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[alleyoxenfree]

And chair massage.  Having someone touch you in a way where you are not vulnerable (clothed) and the touch is therapeutic but nonsexual.  And it's usually not too expensive.

[myalterego]

I don't know what will happen next.  I'm hoping my SO will make some calls for me and magically find the type of psychiatrist that didn't exist earlier this morning.  Maybe I missed something?

So, do the psychiatrists in your area only do medication management and not clinical therapy? If that is the case, you may be able to find a psychiatrist and a licensed therapist who work cooperatively--perhaps even in the same practice. You and/or your SO might try asking that question when you call around. Also, if you look in the Yellow Pages at listings, you may see practices with some of each type of practitioner.

My SO found a place like that, and I have an appointment for tomorrow.  I really hope this helps, since I am so nonfunctional at work right now.  This has been extremely difficult for me, and I can't take much more of it.  (My collaborators probably can't take much more of me flaking out, either.)

I'm partial to clinical psych Ph.Ds.  I've always found their training the best, and have never gelled with either a social worker or a MFT or a psychiatrist. YMMV.  So looking for the Ph.D. by the name is a first.  Then there is a phone test; listen to their message by calling at a time that I know they will be in session.  I can tell a lot by the voice.  Drive by the office; depressing neighborhood?  If the shrink and I have compatible tastes, which is not the same as upscale, just compatible, if I like their office, it can work; our personalities will work together.  First session or first phone call, go with your gut, think of it just like dating.  What's your first impression?  Are they as flexible as you want - i.e. able to work with a doctor on your medication, or able to treat you without?  Rigidity to me is a no-go.  Discuss your history with other shrinks and see if they are defensive or derisive or critical about what you say.  For myself, I don't care what my diagnosis is; I am paying to have someone be supportive, help me disentangle my thinking, hear myself, think of things I didn't think of, suggest things in a supportive way.

So the look for the credential and the phone message takes little time.  I also started with the list of providers my insurance would pay for, and always found someone.  You are smart to start with lack of trust and build it, rather than extending it as a default and getting burned.

But other options: since faith is a potential part, ask a pastor or priest for a referral.  I also have a preference not for an MD but for a D.O. and find they are much better about working with physical/mental complexities, better at listening, and they can prescribe.  Get a D.O. and ask him/her for a referral to a psychologist. 

Thanks for all the suggestions.  If this place tomorrow doesn't work out, I'll try to follow up on these ideas.

I'm not a big believer in medication, but don't care if others use it and it helps.  I tend to think lack of motivation is a self-protective stance of the person not actually wanting to work on whatever they are whipping themself to do, whether because of anxiety or whether truly wanting to do something else. Is there something you want to do that you're not letting yourself do?  Make chicken?  Learn the banjo?  Join the circus?  I tend to think physically jolting activities can be very therapeutic, like riding rollercoasters, going on Outward Bound-type quests, taking trapeze lessons.  From what I've read, the mind has grooves, but the grooves can be reset in a number of ways, including talk therapy.  Many places do riding therapy, and mucking out a stable and riding sounds therapeutic to me right about now. 

I like plants, but it's a bad time of year for plants right now.  I pruned all the plants in my office last week and found it very therapeutic, but they don't need any more attention.  Somehow I doubt I'll find plant therapy, but I'll keep an eye out.  It would be fun.  Other stuff that I normally enjoy I don't feel like doing these days.

And chair massage.  Having someone touch you in a way where you are not vulnerable (clothed) and the touch is therapeutic but nonsexual.  And it's usually not too expensive.

Interesting idea.  Maybe I'll look into the massage therapy we have on campus.

[t_r_b]

What kind of mental health coverage do you have?

Have you moved to this area recently (say, within the last year)? Moving and starting a new job, settling into a new community, etc. are all big sources of stress - more so perhaps than we realize. That might account for your especially difficult year.

I wouldn't get too caught up in the distinction between seasonal depression and other kinds of depression. There are all sorts of things that can cause or contribute to depression, including stress and diminishing daylight and genetics and brain chemistry and all sorts of other things. Trying to pin down your condition to just one primary cause is probably not going to get you very far. At the end of the day all that matters is that you are depressed, and that leads to the same set of problems regardless of the cause. And regardless of the cause, the more time you spend depressed, the more likely you are to have future (and deeper and longer) episodes of depression.

It's also worth keeping an open mind about just what label to apply here. I don't doubt that you are depressed, but that's a symptom. There are various disorders that can cause depressive symptoms, and not all of them respond well to the same treatment. The meds may help you get out of your current funk, but there may well be underlying problems that need closer attention. And for that, the key is to find a therapist who is very good for your needs. Finding a good match in a therapist is very difficult, and you've obviously got one bad experience under your belt already. The key is to keep looking until you find one who works for you. Don't worry too much about the degree type. In each category (MD, MSW, PhD, etc.), there are good and bad therapists, and therapists who are a good match for your needs and therapists who aren't.

One last thing: do find yourself a primary care doc, sooner rather than later. One consequence of depression (which also contributes to it in turn) is a diminished ability to take care of oneself physically. That can mean all sorts of things, and not going to the doctor is one of them. And if you find a doc you are comfortable with, that person can both prescribe antidepressant medications for you and refer you to mental health professionals for therapy or more expert help with the meds.

Good luck.

[dr_evil]

Dr_Evil:  bad schedules are the worst!  Try to carve out some time for yourself.  I used to hide in my office with the lights off for 20 minutes or so. 

Thanks.  I'm trying, but still having trouble.  I share an office, so hiding out there isn't always an option.  I think that's part of what makes things more difficult - students are always in there seeing one of us.  Oh, and remember how I thought things would settle down after last week?  Yeah, not so much yet.  Now someone wants me to reschedule something I had planned weeks ago (something for me) so that I can make their schedule easier.  I'm still holding out hope that it will have to improve soon.

MyAlterEgo: I'm glad you're back with updates, but so sorry that things haven't been working out.  I don't have any advise to add to the other excellent suggestions you've already received, but I wish you luck finding something that works for you.

[rubygirl]

Dr_Evil--oh, the shared office!  Implement of Satan! >:-P  I don't have anything else helpful to say at the moment, but my thoughts are with you.

MyAlterEgo:  I had been at my current place for quite some time before I got a doctor, and the motivation was depression.  I was pretty sure I needed some help, and I, personally, was okay with the idea of chemical assistance before I was okay with therapy.  I called the office and asked if they were accepting new patients, and then I explained "I think I'm depressed," and they got me in pretty quickly. (My aunt, a social worker, suggested I try telling them that, because it tends to get you in faster.)

I wish you all the best; please keep us posted.

[dr_evil]

Dr_Evil--oh, the shared office!  Implement of Satan! >:-P  I don't have anything else helpful to say at the moment, but my thoughts are with you.

Yes, it can be.  Thankfully I get along great with the people I share with, but I just feel a need to get away.  It's been worse lately, but I'm not sure why.  I've also been noticing a lot of anger about everything - any little thing - and I feel like a complete failure.  *SIGH*  It is so frustrating.

I haven't seen any updates from others in a while, but I hope everyone else is doing well.

[zarathustra]

I've been struggling all semester with similar sentiments, Dr. E.  Part of the problem might have been a deep-rooted sinus infection for which I'm currently taking antibiotics.  So far (knock on wood), they seem to be helping.  I'm also eating as many omega-3 laden foods as possible.

[derigueurdaguerrotyp]

I usually just lurk here, but I've been struggling with some of the exact same things others on this thread have expressed. Dr_Evil, I've been feeling exactly the same way you have all semester--angry, touchy, feelings of failure, the works. My SO has been unemployed for almost a year now, and he just got turned down for another job, and I'm stressed about my comprehensive exams, and, and...and, I make all the explanations I want, but the fact is that I'm depressed. I've been here before; I know what it feels like. It took me until last night to admit it to myself, but I feel a little better now that I did.

I joined an Acceptance and Commitment Therapy group a few weeks ago (has anyone else here  tried ACT?), and it's helping a little. But honestly, I'm not doing a very good job of taking care of myself. I'm having a hard time resisting the urge to isolate myself, too. I know I should lean on other people for support, but I find it really difficult to open up when I'm feeling like this--it feels like no one understands or cares, even though rationally I know that's not true. What do you guys do when you're struggling with feelings of shame surrounding depression?

[rubygirl]

Derigeur, I don't have anything for you today, because I'm going through a rough patch...but you have my sympathies. I hope you start to feel better soon.

I wondered if anyone here has gone off SSRIs and would be open to sharing their experience (or PM'ing me).  I've been having a few symptoms of withdrawal (brain zaps, nausea) BUT I'm still on the meds!  However, I've been considering tapering off.  I've been on for a few years and I feel like it's not working as well as it used to. Also, I have gained a great deal of weight due to the medication, and it's beginning to be a pain (sigh). 

Thoughts?

[alleyoxenfree]

I know I should lean on other people for support, but I find it really difficult to open up when I'm feeling like this--it feels like no one understands or cares, even though rationally I know that's not true. What do you guys do when you're struggling with feelings of shame surrounding depression?

After running through all my friends during a prolonged period of bad job jujus, I've tried to sort of ration how much I talk about it.  That makes me feel less ashamed.  I focus instead on taking a mental vacation from it and making sure I'm paying attention to them, and paying attention to all the good stuff that comes my way.  I have come to feel that it was a family style to focus on the disaster and the bad, and that was partly because neither of my parents had living parents.  I think they felt way out at the edge without money, without family support, with many kids and just their educations between them and the lower classes they got out of.  So they were ever vigilant and cautious, especially my mother.  "Getting" this has made me observant of how often I do the same thing because, of course, my parents are gone and I'm out there on the plank myself.  But it is still an explanatory style that makes me focus on the plank instead of on all the possibilities.  I have to deliberately work to get more options.  This comes from a favorite book, What Do I Do Now?: Dr Fosters 30 Laws Of Great Decision Making, by Charles Foster.  I swear by this book, as well as by a little classic called Compassion and Self-Hate.  When I'm low, I go back to the basics reviewing this stuff. 

Sometimes I also use a technique of just spending just one day lying in a darkened room.  I haven't done this in awhile, but I use it as an option.  I read some research awhile back about the mechanism of this but don't have a link - evidently, it really does something biochemical.  I may or may not get up and shower, then go back to bed and just stay there for one day.  Keep everything dark and quiet.  I usually have some sort of breakthrough after this, so much so that I've come to think of being this low as a creative depression.  Sometimes I think we just have so much to process emotionally and intellectually that we need a super-rest to do so.

Recently, I have come to rely more on getting out and going for a really brisk walk in the prettiest nature place I can find.  I am not nearly as depressed here, despite the instability of my job picture, as I was when I lived in a claustrophobic place, an ugly place, or in a place with an a**hole for a boss.  Right now, the endorphins are really keeping me going.

Last thing I can think of is that I have recently noticed that when I take thyroid medication at night, I sleep well and wake up in a better mood.  For many years, I took it in the morning, which is when they usually recommend it (because your stomach is more likely to be empty).  Yet I would wake up with a lot of anxiety.   Recently, I took it a few days in the morning and - guess what - the morning anxiety returned upon awaking.  So I'm going back to taking it at night.  I know that a lot of drugs for things like chemo have been proven to have different effects depending on things like time of day taken, and even when they are taken in the menstrual cycle.  Perhaps experimenting with some of this might help.

[thundering_m]

Derigeur, I don't have anything for you today, because I'm going through a rough patch...but you have my sympathies. I hope you start to feel better soon.

I wondered if anyone here has gone off SSRIs and would be open to sharing their experience (or PM'ing me).  I've been having a few symptoms of withdrawal (brain zaps, nausea) BUT I'm still on the meds!  However, I've been considering tapering off.  I've been on for a few years and I feel like it's not working as well as it used to. Also, I have gained a great deal of weight due to the medication, and it's beginning to be a pain (sigh). 

Thoughts?

Rubygirl, I hope you do not change your dosage without consultation with the medico who prescribed it. I'm sure you've already considered interactions with other things you ingest that might be triggering nausea etc. On the other hand, if this is becoming chronic, you might need your eyes checked. No joke. Especially if you are on screen so much. Worth checking out because everything you decide to actually do is evidence of your capacity for initiative and therefore your capacity to reverse the downward course.
As far as a rough patch, how soon do you think it might naturally lift, given your patterns so far? Sorry for the scattershot responses, Rubygirl, but I'm feeling a bit scattered myself.

[derigueurdaguerrotyp]

Rubygirl, hang in there! I have never been on SSRIs, but the issues you're having sound very frustrating and a little scary. I hope you get them worked out soon!

After running through all my friends during a prolonged period of bad job jujus, I've tried to sort of ration how much I talk about it.  That makes me feel less ashamed.  I focus instead on taking a mental vacation from it and making sure I'm paying attention to them, and paying attention to all the good stuff that comes my way. 

This is where I've arrived now, I think. I'm feeling a bit better--after a few days of feeling considerably worse--and I think it might be more helpful for me in the long run to try to focus as much on others as possible, rather than seeking help from them. I'm never quite comfortable with that. So I think I'll try your technique. Did you inform your friends that this was your new plan? Or did you just sort of phase out talk about your struggles?

Sometimes I also use a technique of just spending just one day lying in a darkened room.  I haven't done this in awhile, but I use it as an option.  I read some research awhile back about the mechanism of this but don't have a link - evidently, it really does something biochemical.  I may or may not get up and shower, then go back to bed and just stay there for one day.  Keep everything dark and quiet.  I usually have some sort of breakthrough after this, so much so that I've come to think of being this low as a creative depression.  Sometimes I think we just have so much to process emotionally and intellectually that we need a super-rest to do so.

Kind of random question: do you have an SO? and if so, what does hu think when you do this? Because I find this technique really intriguing, and I'd like to try it--but Mr. Derigeur might get a little concerned if I remained in a darkened room all day.

I'm going to check out the books you mentioned, too. Thanks so much for the helpful suggestions, Alley!

[alleyoxenfree]

Rubygirl, hang in there! I have never been on SSRIs, but the issues you're having sound very frustrating and a little scary. I hope you get them worked out soon!

After running through all my friends during a prolonged period of bad job jujus, I've tried to sort of ration how much I talk about it.  That makes me feel less ashamed.  I focus instead on taking a mental vacation from it and making sure I'm paying attention to them, and paying attention to all the good stuff that comes my way. 

This is where I've arrived now, I think. I'm feeling a bit better--after a few days of feeling considerably worse--and I think it might be more helpful for me in the long run to try to focus as much on others as possible, rather than seeking help from them. I'm never quite comfortable with that. So I think I'll try your technique. Did you inform your friends that this was your new plan? Or did you just sort of phase out talk about your struggles?

Sometimes I also use a technique of just spending just one day lying in a darkened room.  I haven't done this in awhile, but I use it as an option.  I read some research awhile back about the mechanism of this but don't have a link - evidently, it really does something biochemical.  I may or may not get up and shower, then go back to bed and just stay there for one day.  Keep everything dark and quiet.  I usually have some sort of breakthrough after this, so much so that I've come to think of being this low as a creative depression.  Sometimes I think we just have so much to process emotionally and intellectually that we need a super-rest to do so.

Kind of random question: do you have an SO? and if so, what does hu think when you do this? Because I find this technique really intriguing, and I'd like to try it--but Mr. Derigeur might get a little concerned if I remained in a darkened room all day.

I'm going to check out the books you mentioned, too. Thanks so much for the helpful suggestions, Alley!

I didn't announce anything to friends, other than from time to time, I have said something like, "It's been great to have someone to talk to; I hope it hasn't been too taxing," or "I really appreciate being able to lean on you during that period of time."  I realized I wanted them to know that I wouldn't always be needing that degree of help, and that I acknowledged I really used them as a listening ear.  But mostly, I just made a concerted effort not to cover up but to say, yes, things still suck a bit, but you know, they'll get better.  So what's up with you?

As for staying in bed a day, treat is as though you have a migraine (which I have, so it's never been an issue with an SO).  But give it a name.  If your SO is a reasonable person, they should not have a problem with your taking a Low Stim(ulus) Day, or a Recuperation Day.  Assure them you don't need anything except a deep rest - no light, no noise, no expectations, no one around.  As I said, there is science behind this; I just can't remember how exactly it works but I know it does.  This is not the same thing as being severely depressed and unable to get out of bed for days and weeks at a time.  But IIRC, they did make a comparison to the way people naturally take to their beds when they've had a big shock, like after a death in the family.  The body knows when it is overwhelmed and needs to recuperate by limiting functioning and pressing reboot.

[derigueurdaguerrotyp]

As for staying in bed a day, treat is as though you have a migraine (which I have, so it's never been an issue with an SO).  But give it a name.  If your SO is a reasonable person, they should not have a problem with your taking a Low Stim(ulus) Day, or a Recuperation Day.  Assure them you don't need anything except a deep rest - no light, no noise, no expectations, no one around.  As I said, there is science behind this; I just can't remember how exactly it works but I know it does.  This is not the same thing as being severely depressed and unable to get out of bed for days and weeks at a time.  But IIRC, they did make a comparison to the way people naturally take to their beds when they've had a big shock, like after a death in the family.  The body knows when it is overwhelmed and needs to recuperate by limiting functioning and pressing reboot.

Thanks for the clarification, alley! That makes a lot of sense. I'll remember this the next time every cell in my body is telling me to take a mental health day.

[rubygirl]

Thanks for the good thoughts, everyone!  I hope all are doing well.

Thundering--good point about getting the eyes checked.  It's definitely time to do that; I've noticed some changes.

Have no fear:  I would never go off my SSRI without help/being monitored.  I'd rather not screw around with that drama. :-p

I've got an appointment with a new doctor next month.  I also spoke to my therapist about my concerns, and we're working on good coping strategies from that direction.

I feel pretty good about where I am right now.  I've had a productive week, and am working on positive self-talk (always tricky, esp. when anxious or depressed).  I want to make it a habit.

Anyway, part of my good health plan is adequate sleep, so I'm off to bed. :-)  Best wishes to all.