Getting Better: How do you know?

[David Baxter PhD]

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?

 

[Halo]

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?

 

[David Baxter PhD]

Exactly.

 

[braveheart]

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.

 

[Halo]

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.

 

[sunset]

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!

 

[Halo]

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.

 

[sunset]

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

 

[Cat Dancer]

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.

 

[Cavi]

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

 

[Into The Light]

i think it may have been manipulation on her part, rimh. to keep you from leaving therapy.

 

[Cavi]

thatswhat i was wondering too.....rimh

 

[Halo]

I definitely think that it was a manipulation on her part trying to tell you that you were getting better so that you would not terminate therapy with her.

 

[chell]

l just happened on this topic and funny enough, l was at the Psychiatrist yesterday, and l am not sure that many on here know me as l don't post much as l read more, but l come out of the Dr.s office feeling much worse, crying and depressed more, then l do going in to see her. l dread the visits and l have severe anxiety just sitting with her. l don't like her and l don't like talking to her, but she is the only Dr. within the rural area so l have no choice but to see her.

Anyways, l just went through a very nasty separation/breakup with a live in boyfriend who decided a week before Xmas to ask my Daughter and to leave and a week before the Anniversary of my third Child's Death in Dec, so we had no choice but to go to a Women's Shelter, start over, which brought us to where we are now, and my Daughter is leaving at the end of the School Year to move back to Ottawa to go to school (University) and l will live alone and l have abandonment issues (severe) from childhood abuse that l am working on, PTSD, Panic and Anxiety issues and to make this short, l am not doing so hot since l was put on a drug that was not working for me and l was swinging up and down, from extremely depressed to so filled with panic my Agoraphobia was in full bloom and anxiety attacks were a common thing, and in talking with the Psychiatrist, l know l was doing terribly, much worse then last year at this time when things seemed much more stable and l could think much more clearly and yesterday at the visit, l was crying and unable to stop as l was full of panic and anxiety and l looked at her and said l feel hopeless and her reply to me was "You are doing so much better now and l can see so much improvement!"

l just looked at her like she was nuts and l mean nuts. l think l was sitting on the wrong side of the desk at that point. She was smiling and l had both hands full of Kleenex, crying more then l used to because my life seems to be crumbling all around me and she is telling me how much better l am doing.

When l told my Therapist that, she just stared at me and asked me to repeat it and again said, "You are sure she said that to you?"

My own Therapist told me that over the Xmas season l fell apart emotionally having to leave everything behind me and going to the women's shelter and starting over with nothing and emotionally l was just a shell of the person she knew, that she had to start working over with emotionally and was completely taken back, so that comes back to the question, how does one know when do you know or does the Dr. know when you are getting better?

Michelle

 

[AL]

Easy - don't think when you'll get better - just get better!

Here is my case how it brought about the change-

I realized that I was not doing well and was totally out of track some four years back. I didn?t face any major episode or something of that kind but my overall progress in professional life took me to health care professional. My tests revealed multitude of problems.

In my course of treatment I protested several times to my consultant that it wasn?t going direction desired to me. I was averse to medication as I found myself pretty stable to tackle the situation without. In a very critical stage of my profession I felt that medication was actually stopping me from performing, I chose to abandon the treatment with a heated argument with my consultant. Total time frame of my incomplete therapy was around 5-6 months.

In course of treatment, my consultant gave me exercises to realize what?s actually happening and how to handle that. That time I didn?t realize how important that was.

Today, looking back, I feel I learnt heavens in that period and I am going to take all my learning with me for lifetime. One of the major was thinking rational and positive. As they said rational thinking gets into habit and later one doesn?t have to do it intentionally. Today I find myself stable even more than people around me and do my part to keep situation calm and progressive. Its three years to my last visit to the consultant and in last year I have achieved substantially in my professional life. Needless to say what I did three years back is showing up very gradually but in a sure-shot manner.
Just a couple of weeks back I visited my consultant just like that. She was very happy to see me and we had very lively conversation. That ?free-willed? visit erased all the uncomfortable feeling I had about the whole process of therapy, even without discussing it.

It's not just that I myself felt the change. People around me find me at good mood and respond in supportive manner.

For this thread of discussion- it?s perfectly possible to know the change occurred after therapy. And this ?after? might come after a long time but then it's all worth waiting for. My experience says - one should make it point to concentrate on his/her own well being and behavior than ?how much have therapy progressed?.

 

[Joseph]

Very useful article. Thanks.

 

[tjgrahamcracker]

A very good article! For someone like me, who has had many depressive episodes seperated by many normal, happy periods it gets really confusing and scary to think about "When do I know I'm getting better?" But I have seen so many people on here talk about how they stuck with therapy for years and years, and I'm hoping some day if I stick with it I will be secure enough in life to think about life without a therapist!

*fingers crossed!*

 

[wardchambre]

Sometimes other people can see you getting better before you do. Also sometimes when a person begins therapy they can become more depressed as they go deeper into their issues but then as they work them through they begin to feel better. Also at times once the medication begins to work people feel more energy and motivation which helps them feel less helpless and more in control which decreases depression

 

[insideiamdying]

I really enjoyed reading this thread... It caused me to do a lot of reflection...

This may be off point... I feel I am doing better... and that disturbs me... I am afraid of getting better... getting better means more responsibility... and that scares me... Sometimes I feel like cutting... just to sabotage everything...

Tariki...

 

[Mari]

Sigh... sometimes we are our own worst enemy.