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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by mair on March 15, 2005, at 17:14:48
I vascillate between thinking I'm ok, and thinking I'm plummeting into a major depressive episode. Alot of how I feel depends on how well I'm working. Yesterday I got to work and couldn't do much other than move paper from one end of my desk to another, while occasionally playing solitaire and obsessing about all the work I'm not doing. So, predictably, I was too anxious to accomplish much in therapy today and I was back to that place where I'm not a great contributor in therapy because I have too many thoughts and I can't put them together long enough to communicate them to my T.
Last week we started a thread of discussion that seems interesting and relevant to me and not immediately threatening. Basically she wanted to go back and revisit my work history to see if that could help explain why my whole sense of self seems to hang on the shaky precipice of how I judge my work performance. My T told me she felt that it would be a helpful exercise and that she had introduced the discussion to give me a break from weightier matters. But today I couldn't even imagine being able to hold my attention long enough to really analyze my work history or anything else for that matter. And there was far too much coming to mind to be able to talk about any one thing. It brought to mind what my T has said to me before about the difficulty of making any headway in therapy when the patient is too depressed to work at it.
Driving back to my office, I felt this great sense of despair - that things weren't going to turn around on their own, that I wouldn't really be able to get any relief from therapy because I wasn't in a place where I could really constructively contribute, and that there are no medical solutions that would have an immediate enough impact to make going to work tolerable. I strated doing this thing I do occasionally where I try to remember where all the gun stores are where I live, and I was trying to remember if there was one between my office and my T's office.
The rest of the work day was actually ok mostly because I got too busy to obsess about stuff, but as soon as I got home I started thinking again about how I can't go back to where I was when I first got really depressed - where I would spend whole days staring out the window and feeling just persistently anxious. I got through it, but I came to accept it because I had been diagnosed with depression and had just started treatment and was trying to find meds that might work. However, it really did hurt me financially and professionally, and having done so much better since then (despite short lived down periods), it's just not acceptable to me to go through that again. I have a son in college and a daughter who'll be going in another year or so - I can't afford to let everything slip. And to me there is something just so overwelmingly shameful about being in my situation.
So just a little while ago, my T called me out of the blue to tell me she's going out of town tomorrow and wouldn't get a message on her office machine if i left one. (I've never left one for any reason other than to ask to reschedule and appointment). She told me if I wanted to talk to her to leave a message on her home machine and she would love to talk to me tomorrow night. I see her anyway on Thursday, so it never occurred to me that I'd want to talk to her before then. I never even mentioned the S word in our session today so she can't be worried about that. She's never called me before like this.
I was actually more thinking that if I can't work at therapy, I should at least bow out of it until my head is in a place where I can make some progress. It's not as if there's great comfort to be drawn from just sharing my pain - I'm too ashamed to feel much pain anyway.
mair
Posted by Tamar on March 15, 2005, at 17:47:32
In reply to so what's this all about? (long a trigger ), posted by mair on March 15, 2005, at 17:14:48
I used to have solitaire days at work too, but then I discovered Free Cell :)
Have you tried writing down your thoughts in between sessions? When I was quite depressed I would think about all my anxieties in a kind of list and I felt like I couldn't keep it all in my head. So I started writing things down and then they were safety recorded and I could think about things one at a time. It also helped in the session because I had organised my thoughts a little, and I felt I was able to pick one or two things and explore them with my T.
I also define myself by my work performance and I'm deeply ashamed whenever I underperform. I'm trying to accept that my depression is like any other illness and inevitably takes its toll on my performance. But it's hard.
It's interesting that your T chose to call you just when you're thinking you're not making enough progress and questioning the point of continuing in therapy. Do you think she might have picked up on your feelings, even though you didn't mention the S word? It seems to me as if she's concerned for you and wants to help. Have you talked to her about your sense of shame at being depressed? (Did I understand you correctly- do you feel ashamed because of your illness?)
If you are having thoughts that scare or worry you, it might be an idea to call the number she gave you.
Please take care of yourself.
Tamar
Posted by mair on March 15, 2005, at 22:20:54
In reply to Re: so what's this all about? (long a trigger ) » mair, posted by Tamar on March 15, 2005, at 17:47:32
I think writing things down would probably be a good idea. I was doing that several weeks ago, after each therapy session becasue I didn't want to forget everything like I usually do. But it's a discipline I have trouble imposing on myself when I'm more depressed. I want to stick my head in the sand and just make all thoughts disappear. Probably if I forced myself to think about things more rationally, I would see that things can get better.
I am ashamed of my illness and I'm ashamed of my work performance. I'm not sure where one stops and the other begins. I'm not ashamed of my illness when its effects aren't manifest. And I don't necessarily excuse my poor work performance as being a byproduct of my depression. At one point I could live with that - I had myself convinced that I could accept several bad months at work and make it up later, because my mental health was so much more important than work. Now that I've been there and done that, doing it all over again seems unacceptable.
I don't want to quit therapy; I just think it's silly to be going when I can't work at it constructively. And it's painful for me to struggle to communicate so much.
In 6+ years with this therapist, I think I've only ever called her once. I'll see how I do at work tomorrow. It's nice to be encouraged to call her; maybe I'll try it although I'm really awful on the phone.
thank you
mair
Posted by antigua on March 15, 2005, at 22:28:22
In reply to Re: so what's this all about? (long a trigger ) » Tamar, posted by mair on March 15, 2005, at 22:20:54
I'm sorry you feel so badly lately. I hope I didn't make you feel worse (did you get my babblemail?)by throwing all my stuff out there lately.
Please try to separate your shame from your illness. You didn't cause any of this to happen to you, it just happens to some of us who are wired a different way.
I give you huge credit for being able to go back to work. I haven't been able to do that yet and I have to get going before my son heads off to college (not this year, thank goodness)because he can't go if we don't have the funds and having to look him in the eye when he has worked so hard would be devestating for me.
Please keep some of that compassion that you so kindly offer to others.
best,
antigua
Posted by Dinah on March 16, 2005, at 8:48:29
In reply to so what's this all about? (long a trigger ), posted by mair on March 15, 2005, at 17:14:48
Mair, again I don't think acting on a sudden change in position is usually wise. It wasn't that long ago that you were optimistic about therapy and your ability to connect. Something happened between now and then. Do you know what it was?
I try not to act on momentary feelings in any long term relationship. It's always easy to find reasons to back the feelings up, on any side of an issue. But I prefer to sit with them for a while and see if I can figure out where they came from and if they are long term in my best interests.
Sometimes the answer is to stop or pause. But I'd wait till the feelings had a chance to settle a bit before deciding. (And believe me, I have trouble believing that I ever felt any differently than I do *at this minute*. But intellectually I know I did.)
Posted by mair on March 16, 2005, at 10:09:10
In reply to Re: so what's this all about? (long a trigger ) » mair, posted by Dinah on March 16, 2005, at 8:48:29
No Dinah - I'm not going to act rashly and I'm not going to do anything consciously which might further isolate me. And maybe we'll have a good session to follow the bad one anyway. I know I fly all over the place which in and of itself is unnerving, and to me anyway, seems to invalidate whatever I'm feeling. How can I take myself seriously, let alone expect anyone else to, when I might feel totally different tomorrow?
I guess I'm just expressing the frustration of trying to make good use of therapy when I'm so unable to think about anything in a systematic way.
Also I'm sure some of this is just plain fear. It's really horrifying to me to look back over the last few months and realize suddenly how long I've been feeling so nonfunctional at work. The "what if I don't come out of this" question looms large.
Mair
Posted by Dinah on March 16, 2005, at 10:29:08
In reply to Re: so what's this all about? (long a trigger ) » Dinah, posted by mair on March 16, 2005, at 10:09:10
As you know, I can identify. Both with the frustration of not feeling the same one day as the next (and having trouble remembering what it felt like to feel differently) and also about work.
I know I'm not as productive today as I was a year ago, which was not as productive as two years ago, which was definitely not as productive as six years ago.
I'm reading a book "The Dependent Patient: A Practitioners Guide" and though I haven't gotten very far, it discusses the ways in which dependence can be expressed. I'm not really clear enough to explain it, but it is something along the lines that if certain behaviors (like being competent and productive) were rewarded with the emotional reaction desired in certain situations, then those behaviors can be motivated by dependency even though they don't look like it. I don't know if it is applicable in your situation, but it explains a lot in mine. Why my productivity nosedived when my father retired. And certain aspects of why it's even poorer now.
Of course, I also have to factor in physical reasons like depression and diabetes. But still, it's an interesting line of inquiry into my lack of productivity, and I'm just offering it to you in case it might have some relevance.
Is it at all possible that your motivations for work have a component that relate to desired emotional response from others. And while you used to get it, you no longer do?
On the other hand, that may just be my issue. :)
Posted by daisym on March 16, 2005, at 10:42:24
In reply to Re: so what's this all about? (long a trigger ), posted by Dinah on March 16, 2005, at 10:29:08
I think what you said makes a lot of sense. My therapist has noted many times how work seems to ground me, how I know who I am when I'm in that mode.
At the same time, he is trying to make it OK for me to not work so hard, and to hand off projects. But he is careful around this. I think he gets that I need the ego validation that work offers me. The only time he isn't really careful is when I resist scheduling because I'm too busy. He knows too well that I come and go as I please, unless there is a meeting or I'm gone. He makes a case for carving out time for me, etc. etc. One of the dangers of long term relationship, I guess. They know too much in some realms.
Posted by daisym on March 16, 2005, at 10:46:21
In reply to Re: so what's this all about? (long a trigger ) » Dinah, posted by mair on March 16, 2005, at 10:09:10
>>>>>Also I'm sure some of this is just plain fear. It's really horrifying to me to look back over the last few months and realize suddenly how long I've been feeling so nonfunctional at work. The "what if I don't come out of this" question looms large.
I think I know exactly how you are feeling. I get horrified to think people are covering for me or that I can't hold it together for days on end. I lost it yesterday afternoon and had to leave the meeting for awhile. Luckily, my therapist was scheduled to call me at 5 and we were able to sort out what happened. But I was mortified that I couln't keep my work separate from my own stuff. It doesn't help that so much of my work is about infant mental health right now.
I think you have to recognize when you feel strong and work like crazy and when you feel less capable and take good care of yourself. It is a balance I'm not good at yet. Let me know if you have tricks.
Posted by judy1 on March 16, 2005, at 11:40:07
In reply to Re: so what's this all about? (long a trigger ) » Dinah, posted by mair on March 16, 2005, at 10:09:10
Hi Mair,
just wanted to put in my two cents, or three cents- whatever :-).
I always have gotten the impression from your posts that you convey a strength to other people that at times you don't feel yourself. I truly don't think that's a bad thing, it's ceratinly a ruse I have employed myself (particularly in work situations, but with my husband and kids as well). The problem comes when we don't allow ourselves to take advantage of any help that is offered- for example your therp's phone call. Maybe at this time you can't make any therapeutic progress- but you certainly can use someone to lean on, even if it's just to sit and cry for an hour in your therp's office. I most certainly have been there, feeling ashamed of my meltdown and afraid to show it. I guess that's the great thing about therps- they never make you feel guilty about being depressed (and I know you realize that's why you are feeling ashamed, unmotivated, etc.). Basically I'm asking if you can just accept that you are going to feel this way for 'X' amount of time, have your support in place and use it (your therp), realize that you will make it through this day, week, or month and come out on the other side.
did I just ramble? sorry. Please take care of yourself, mair- judy
Posted by mair on March 17, 2005, at 16:43:28
In reply to Re: so what's this all about? (long a trigger ) » mair, posted by judy1 on March 16, 2005, at 11:40:07
Judy - you're not rambling at all; what you say is helpful. After my last session I was just so worried that as long as I'm in my current state of depression and anxiety, therapy will not seem useful, or at least I won't know how to use it. My T is always getting after me about the dangers of categorizing sessions as good sessions and bad sessions, particularly since my definition of a bad session has more to do with my own communication difficulties than it does with anything she's doing or even subject matter.
Today was less stressful maybe because at her urging, I've started taking xanax a little more frequently so at least I'm not bouncing off the ceiling. She's being pretty great - making it clear that she's there to help me in whatever way works best. I told her that I really don't know how to lean on someone - every instinct I have is to draw inward when I'm depressed. I've agreed to add a session so I'll see her again tomorrow, although, as she noted, it won't be any good for me to see her more often if I come out feeling so much worse on account of not communicating well. We'll see.
Thanks as always
Mair
Posted by mair on March 17, 2005, at 16:52:37
In reply to Re: so what's this all about? (long a trigger ) » mair, posted by daisym on March 16, 2005, at 10:46:21
Daisy, I've worked on the balance problem over dozens of sessions (really more than that), but usually with an eye towards not letting work consume me to the point where everything else slides including my sanity.
When I first started getting treated for depression, probably 9 years ago I went through days at a time where i did little other than stare out the window. It was awful and took a real toll on me professionally. I feel that it's taken years to dig out from the hole I created, and I'll never ever be able to get back to where I was well before that. What's so frightening now if the thought that I might be headed down that path again. I wake up feeling this sense of foreboding; I dread going to work; I feel paralyzed much of the time I'm there; I'm totally focused on how poorly things are going, and I can't see myself right now coming out of it before I've done too much damage to recover. And the money stuff starts weighing on me too. It's so hard sitting here feeling like such a total fraud.
Mair
Posted by judy1 on March 23, 2005, at 12:50:40
In reply to Re: so what's this all about? (long a trigger ) » judy1, posted by mair on March 17, 2005, at 16:43:28
not to be flippant, but xanax has saved me on more than one occasion. mostly because it has allowed me to focus on whatever the problem is- cutting through the fog of confusion, and just allowing me to breathe. my therps have taught me so many coping skills (meditation, etc.) but sometimes nothing will work except for that 1 or 2 mg of xanax. I hope you continue to use it as often as you need it now, please don't worry about becoming 'addicted'- I've lost count how many times I have stopped when I no longer needed it. anyway, I hope your session went better than the last one. I truly think that many of us have two modes- the shut down, no emotion expressed or the melt-down one. hopefully, you'll be able to find some middle ground.
take care, judy
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