I am 43 years old and have tried years of therapy with different therapists to address chronic depression. I have also worked with a psychiatrist and my physician with little success—my depression always comes back. How can I get rid of this monster for good? Who is the best person to help me? Are there specialists for people like me? How do I find the resources that can help?
Recurrent depression can be a challenge. You are to be commended for seeking to improve your treatment. Your primary care physician and psychiatrist can work to rule out physical disruptions in your hormonal levels and illnesses that correlate with depression; this will help you tailor your treatment options. You may have either unipolar or bipolar depression, each of which requires different approaches. There is at least one key arena in which a psychologist can be invaluable, above and beyond the medical interventions. A psychologist can help you deal with your attitudes to chronic depression itself. If you were my client, I would briefly explore your family history, genetic predisposition, and life history first, but then identify your attitude toward depression itself.
The most important attitudinal approach to dealing with recurrent depression is to work on not getting depressed about getting depressed. This meta-level approach tends to limit the depressive spiral. It makes things more manageable. But how do you not get depressed about getting depressed? By accepting that your current condition is a frustration, but not a horror. If you look hard enough, and work at it, you'll find that you can still enjoy life in spite of the recurring depression. Also, do not blame yourself for having what might be an inherited tendency—you can look for ways to overcome it.
Some inherited traits are deterministic (like eye color). But most are not, they are amenable to choices, environment, and also chance. This means that even if you inherited a tendency toward depression, you can still find ways to ameliorate it.
I would work with you to find behavioral experiments you are willing to stick to—such as thinking assignments like finding out whether you are running yourself down with self-talk, getting anxious and worried about some vague future occurrence, or feeling helpless about the goals you'd like to attain.
If you are feeling helpless or powerless, ask yourself what goal you're really trying to accomplish. You may be putting too much pressure on yourself—or making your goals too vague and grand. Take a few steps that are outside your norm: explore a new area of your neighborhood for the day or write your thoughts down and examine them later for accuracy.
If you're feeling a vague resentment directed at the universe or others for unfairness—ask yourself whether your time can be spent more productively. Let go of any hurt about the past by reconnecting with the choices you can make in the present.
Smile more. Your physiology and emotions can respond to your facial muscles, and may make you more approachable to others.
Recurrent depression is not an easy beast to tackle, but optimistically and courageously tackling it can do wonders for your experience of life.
Resources:
Psychology Today's Depression Center
Psychology Today's Therapy Directory
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meta level,
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recurrent depression,
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