The future without them looked stark and bleak.
Outwardly, I was going about my life as usual. I longed to talk publicly about what I was going through, so that I could find others who were in the same boat, or who had come out the other side and could reassure me that it was going to be okay. But I tend to go into isolation mode when depressed. Instead of trying to find connection with others in similar situations, I crawled back into my hidey-hole.
Thankfully, my spouse and kids (and my therapist, of course) were there to help me through it. Starting early on in the process, I’ve made it a point to let my kids know when I’m going through a rough time—and that I’m getting outside help for it. That way, they know my irritability and moodiness is not their fault, and also that they are not responsible for “fixing” me.
This was really, really hard for me to do, because I’m so uncomfortable airing unpleasant emotions in front of others. But I think it set a good precedent and has allowed them to be more emotionally open with me, which feels extra important now that they’ve hit the teenage years.
When I told them I was going to transition off the meds and might be extra moody while my brain was running low on serotonin (cue Girl in Red’s fantastic song), my daughter jumped right into brainstorming. “Okay,” she said. “So, what are some things that keep you serotonined?”
That question became my beacon through the hard months that followed. To try to boost my serotonin production, I started taking a few dietary supplements (N-acetyl-cysteine and zinc). Every single morning, I did 20 minutes of breathwork/meditation. I also carved out time for daily movement in the form of walking, roller skating, or yoga. I took every opportunity to revel in nature, sing loudly, end my showers with cold plunges, and read books and watch shows/movies that entertained and transported me.
Eventually I made it out the other side, but it took a while before I finally felt more like myself. If I were to do it over again, I would try not to time antidepressant discontinuation with the dreary winter months, and I would taper much more slowly, taking at least 6 months to decrease the dose bit by bit. For the record, I’m doing much better now—but I still have to incorporate things that keep me adequately serotonined into my everyday routine. I’ve learned that my depression waxes and wanes over time, and it’s something I’ll probably be dancing with for the rest of my life.
Resources & Closing Thoughts
I've compiled some mental health resources on my website. If you're feeling overwhelmed and don't know where to turn, please get in contact with a crisis line (there are text-based options if voice calls feel too intimidating). Regardless of what your brain may be telling you, you deserve to get the help you need!
Part of the reason I am sharing this is to show others who feel this way that they aren’t alone (even though I personally could not stand hearing the phrase “you are not alone” when I was depressed! I know rationally that it’s true, and the intentions behind it are good. Still, it just felt trite and dismissive, like a teensy band-aid slapped on a gushing wound. Hearing stories about people who have been there, though, makes me feel that sense of shared struggle, and that helps me know, deep in my bones, how connected we truly are). ❤️
Just chiming in here. I struggled with depression and anxiety throughout my life. I put a lot of energy into managing it with exercise, vitamin supplements, and trying to have a positive attitude. I started to feel like I was losing the battle at about 42 years old. I finally went on Prozac. It made a huge difference. I don't like being on "drugs" but as one doctor put it... it is no different than having a cup of coffee in the morning. (Caffine is a psycoactive drug https://www.newscientist.com/definition/caffeine/ ). I did try weaning myself off of it a couple of times but I did become short tempered and moody. This was really hard on my relationship. I went back on Prozac. I will probably just continue indefinitely. There are side effects to antidepressants, but I think it is by far the lesser of two evils. If the meds really help I don't see any reason to live with depression, life is too short. However, I do completely understand not wanting to be dependent on a drug. I also now use poles when I go hiking, it sounds silly but I resisted using them because I felt I didn't need them. They were a crutch. Hiking with poles has relived a lot of stress in my knees and hips, most likely enabling me to hike for many more years than I would have otherwise.
Food for thought
Sometimes it is truly painful to know you’re not alone. Depression has been my ugly shadow for most of my life. It wasn’t until I identified the issue (in my mid thirties, yikes) that I realized there was a name for my dark and troubled thoughts. A low dose of antidepressants helps to mostly keep me steady but sometimes life feels like a tiresome endless uphill trudge with bits of beauty and peace tucked in between the paths. I seek out those bits and try to use them as a shield against the insidious sadness of depression. Thank you for sharing your journey. Depression isn’t a choice we make and it’s important to shout that out to the world.