Dear New Shrink,
I am wondering if you can help me figure something out. I feel terrible. I have been feeling discouraged, sometimes kind of depressed and hopeless and I also have trouble sleeping plus I eat and drink more than I should, especially at night.
It took a lot of courage on my part to go and see a psychiatrist, but I did it. I looked it up online and picked a doctor that sounded good and was nearby and I made the appointment.
I was a little afraid to go because I heard that they always want to put you on drugs, but I also was hoping that he would give me something to help me feel better. Much to my surprise, he said that I was not “clinically depressed,” whatever that means, and that I did not need an anti-depressant medication.
The visit was pretty short and he didn’t really say what I should do, so I am hoping you can tell me what to do.
First off I would never try to second-guess another doctor, especially when I am not in that interview with you nor do I know you or your circumstances.
A clinical depression is a “major depression” and you can look that up pretty easily. Go to the NIMH.gov website or maybe just WebMD.
When you have this type of depression, you can barely get out of bed in the morning, sometimes don’t and have a great deal of difficulty functioning. You may cry for no apparent good reason; your concentration is usually seriously impaired; your self-esteem is way down and you often do not want to live or actually have active thoughts of suicide.
This is just the short version but I would recommend that you read up on it because it is serious and does require treatment.
So now back to you. Perhaps you are not really depressed but have bouts of it from time to time. This could be due to your life circumstances for example, stress in your life or an unresolved loss. Also, anger turned inward is the single greatest cause of these types of depressed moods.
Often people do not realize that they are suppressing their anger, which inevitably means it will come out in a passive-aggressive way, cause physical aches and pains or turn into depression. Ask yourself what you are angry about. Try hard to be honest and write it down. Talk to someone you can trust about it.
Many people confuse sadness with depression. Have you had a recent, say within the last few years, loss that really troubled you? Think hard if nothing comes to mind right away. It can be a job, marriage, love, good friend, home, parent, sibling, favorite cousin or a pet. If you feel yourself getting sad while reading this and thinking about it, you need to talk to someone. It can be a therapist, rabbi, minister or priest or there are bereavement groups.
Another possibility is post-traumatic stress, which is not limited to military folks. Any traumatic event that is unresolved, or at least not processed, leads to feelings of helplessness, which in turn, leads to hopelessness.
“Discouraged” is related to helpless and hopeless and also says that there is something you are trying to do or accomplish but that you are not getting there.
The feelings and symptoms you describe sound like post trauma, unresolved loss and difficulty dealing with frustration and anger. Eating and drinking too much is usually a form of self-medicating, which means trying to medicate or soothe your pain with food and drink.
Lastly, if you are really drinking too much, it may be a drinking problem. Did the psychiatrist ask you about this? Were you honest with him and are you honest with yourself? If you have a drinking problem it can lead to all the other problems you are struggling with.
Anti-depressants are not the solution for a drinking problem. They can help our mood when we are trying to get through a loss or trauma of some kind.
But I think you should consider seeing a psychotherapist. This would help you figure out what the real issues are and it would help you resolve the problems that you are having.
I hope this helps you out but think seriously about seeing a therapist as well. I generally tell patients to give it six visits and if it isn’t helping or doesn’t feel right at that point, find a different therapist or call it a day.
Dr. JoAnne Barge is a licensed psychologist and licensed marriage and family therapist. She is also APA Certified in the treatment of substance abuse. Please send your inquires and replies to firstname.lastname@example.org. Got something on your mind? Let us help you with your life matters.