Is it a mental illness or just depression?

[The_Abyss]

I am struggling. I have had periods of depression before, but this one has been long-lasting and all consuming. After a couple of episodes of self harm, and realising I had everything in place for accessing a successful suicide, I swallowed my pride and sought a referral to a psychologist. I felt more positive after the first visit, and felt I had the beginning of the tools to start climbing out of my abyss. At the second visit, many of my childhood traumas where cracked open, and like a Pandora's box, the poison has spilled forth, never to be re-constrained. Rather than making an appointment a week later, the psychologist made it at 3 weeks, and I felt like a victim of abuse all over again. He constantly refers to my inner voices of failure and hopelessness, which has the affect of making me feel more hopeless, more of a failure. Despite this, I have already developed a dependence - like a hostage dependent on the kidnapper, or a victim dependent on the abuser. Today he introduced Schema therapy, but I was unable to focus on that enough to get benefit. He is again unavailable for the next 5 weeks, and I feel like I'm drowning with no one to turn to. My husband doesn't know I've been attending the psychologist, and it's not a conversation I feel I can have. To make it worse, I have started getting menopause symptoms combined with dreadful PMS symptoms at the same time. I dread the next one as I swing between suicidal and homicidal during that week. I don't feel I can speak with my GP as he is also a work colleague, and living in a small town, I know or am known by people at each practice. In the meantime, I have started to get serious concerns that this isn't just a simple depression, but the manifestation of a borderline personality disorder, and that terrifies me. I don't know where to turn or what to do. Do I try a different psychologist and have to start all over again, risking ripping open the Pandora's box further? Or do I bide my time, work on the Schema therapy exercises the psychologist introduced me to and wait for him to have time for me? Do I do nothing, drowning deeper and deeper? What if it is a mental disorder rather than just a depression? GP suggested medication, but I'm not ready to admit I have a problem to that degree. Like an alcoholic that attends their first AA meeting, but isn't yet prepared to tell anyone they are going, or admit they have a problem. I'm sorry to ramble - I feel so lost and alone, drowning, terrified. In the Abyss.

[james1]

Hey The Abyss,

Welcome to the forums. I'm really glad you've come here and sought help from us as well as a psychologist, because any kind of mental health difficulty is really hard to do alone and there are many supportive people here.

I have also done a bit of Schema Therapy as well as DBT and now Transferance Focussed Therapy for my BPD symptoms. I don't know if you have a BPD diagnosis or not, but if your psychologist is looking at Schema Therapy, then I'd say they probably see symptoms of it. That's not a bad thing - personality disorders are simply reflections of what happened to us as children. They are reflective of not a bad person, but a person struggling with hard to break mental habits.

It's very normal to have all these questions and concerns about your visit. It's really scary to go and start tackling issues from decades ago. But I am a bit worried that your psychologist is putting such long waits in between. The longest I've ever had to wait was 3 weeks over a holiday. Otherwise I used to see mine weekly..

All these bad thoughts and feelings you've described show how much you need support right now. Can you give them a call and see if they can schedule an appointment before, or ask what alternatives they have because you don't feel like you can wait for five weeks?

There is a long journey ahead for you - I've been in therapy for a year now and I'm only at the beginning - but I hope you feel safe coming back here to share how you are going. If you ever feel you can't keep yourself safe, please call emergency. Otherwise, Lifeline 13 11 14 and BeyondBlue 1300 22 4636 offer support lines as well. I've been in hospital and it really isn't a big deal. Your well being is what matters and you have a real community of fellow suffers here on the forums.

James

[White_Rose]

Dear TA

Hello and welcome back to Beyond Blue. It's tremendous you felt OK to come back and talk to us. Thank you for your trust.

Unless there is another GP you can access locally I think you will have to put your trust in this GP. One reason is he must be absolutely discreet about all his patients. It is also not in the best interests of his patients to gossip.

You say, I have started getting menopause symptoms combined with dreadful PMS symptoms, and this may well be a significant contributor to your depression. It is amazing what this can do to our physical and mental well-being. So if I may suggest, go and see your GP and get this bit sorted. Once under control you will feel heaps better. I thought I was lucky not to have these symptoms and sailed through these changes, so to speak. But then I had breast cancer and after surgery etc I was given a medication to stop the cancer reappearing. Great idea if it hadn't given me those symptoms I was so smug about missing out on. I was so ticked off. And I assure you that you are not the first or only woman to have suicidal thoughts because of menopause.

If your psychologist is keeping you waiting for long periods between appointments because he has a large practice. If you are on a mental health plan (MHP) the psychologist is stringing out the appointments in order to give you a longer time in therapy. The more I see about MHP the less impressed I am. This is no excuse to make you wait when you are having thoughts of suicide. It sounds very much like incompetence and a dangerous practice.

You have started to look for help and that is fantastic. I can totally relate to your feelings of dependence and in many ways these long waits for appointments add to that dependence. I once saw a psychiatrist who fell asleep while I talked to him. Yet I continued to go because I felt the same sort of dependence as you. Ridiculous! Is there another psychologist or psychiatrist you can see? I do understand about living in a small town and gossip, but you are seeing a psychologist anyway, why not make your sessions with someone who is more capable and empathetic.

I see a wonderful psychiatrist as a result of my attempted suicide a while ago. Best thing I did. Try to get a referral to a psychiatrist. You may also find it cheaper as Medicare does pay a large chunk of the bill. And of course there is the Medicare safety net. Talk to your GP about all these options. Talk more next time.

Mary

[NurseK]

Dear Abyss

As a mental health professional and someone with two mental illnesses (Anxiety & Depression) finding the right psychologist can take a while, it is okay to change your mind and find the right psychologist that suits you. You also have the right to tell your psychologist if you are not ready to open up about trauma's. Bringing up a tough history can open new wounds and if you don't have the skills to deal with the destress it can set you back. Maybe try talking to your psychologist about gaining skills to deal with your current suicidal and homicidal thoughts and putting together a safety plan. Your safety is the most important thing when you are in crisis. I have lived in both rural areas and Sydney. It can be really frustrating when you open up old wounds and then have to wait weeks before you see your psychologist. If possible try linking in with your community mental health team- they typically have a crisis team you can have access to around the clock. I understand being worried about the stigma attached to mental health, especially if you work in the health sector. I myself work in mental health and had great trepidation when I required a hospital admission on the campus I work at, remember that your care is confidential.

Please don't give up hope. I am sorry that the way your psychologist talks about your inner voices/thoughts puts you down, I have also experienced a similar situation where a psychologist started talking to me as if I were a child just because I had shutdown and put up my walls. This was very upsetting and she asked me why I had become flat and withdrawn it took a lot of courage to tell her it was the way she was treating me, I wanted to let her know her approach wasn't therapeutic and I wanted to make sure other patients didn't have to feel the same.

You sound like a strong person and you are trying your best to access treatment and get the help you need. As James1 said if things get too much contact lifeline & beyond blue.

Good Luck!

[The_Abyss]

Thank you James, Mary, and NurseK.

I travel to a different town to see the psychologist - I have worked, played, or socialised with the ones in town and so aren't comfortable seeing them professionally, or having people who know me see me coming out of their rooms. I see a physio in the same other town which gives me an excuse for being there. I am terrified about being "discovered" as I have spent my entire life appearing to be strong when inside I was shattering apart. Admitting I have depression or a mental illness is too much at the moment, it's admitting a weakness I am not ready to face in myself. (please don't take that I think mental illness is a weakness - I feel that MY lack of ability to cope with everything at the moment is MY weakness. I should be able to deal with all this crap and just can't right now, and because of my personal hangups, I see this as a weakness in my character).

You're right, I should be able to request more frequent visits. When he gave me the three week gap after opening Pandora's box, I wasn't sure if it was done for a reason or just an oversight, and didn't have the mental presence to ask. The 5 week break is because he is away, and I have debated today whether I should try and see someone else there just to get some relief. I would like to tell him what his methods are doing to me, would like to request that he challenge my current beliefs rather than taking me back to the past, would like him to ask me each week what MY priority is that week. I can have these conversations in my head, but can't challenge the instigator. He speaks of my "healthy adult" (something I have since discovered appears to come from the Schema therapy) - what would my healthy adult do or say. Well they can do or say anything when it's not important, but they retreat pretty fast when I need them to stand up for me!

I have resisted ringing Lifeline. My mother is a main perpetrator in my hang-ups and was a counsellor at Lifeline for many years. It was only the other day I remembers seeing Beyond Blue advertised and so thought I would see if there was help available here. I have already found reading other people's posts have helped me from feeling as sorry for myself - there are people so much worse off than myself. The helpful posts from others have also helped remind me of some of the previous strategies that have worked to keep me from the Abyss - it's so easy to get tunnel vision when depressed and alone.

Thank you again.

[geoff]

hi TA, well depression is a MI, and likewise MI can be having depression, the main contributor to all sorts of different types of depression.
Psychologist all work in different ways, some first concentrate on the present while others dive into your childhood, that you won't know until you start speaking to them, either way may not suit you, but then talking with a psych could make you feel very uneasy.
If they are worried about your state of mind then leaving a week or two between appointments is really not satisfactory, especially if you don't feel comfortable talking to someone else, because when they open past memories, it's like 'opening a can of worms', and then don't want to see until 3 or 4 weeks time is not what should happen, because it leaves you with all this time to think which will then make you more unsettled and bringing back thoughts which you don't want or know how to handle them.
You can't fight denial because when you do, you build a barrier that keeps getting higher, making it much harder for accepting help and realising that that's what you need.
There is nothing to be ashamed of if you do have MI, you didn't ask for it nor did you ever want it, we never know if or when we are to be stricken down, but when you don't talk to your husband, then who can you talk to, and if you say nobody then you need to make the appointments more frequent.
You're not on your own here because all of us have struggled through some type of depression ourselves, and the mistake I made was that I stayed in denial for too long. Geoff. x

[The_Abyss]

Thanks Geoff,

You are right, I do need to talk with someone, and more regularly. When the first two appointments were set at 2 weeks, it was hard but manageable. When things were circling the drain, I had the appointment to anchor me. The three week gap was too long though, especially as it came after the Pandora box incident. To make it worse, I got home to a major triggering event, which was enough to spiral me right out of control. Those three weeks were the hardest I'd had for quite a while, but once again had the appointment to (just) hang on to. I had hoped to put to bed some of the previous issues during the appointment, and to discuss the triggering incident, but instead it moved into different directions. With him not being available now for 5 weeks, I'm lost. I would like to make another appointment (which I struggle with as I have always been a "rule follower"), to discuss how I am feeling, what I need, how lost I am, but now it's all up in the air. I think ultimately he will be good for me in the long run, but at the moment it's just not working and I can't address it until he gets back.

I saw a different psychologist in the same practice a few years ago as a result of PTSD compounded by huge work issues. I spent 9 months there (through an assisted employee program), and he was often my much needed sounding board. We started weekly, and gradually extended the time between as my coping mechanisms improved. I grew overly dependant on him and when he took an unscheduled medical discharge I was devastated. I tried someone else, but it was a complete misfit and I just stopped going. Some of his exercises have got me through the tough times, but even they have stopped working.

Lack of sleep doesn't help, and nor does my embarrassment over having a "problem". Yes, denial is a major issue right now - outwardly having to appear "normal" - it's a terrible strain! I look forward to when there is no one home so I can just be me, but that's also the danger time as I have less restrictions on the harm I can cause myself or the thoughts that are left unchecked. A bit like the classic closet drinker!

I do worry about using up my allocated MHCP visits on something so "trivial" as I can't afford ongoing care. On the other hand, I guess I pay for fortnightly physio so it's not that different. Makes it an expensive sounding board!!!

Thanks for the advise / support.

[geoff]

hello TA, thanks for getting back to us, because you have a 3 or 5 week break from seeing your psychologist there is always something/s that upset you to the point of you don't being able to cope, it alway happens without doubt.
No embarrassment for how you feel should never be taken into account, yes I do know that that's how you do feel, I think that's normal when we get depression, so this is the very first problem that you have to overcome before you can then accept the help that is provided for you.
Does embarrassment occur when you have another illness, no all you do is curse and swear, and do we ever pretend that everything is OK, no we don't, that's when depression is no different, sure it's much more an unknown illness, and if you have been let down by your psychologist then make a point and try someone else if that is at all possible, remember you aren't helping the psychologist, it's their job to help you.
All of this may sound to very confusing, but isn't depression just that. Geoff.

[james1]

Hey The Abyss,

Geoff's given some great insight into the nature of depression and how it affects our embarrassment. Having done Schema Therapy myself, I hope you don't mind if I invoke a little bit of it here.

You said: "You are right, I do need to talk with someone, and more regularly."

This is your Healthy Adult recognising that the nurture you require is more frequent than 5 weeks, or even 3 weeks. In fact, most of your posts here are in Healthy Adult mode - recognising when you are struggling and need help.

The challenge of course is how to bring Healthy Adult into your sessions. This is a really personal challenge and what works for me may be difficult for you.

One time, I managed to trick myself. I had a poem I wanted to give to my psych so I physically brought the representation of Healthy Adult with my by printing it and stuffing it in my pocket the day before. Naturally, I forgot about it until I got there and - because I get fidgety - I found it in my pocket and my psych asked me what it was. The child modes in me then got stuck because, to please my psychologist, I was then bound to read it. So printing your thoughts about what you want from therapy while you're in Healthy Adult mode, and then bringing those with you, could help.

The other thing I've been working on is to try and engage only one aspect of healthy adult: voicing your thoughts in session. So I say stuff it to anger and all that, but I will voice my thoughts. It is actually surprisingly easy once you get the ball rolling. Yes, it's impulsive which is not Healthy Adult, but you are purposely doing this to show another side of Healthy Adult. So I stand up to talk sometimes, I sit on the floor, I stare out the window or at wall - whatever it is that makes it easier for me to talk. I regularly butt in mid-sentence and if she deflects, I tell her she's deflected.

It can be quite confronting for the psychologist, but they are trained to deal with that - and you are training yourself to speak up.

James

[The_Abyss]

Thanks James.

That all makes sense. I feel better and communicate better while I'm active and moving, but the psych's room is too small. I look longingly outside as that's where I feel better, but feel trapped where I sit. If I pace, I will move closer to the source, and I'm not comfortable to do that just yet. On the "Pandora day" I felt so trapped I almost ran from the room once the door was opened. Going back the next time was hard.

I have just phoned the office to see if I could see someone else while he was away, but I only have one day of the week I can access the clinic, and they are booked out on that day until after he returns. So, that effectively rules out that option. It deflated me, but I guess I made the move, got the answer, and so will just have to move on (hey, perhaps the healthy adult does reside here!). I will either have to tough it out or find an alternate solution. I have felt better in the last 12 hours having accessed this site, so I thank you all for that. I at least know it's here and it will no doubt become my anchor over the next few weeks.

Before he left, the psych recommended a book on Schema therapy....I managed to borrow it while in Sydney yesterday so will put aside some time to get to understand it a little better before his return. I will also do as you suggest James and write down my concerns. Just writing helps with the healing....will I take it with me and express it? I don't know - that depends on how much of my alter ego goes with me!

Thank you for sharing your strength with me.