Can Therapy Make Depression Worse?
From childhood through high school, I was never a “happy” child but I got by. Looking back at my worst I was “difficult,” sometimes moody or irritable. But I guess everyone around me chalked it up to puberty/PMS because no one ever said I should get help. In college, I developed an eating disorder. It was a major source of tension to my family, whose response was anger. They yelled at me to “eat” that I was “too skinny” as if I was doing it JUST to make them mad. They never offered to take me to a therapist, and when I tried to talk about my feelings about my body and food my mom’s response was that she didn’t want to hear it and I was over reacting.
So, I took it upon myself to get counseling at school. My mom didn’t care about my emotions, but forced me to see her GP so she could weigh me and give me a physical. Upon seeing this GP, she took blood work which revealed that my liver was inflamed from taking Tylenol PM on a regular basis to sleep. When I tried every other herb and natural supplement and nothing else put me to sleep, the GP prescribed me Seroquel.
When I told my counselor this, she consulted the school’s Psychiatrist. He said the Seroquel was a terrible idea for me. After meeting with him, he said I should be on medication for anxiety, not an antipsychotic. I told him I really didn’t want long term medication, all I wanted was to sleep so I could finish the semester’s classes.
He prescribed me Ativan, which worked wonderfully at helping me sleep. But he said the Ativan was really a band aid on a bigger problem and felt I should be on Celexa. After some consideration, I agreed to try the Celexa. I have been on 20 mg of it for a little less than a month and have been continuing to see him and my regular counselor for therapy. (I have to lie to my parents about where I am going since they don’t believe I need any therapy. My dad does not even know about my meds, my mom knows and strongly disapproves, claiming “you’re not depressed you’re neurotic”).
Anyway, lately I feel even though I care less about my weight, I generally don’t care about life because I am extremely unhappy. I hate my living situation (at home financially dependent on parents), I think I am ugly, I have no self esteem, and I just feel like a basket case. I know therapy is supposed to increase self awareness, but I think all this self awareness may be making things worse. I don’t know what to do. Sometimes I want to just “break up” with my therapists but I fear that things could be EVEN WORSE if I do that. Are some people better off without therapy? Or should I keep trying?
A: Hello and thank you for your question:
Goodness, you’ve had an awful time getting the help you need. I’m sorry that you have struggled so. I’m not a psychiatrist, so I can’t prescribe (at least in my state), but what you need to know is that if the Tylenol PM was working for your sleep, it wasn’t the Tylenol itself that was working, it was the diphenhydramine (Benadryl). Benadryl has side effects like any other drug, but it was the Tylenol that irritated your liver, not the Benadryl. Many people use the generic Benadryl with great success for sleep. What you need to know about it is that occasionally, it stops working. It is not addictive and you cannot develop a tolerance for it, but if you take a break from it, it will again begin working. The reason I know this is because I taught psychopharmacology at the graduate level for many years and have learned a lot about medications.
That being said, I wouldn’t break up with a therapist unless you think that particular therapist isn’t helping. Understand that therapists are like blue jeans. There are tons of them, but not all are a good fit. You might consider finding one that fits better. Or, you might just stick it out with this one. Things often get worse before they get better, since in therapy you have to dig into stuff that isn’t fun.
The other thing is that it sounds like your family doesn’t have very good boundaries. What is “wrong” with you isn’t their business since you are legally an adult now. Never mind who is paying for your schooling, if you don’t want to be weighed, and you don’t want mom prying into your personal issues, tell her in a very nice way, “Mom, I have to figure these things out for myself. I know you mean well, but I need some time to sort things out. I can’t eat what you tell me to eat, and I won’t be weighed anymore.”
She may have a hard time hearing these things, but you are an adult and should be treated like one. Set some boundaries, stay in therapy (even if it is with a new therapist) and take good care of yourself. You deserve it. If you want to find a therapist outside of school, look at the our therapist directory for one in your area.
I hope this helps,
Dr. Diana Walcutt
Walcutt, D. (2009). Can Therapy Make Depression Worse?. Psych Central. Retrieved on March 30, 2015, from http://psychcentral.com/ask-the-therapist/2009/06/29/can-therapy-make-depression-worse/