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  1. #1

    Getting Better: How do you know?

    Getting Better
    by Christopher Lukas
    Monday, March 19, 2007

    Over the past 50 years, I’ve gotten better.

    The question is, how do I know?

    That may seem a stupid question to some: after all, if you’re less depressed, then you’ve “gotten better.”

    But there are a lot of other components to depression that may not be recognized by people who suffering from the deep and disturbing emotions that depression can slam on them. Most of us know about sleep disorders, eating too much (or too little), irritation and anger, hopelessness, and a heavy physical feeling that “descends” out of nowhere. Then there’s a lack of confidence in your ability to do tasks or take on work; guilt; a feeling that people don’t like you.

    But let me mention a few items that aren’t always known to be associated with the disorder, but which often accompany it.

    • Cognitive dysfunction, that is, the inability to think straight, to reason, to act logically.
    • Memory. Many people who are depressed can’t recall the simplest things; some don’t remember luncheon or dinner engagements, dates, paying bills.
    • Physical ailments. For years, physicians have known that people with depression often show up in their offices suffering from stomach aches, headaches, bad backs, and other “somatic” symptoms. In fact, these patients often don’t know they’re depressed; they just have these physical problems.
    • Anxiety. Fear of being alone. Fear of being in large crowds.
    • Feeling as if you’re a burden to your family.
    • Finally, a sense of anhedonia, an overall sense of having lost whatever joy or pleasure you had in activities or people around you. This may show up in postpartum depression, where a mother doesn’t feel close to her child, or with any of us who have a major or minor episode of depression.

    With this expanded list of symptoms, it now should be possible to detect when psychotherapy or medication (or both) are helping you make progress. You may not feel all of these things changing or lifting at once. In fact, some may stay with you for the rest of your life. But you – or those around you – may notice that your irritability has lessened; you don’t have those stomach aches any more; you can be alone without feeling like you’re “going crazy.” And so on.

    In short, “getting better” can be as any one or several of these symptoms begin to slip away.

    The reason this is crucial for people who are depressed is that we often say “I’m not getting better” after a few weeks of medication or six months of therapy, and we want to abandon the treatments.

    This can be a big mistake, so it’s important to look at where you’ve been and where you are now: what’s changed? Have you been getting better without even knowing it?

  2. #2

    Re: Getting Better: How do you know?

    Great post David I really liked this part:

    it’s important to look at where you’ve been and where you are now: what’s changed? Have you been getting better without even knowing it?

  3. #3

  4. #4

    Re: Getting Better: How do you know?

    I had my appraisal at work yesterday, and it was interesting to hear how my manager said how far I have come in the past year. She sees me from day to day, and can tell when I have 'bad days' or am going through a difficult time. She sees things that I can't always. Also my therapist has told me I have grown a lot. I think when one lives with one's symptoms day in day out, one doesn't always see self as others see them.


  5. #5

    Re: Getting Better: How do you know?

    Good point Braveheart. This is so true and why it is great to have a therapist to help us see the progress.

    I think when one lives with one's symptoms day in day out, one doesn't always see self as others see them.

  6. Re: Getting Better: How do you know?

    Its funny, but my T told me I was a lot better a couple of weeks ago, and I was surprised. I said Really? And he went on to say why he felt that way, and I didnt even notice!

  7. #7

    Re: Getting Better: How do you know?

    Sunset, I can relate to that so well. I often feel like I am not making any progress and sometimes even feel like I am going backwards and it is only when my psych points it out to me the progress that I have made over the past months do I realize how far I have actually come which I didn't even realize. I guess my brain is still so use to seeing the negative and disregarding any positive.

  8. Re: Getting Better: How do you know?

    Me too Halo. I am trying to concentrate on the half full glass. LOL!

  9. #9

    Re: Getting Better: How do you know?

    Sometimes feeling worse means you're actually getting better. Maybe? If that makes any sense.

    At least this is what I am hoping for today.

    Challenging every thought you've thought wrong for so many years feels really bad, confronting the past feels really bad too, but I think it's the only way to get better, hard as it is.

    And I think it does take someone else's perspective to help you see that you are getting better.

  10. #10

    Re: Getting Better: How do you know?

    I was thinking about this and I was curious...My ex T told me that I had grown alot and doing alot better...It blew my mind when she said it because...I was having major panic attacks plus I had developed an eating disorder...(My current T confirmed that I have an ED)...I think I have grown alot since leaving my ex T...I'm curious whether she couldn't except the fact that i had gone backwards or if I felt like I was...RIMH

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