What to Expect When You're Depressed - THERAPISTS

THERAPISTS

Your therapist is the most important person in your mental health journey. By therapist I should clarify, I don't necessarily mean someone with letters after their name. A therapist could be a friend, a spouse, a parent or a sibling. It could also be a professional therapist or a family doctor. What is most important is that it is someone you trust and someone you feel comfortable speaking with. The most important skill a therapist must have is the ability to listen without judgment. Their job is not to offer advice or solve problems. It is about listening with compassion and allowing you to recognize your own distorted thinking so that you can solve your own problems. you're responsible for your own healing. I know how daunting that feels, especially when you're suffering, but without accepting that fact, you will never get better. No drugs or therapy can match your own potential to heal. A therapist is someone who can help you along the way.

Be choosy

It took me a while to figure this one out. I stuck with some therapists much longer than I should have. I had one who insisted on eye contact and good posture both of which made me anxious during session. If I slouched she would stop our conversation and tell me to sit up straight. If my eyes wandered or looked down in shame, she would call my name so I would refocus. My mind was constantly being told to focus on my physical state as opposed to my mental health. When our session was over, I left exhausted. At the time I had no reference point for therapy so I figured I just had to endure and hope for the best.

Another therapist told me, in no uncertain terms, that we were not going to “crack me open.” She was only interested in discussing my immediate concerns. Since we only had 5 sessions, we could not “waste” any time. Yet another liked to quote Freud. as if the pithy sayings would both impress me and make me feel better. It didn't do either. It made feel like I was be categorized instead of helped. Another therapist had seen so many patients before that his initial introduction was rehearsed and robotic right down to the hand movements. Still another was overly compassionate, to the point where it seemed more like syrup than substance. I lost count of the number of times she said “Oh my goodness.” or the shortened form “Oh my.” I even had one exasperated therapist suddenly stopped me mid-sentence to ask if I even wanted to get better. I was stunned by her outburst. I had actually thought I was making progress that day. She wrote something down in notes then informed me we only had one session left.

Time is up

This brings me to one of the most common problems with professional therapists: expiry dates. They all have a set number of sessions available usually somewhere between 6 and 10. My experience is limited to Employee Assistance Programs (EAP), subsidized and free counselling so I cannot speak for pay as you go therapists. I suppose if you have the money, you could go on indefinitely. The real problem is there are not enough therapists to meet the surging mental health demand. There is no easy fix. All I can recommend is that you ask up front how many sessions you have so that you can perhap focus your sessions on a specific challenge.

Therapists also keep a close eye on the clock. Sessions never run longer than the set time regardless of what sort of break through or crisis might be happening. I had one therapist actually chide me for not taken my anti-anxiety medication prior to visiting with her. She told me it would have saved a lot of time in session. I understand that they are very busy and need to keep on schedule. It is just that some therapists are better at managing session times than others. I'm not trying scare anyone away from profession therapists. All of them were trying their best. I'm just trying to point out why some were not a good fit for me. I definitely had some excellent therapists who listened to me and helped me turn back my distorted perception.

If like me, you do not have the money to hire a private therapist, there are a number of free or subsidized options. These include community counselling services, urgent care at a hospital, a mood disorder clinic, and Employee Assistance Programs (EAP). For some of these, such as community counselling and EAP, you make contact yourself while hospital urgent care and mood disorder clinics require a referral from your family doctor. Be advised that, as with all mental health services, there can be lengthy waiting lists. From my experience EAP provided the fastest access to a therapist.

The best therapist I have ever had is my family doctor. She is generous with her time and listens. Her advice is always considered and applicable. Most of the time she just asks questions to get me to clarify or expand on what I'm saying. She understands that therapy is really a process of self awareness. Her goal is to keep me safe and to help me heal myself. She also recognizes her limitations and put me on waiting lists for specialized help such as the mood disorder clinic. I cannot thank her enough for all she has done for me.

Nurses

If you're in the hospital, the psychiatric nurses check in with you one or two times a shift. Some are excellent listeners, others not so much. All of them want to help. When they check in with you, be honest about how you feel. It is the only way they can offer assistance.

Nurses, psychologists and social workers also run group therapy sessions. At first I was skeptical of group therapy. I suffer from social anxiety, so why would they put me in a room with others suffering from the same condition? That first session was so uncomfortable. There was little eye contact and even less discussion. But then as the weeks went on, I realized the advantage of working through challenges with other like minds. It was comforting to know that other people had thoughts similar to my own. This made the discussions more relevant, and the actual results outside session much more pronounced. By the end we were no longer just patients, we were friends supporting friends.

Cognitive Behavioural Therapy (CBT).

I have attended a number of different group therapies. All of them have focused in some way or another on Cognitive Behavioural Therapy (CBT). The key points of CBT are that you recognize and label distorted thinking, and that you consciously change your behaviours through planned and meaningful activities. At least that was the big take away for me. It was interesting how at the beginning of each of these sessions, all the therapists were eager to point out that CBT has been scientifically proven to be successful. It was a curious assertion, as if they anticipated skepticism on our part. Personally, even without scientific proof, I have always found something helpful in CBT sessions. For me the most important skill I've learned is to identify distorted thoughts as a symptom of my disease. Some sessions were much more effective than others either because of the instructors and/or the participants. If you have taken a group session before and found it was not helpful, don't give up. There are others you can try. Most group sessions need a referral from a doctor. Make sure your family doctor puts you on as many wait lists as are applicable.

Crisis centre call line
I should mention one more type of therapist – the crisis centre call line. This is part of my safety plan. If I'm suicidal and feel imminent, I'm suppose to call the crisis hot line immediately. I must admit I didn't originally like the idea of calling for help. I had images of the ghostbusters hitting a panic button and sending the police with sirens blaring and a social worker in tow. After all they do warn of that option on their website (minus the ghostbusters). I didn't want to be taken into custody.

Nevertheless, one night I felt imminent and so made that first call. As soon as the crisis centre answered they asked me where I lived then promptly told me I had the wrong number. They didn't offer any further assistance other than supplying me with a new number for my region. I guess it had to do with municipal funding. Whatever the case it seemed a flaw in the system, after all I was suicidal at the time. It was lucky I had enough resolve to call a second number.

When I finally got hold of someone in my jurisdiction she proved to be very helpful and to my relief, didn't hit any panic buttons. She remained calm and understanding for the entire call. She listened to me talk then offered advice on how to settle my thoughts. We practiced mindfulness techniques together and by the time I was off the phone, my crisis had passed.

While a crisis line therapist does not replace full therapy, they are a very useful resource in the moment. Make sure you get the right phone number. I suggest you write it down on a piece of paper . I keep mine in my wallet.

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