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New Phase of Life / Depression, Insight Needed

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Hey there! Just to point this out in advance, I am seeing a few professionals about my mental health, I’m on medication and I’ve already been diagnosed with Major Depressive Disorder, PDD-NOS, and potentially ADHD. I do not have the means to explore these further, but I have regular monthly visits with my psychiatrist and therapist.

I’m currently dealing with drug abuse, my anxiety-fueled fight or flight response has led me to self-terminate from several jobs, and I typically carry really low self-esteem and distrust for myself and everyone around me. My social skills are acceptable, but I’ve adopted several toxic behaviors that lead me to manipulate, hurt, and abuse others. This is pretty self-destructive considering I’m also incredibly lonely and have no friends. I spent way too much time obsessing over perfectionism and believed I wouldn’t deserve to be loved otherwise.

Since failing high school, the only things I strived for is daily drug use and sexual stimulation. My therapist theorizes that most of this behavior stems from repeated emotional trauma that we’ve discussed, but thinking about those events doesn’t stir up any emotional response at all which just confuses me and makes me feel worse. I’m 23 now, and a few months ago something happened inside my head and I feel an intense need to fix things and help my life turn for the better, but the more I pursue that the more I stir up bottled emotions, toxic behaviors and self-hate. I struggle with managing my emotions in general and don’t have any support from family or any friends to fall back on, so making changes to my life is a little terrifying.

I still have a lot of questions I’m trying to figure out, trying to quit drugs is difficult when I lose all motivation and drive to change while sober, especially since I was like this long before I started drug use. I don’t know if I’m a good or bad person, or if I’ll ever feel like I’m worth anything. I don’t want to go through all the effort to improve things and still feel the way I feel right now, I’d be utterly hopeless after that. At the same time though, I really don’t want this need for change to disappear, I don’t like feeling this way.
Thoughts?

New Phase of Life / Depression, Insight Needed

Answered by on -

A.

What’s evident from your letter is your drive to resolve these issues and succeed. You want to change. You want a better life. You are moving in the right direction. Without that motivation, change may not be possible.

It sounds as though you need a possible medication adjustment. Your therapists’ assessment of your situation doesn’t resonate with you. That might be a sign you need a new therapist. Each time you go to therapy, you should feel slight improvement. Overtime, there should be some evidence of progress.

Alternatively, you mentioned that you don’t go to therapy often. You seem to need more help than you’re getting. It’s not clear whether your therapist is the problem or if you’re not attending as much as you should. Once a month is rarely enough.

Another issue may be your use of drugs. Drugs alter brain chemistry. They may be interfering with the medication you have been prescribed. The use of drugs would suggest a lack of coping skills. If you had a healthy way of dealing with stress, you would not be using drugs.

Generally speaking, it seems time to reassess your current treatment situation. As described above, you might need new medication and/or a new therapist. If what you’re doing isn’t working, then you must try something else. Don’t stop until you find something that works or someone who can help. It is worth it. Good luck with your efforts. Please take care.

Dr. Kristina Randle

New Phase of Life / Depression, Insight Needed

Kristina Randle, Ph.D., LCSW

Kristina Randle, Ph.D., LCSW is a licensed psychotherapist and Assistant Professor of Social Work and Forensics with extensive experience in the field of mental health. She works in private practice with adults, adolescents and families. Kristina has worked in a large array of settings including community mental health, college counseling and university research centers.

APA Reference
Randle, K. (2019). New Phase of Life / Depression, Insight Needed. Psych Central. Retrieved on May 26, 2019, from https://psychcentral.com/ask-the-therapist/2019/02/28/new-phase-of-life-depression-insight-needed/
Scientifically Reviewed
Last updated: 27 Feb 2019
Last reviewed: By a member of our scientific advisory board on 27 Feb 2019
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