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Therapist questions for depression


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Dead or just tired: 15 stupid questions about depression

Depression is confused with everything from chronic fatigue to an elementary bad mood. Meanwhile, spring, which came into its own almost a month ago, is making itself felt - the offices of psychotherapists are bursting with patients complaining of seasonal disorder.

Enter asked psychotherapist, psychiatrist and doctor of medical sciences Sergey Babin to answer 15 obvious questions about how to distinguish depression from fatigue, whether online tests can be trusted, and what is fraught with drinking alcohol during a period of disorder.

Unfortunately, recently this term is often (including in the media) used incorrectly: to describe almost any decrease in mood. And this is not entirely true.

Depression is a disorder of the human psyche, which is characterized by specific symptoms: bad mood, slowdown or decrease in labor or motor activity. Depression is often accompanied by loss of appetite or weight loss. There are also other symptoms, such as anxiety.

In general, there is a certain category of people with a predisposition to depression. The reason for this is the peculiarities of their biochemistry and functioning.

Everyone's life consists of a mass of various psychological, stressful and psycho-traumatic events - they are the ones that can provoke depression in a person. Unhappy love, divorce, job loss, illness of a loved one - all this at the initial stage provokes a decrease in mood. And then, when a person can no longer cope with the situation, such events lead to depression.

The fact is that ordinary fatigue disappears if a person rests. Yes, he worked hard, overworked - you need to take a break on Saturday and Sunday, or even take a short vacation, and after that everything will fall into place. If we are talking about sadness, then it must be preceded by some sad event. Further, a person identifies this sadness, lives, shares it, and finally cries. After a while, it decreases, and then completely disappears.

When we talk about depression, neither sadness nor fatigue disappears anywhere, but only intensifies, expands, acquires new manifestations. But depression can also occur without a traumatic event - this too should not be forgotten.

Of course, you can believe: a variety of online tests are available on the Internet, but their data are only preliminary, indicative. Even if you answered all the questions and the result showed the presence of depressive symptoms, you should not immediately worry.

It is always better to contact a specialist for a more accurate consultation, which can also take place online, but with a real person.

Yes. No need to think that with depression, everyone should go to specialists in friendly rows. It is important to understand that disorders are different, and their severity. If depression is mild, initial, then a change in activity, environment may well help. Or the traumatic situation will resolve itself.

But problems mostly occur in people with moderate or severe disease. They, of course, cannot cope with their condition, depression grows, significantly worsens the quality of life and can lead to rather serious consequences.

The consequences can be very different, including positive ones - in cases where depression goes away by itself. The worst thing is that most people with severe disease often have suicidal thoughts, attempts and actions. And this is a threat to life.

Depression leads to the impossibility to fully live and work, to perform elementary habitual duties, to maintain a normal form: family and sexual. All this together significantly worsens the quality of life. And among other things, this disorder exacerbates most of the somatic disorders: for example, coronary heart disease or hypertension.

Women are more likely to be diagnosed with depressive disorders. At least because men in Russia and in the world are much less likely to seek psychological help. But this does not mean that men do not suffer from depression, they just have other ways of coping with the disease.

In Russia, for example, one of the tactics for getting rid of depression is alcohol. In our culture, a man with anxiety is much more likely to go to a friend to drink a liter with him than to seek help from a psychotherapist. Some people who are later diagnosed as addicts were initially worried about a depressive disorder.

Yes. If a person has a predisposition to this disease, then the use of psychoactive substances can provoke it. However, some people are still trying to fight the initial manifestations of depression with the help of alcohol, for example. And this is not only not a method of treatment, but can also lead to more serious consequences.

There is a certain type of depression that is really associated with seasonality, especially with spring and autumn. There are also those that depend on solar activity - this type is typical for northern countries with short summers and long winters. One of the ways to treat this type of depression is photo and light therapy.

Depressions recur in a certain category of people, which means that they can be “predicted” and cut in the bud. To begin with, it is worth analyzing what events provoke the disorder, at the approach of which season the state deteriorates and try to work with it. For example, taking medications and visiting a psychotherapist.

Probably not. Of course, it is probably possible to distract yourself from problems with the help of physical activity. But a person suffering from depression is not interested in sports or sex - he does not want to do anything like that.

The therapist cannot advise the patient to do something when he cannot even get up from the couch. Not to mention sex. Most likely, the imposition of physical activity will cause even greater deterioration in the condition.

In general, yes. In general, any drug has its indications, contraindications and side effects. And if it does not cause any side effects, then it simply does not work.

However, antidepressants should only be taken under the supervision of a specialist, and never on their own. Only then will they work properly. After all, these are not vitamins, not bioadditives, but effective drugs that have a prescribing tactic, which should be supervised by a specialist.

It's not easy. The most important thing is to be in contact with the person. If the relationship is really sincere and close, then you will see: something is wrong with him, something is definitely wrong. You do not need to be a brilliant specialist or a superpsychiatrist to do this.

All questions and doubts will be taken adequately if you try to ask your loved one what is happening to him, discuss, talk about everything. It is worth taking into account: many depressed people avoid contact and communication, become isolated, withdraw into themselves. It is at this moment that help is most needed.

The main advice for the parent in this situation is to be in contact with the child. Often, suicides in adolescents are demonstrative in nature, but can lead to serious consequences. Parents basically only care about the outer shell: the child is dressed, shod, goes to school - everything is great. They do not ask questions about what is in his soul, why he sits at the computer for a long time, does not leave the room, does not talk. If you immediately try to discuss everything, then depression can be prevented in the early stages, and not when the child has already done something.

There are two options here. First, try to reach out, offer your help and be sure to be there at the moment when it may be needed. Secondly, if depression has already reached a severe degree, it is worth resorting to the help of a psychiatric service. This is especially true for disorders accompanied by suicidal attempts - here you definitely cannot do without a psychiatrist. But this is not the most commonly observed phenomenon.

You can't just tell a person to pull himself together - that's not how it works. And if he could only, he probably did it a long time ago. Helplines (adults or teenagers) and free consultations will help here.

Illustrations: Renata Vogel

Personal experience, how to get out of depression

Tamara Fedorova

asked questions

The profile of the author

Nikuetskaya

All edited the author of the author

The insidiousness of the depression, that is the disease, that is almost invisible.

It seems to a person that he is just a pessimist, always sad and worried about nonsense. Constant fatigue, loss of interest in previously favorite activities and difficulty concentrating can be easily attributed to laziness and try to treat with walks, meetings with friends and immersion in your favorite business.

But this does not always help to get rid of depression. Often you need the help of a specialist to regain joy and strength. A reader of Tinkoff Magazine told how she managed to recognize depression in time and cure it.

This is a Community story. The editors asked leading questions, carefully edited and designed according to the standards of the journal.

The onset of illness

Tatyana

coped with depression

Author profile

I am 41 years old, and from the outside my life seems happy: husband, children, work in IT. But for many years I suffered from depression.

I first felt it when my first daughter was born. I have become not the person I used to be. I didn’t remember what made me happy and what I saw the meaning of before.

The depression grew gradually. At first, I lost my inherent optimism and began to overreact to the news. I remember well how I was visiting my parents with my daughter and found out that three prisoners had escaped from the local colony. Immediately, in colors, I imagined how they break into the house and deal with us. With my mind, I understood that the thoughts were ridiculous, but I could not get rid of them.

Then she began to constantly think about meaninglessness and death: everything is decaying, we will all die. I couldn't control it. Every day I woke up tired. If there were quarrels, she became numb, and then cried in the bathroom. There was no strength to do something to resolve the conflict.

I missed my former self and after about a year I decided to turn to a psychologist. The consultation was free: I came to the neuropsychiatric dispensary, PND, at the place of residence. The choice of a specialist was unsuccessful, although he was recommended by a friend of a friend. The psychologist listened to me and slightly mockingly said: "Darling, you are now a mother, life will never be the same again, just like you." These words didn't help me at all. It felt like I was disturbing him because of a trifling problem. So I decided to refuse the services of this specialist.

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“After the session I was crushed and killed”: 5 signs of bad psychologists

How to distinguish depression from bad mood

Vera Yakupova

psychotherapist, founder of the Good Point psychological center 90603 90603 profile

Depression has symptoms that just a bad mood does not. The main ones you should know about:

  • apathy — you don't want to do anything, there is a feeling of indifference and emotional devastation;
  • it is impossible to rejoice in familiar things and in general in anything;
  • loss of hope for the future, feeling of despair;
  • suicidal thoughts and intentions;
  • difficulties in daily functioning, fog in the head;
  • fatigue, and rest does not help to recover.

Depression is diagnosed not by a psychologist, but by a psychiatrist. For a psychiatrist to make this diagnosis, the symptoms must be persistent—lasting two weeks or longer. And you also need to have several symptoms of depression at once: not just fatigue, but, for example, fatigue, apathy and lack of joy at the same time.

A year later I gave birth to my second child. I didn’t get better, on the contrary: there was pain in my back, which the doctors could not explain. Then the sensitivity in my hands disappeared and it became difficult to hold a mug and a spoon. It even hurt just to walk down the street and sleep. Doctors have diagnosed Guillain-Barré syndrome, a rare condition in which a person's own immune system attacks their peripheral nerves. Later, Bechterew's disease, a chronic inflammation of the joints in the spine, was added to this diagnosis.

Community 11/23/21

What is depression?

First consultations

Perhaps my condition would have worsened further if not for the child psychologist of the district polyclinic. I came to the consultation because of my daughter's tantrums and found out that they rarely occur by themselves in children. More often, tantrums happen against the background of problems in the family, the psychologist said. And then she suddenly asked: “Tatiana, is everything all right with you?” I felt tears welling up in my eyes, and for the first time in a long time I shared my problems with someone. In addition to depression and pain, I then experienced a painful dismissal from work and fear of the future.

I told the psychologist everything, and she listened to me carefully and recommended that I contact the PND rehabilitation department. I did not postpone the visit.

/trevoga/

How I treated generalized anxiety disorder under CHI

At the center I was admitted under the CHI policy. In order for a person to be taken to a rehabilitation program, a decision of the medical and medical commission is usually needed, but I was enrolled in an already recruited rehabilitation group without him. I took tests for free and consulted a therapist and a psychiatrist. The psychiatrist diagnosed depression and prescribed a cryosauna, massage, group body-oriented therapy sessions, oxygen cocktails and individual consultations with a psychologist. I got all this at the rehabilitation center for free.

Another psychiatrist prescribed me a drug to restore sleep. These were antidepressants, but they didn’t tell me about it then and advised me: “Just don’t read about the side effects, otherwise you will definitely find them in yourself.” The psychiatrist did not emphasize the treatment of depression, and explained the need for pills by the fact that they help the body to plunge into a deep sleep phase.

/list/antidepressant-myths/

8 myths about antidepressants

When I was sick and went through rehabilitation, the words of relatives and acquaintances killed me the most. All this time they were saying: “Come on, you have to get out, you have two children,” as if I, on my own, without children, are of no value and as if having children should cure me. I remember that my husband went on another business trip, and I started a session at the university and a new job, and I sent the children to their parents. The back suddenly stopped hurting, to which the psychologist said: "You took off the backpack of responsibility." I was in despair: that is, it will hurt me as soon as the children and husband are at home again? Fortunately, the pain did not return to its former extent. Perhaps antidepressants and anti-inflammatory drugs helped.

During the month of rehabilitation, my life changed dramatically. I felt much better and was able to find a new job with comfortable conditions, passing the interview. Before, when I was an emotional wreck, this was impossible. And in group therapy, I met interesting people with whom I still communicate. Then it seemed that finally everything was fine.

/depression-stories/

“Survived the worst period of my life”: 4 stories about beating depression

The return of depression

My husband has never really helped with the children, and his work involves traveling. At the height of the pandemic, he left on a four-month business trip, leaving me alone with two children and remote work. This meant that I would have to be torn between daughters and affairs.

My husband considers office workers, and even more so those who work from home, to be lazy. Therefore, it did not seem strange to him that I work at home and take care of children at the same time: remote work is not a full-fledged job. Even taking into account the fact that I earn one and a half times more than he does. Of course, this attitude to my work depresses me.

How to convey the importance of your work to your husband

Tatyana Poritskaya

psychologist

Author profile

The situation when a wife earns more than her husband can still be perceived as shameful for a man. Many are convinced that a husband should be a "breadwinner" and support a family, and a woman should be a "keeper of the hearth", raise children and take care of the house.

Of course, this belief is outdated: it was formed when a woman did not have access to work. And even then there were no refrigerators, washing machines, kindergartens and schools, and "separation of duties" between spouses was economically feasible. Now it is already unprofitable for the whole family in most cases. But the convictions are quite tenacious, therefore, in my practice, there were clients who were not only afraid to disclose the real level of income to their spouse, but even deliberately underestimated it.

What to do in this case? Much depends on your own attitude towards work. It is important to know for yourself what you do, what contribution you make to the family budget, the work of the company or society as a whole, and speak about it confidently. Perhaps this way you can gradually convince your spouse that your work is important. If not, realizing the value of your work will help you be more resilient to criticism and shaming.

Ask yourself:

What is my personal attitude to the fact that my salary is higher than that of my husband?

How do I feel about my job in general?

Am I aware of my value as an employee or entrepreneur?

Can I talk about my work in a way that sounds confident?

If you are accustomed to belittling your own merits, you need to rehearse your speech in advance. Record your monologue on a voice recorder, and then listen and make adjustments. Or ask a loved one who is not prone to excessive criticism to play a role-playing game: you will talk about work, and he will give feedback.

A snowball of events happened after the husband's departure. I fell on a scooter and broke my arm. She couldn't even do her girls' hair to make their hair look neat. I had to take them to the hairdresser's, where they got a bob.

At the same time, my problems at work worsened. I have been working as an assistant manager in an IT company for several years. I did my job well, but, alas, this does not save me from the tyranny of the management.

My boss is one of those bosses who suddenly writes at 10 pm and asks to translate the presentation by 8 am the next day. At first, I took it easy. It seemed to me that we are bearers of the same values, we have the same goals, we just want to do our job perfectly. In addition, we used to work together, he also offered to move to a new job together. I considered this proof that the boss appreciates me.

But over time, I began to have doubts. The leader interrupted me in front of colleagues and said that my ideas were wrong, made a scandal over some trifle, and then suddenly praised me because of it. He did not listen to my opinion, and ignored my dissatisfaction. If I asked why we were doing something, he cursed obscenely and answered: “Why are you tormenting me with these questions ?!” I said: "To understand how best to do it." And he answered the phone.

/list/good-feedback/

How to respond to criticism from colleagues: 7 tricks

When I'm away, it's easier for my boss to avoid me. And it became more and more difficult for me to get answers to my questions. Colleagues contacted me, questions and documents for approval were accumulated. Sometimes the work was paralyzed for weeks because the manager did not get in touch. And then on Friday evening the lock opened and an avalanche of new cases fell on me.

After another caustic comment addressed to me, I decided to look for vacancies on the job search site. When I was looking for a place after the decree, I wrote a resume there. Then she didn’t delete it, but simply hid it. It turned out that the site has a feature that is extremely harmful for the applicant: if you publish your resume in the public domain again, the personnel officers from your last job receive a notification: “Your current employee is looking for a new job.” As soon as I realized this, I immediately hid my resume from the search. But the HR specialist has already received a notification. Together with my boss, he began to find out what I was dissatisfied with. To keep me, they promised new interesting tasks.

It was April 2020, the very beginning of the pandemic. Resigning in a situation of uncertainty seemed unreasonable. I thought: since I have a regular income and a VHI policy, everything is not so bad. And I decided to turn to a psychotherapist in order to understand what to do with work and deal with the feelings of insecurity and powerlessness that tormented me.

Can constant pressure from superiors cause depression?

Vera Yakupova

psychotherapist, founder of Good Point 9 psychological center0003

Author Profile

Depression is affected by many factors. In general, depression is a deep mental exhaustion. When a person is in a stressful situation for a long time, whether at home or at work, his mental strength gradually ends. And then depression can set in.

We spend a lot of time at work, and the attitude of colleagues and management towards us and our work is of great importance to us. Not surprisingly, constant devaluation, aggression, boundary violations can harm our psyche.

The reader says that she was under constant stress at work, the personal boundaries of employees were violated, their basic needs for sleep and rest were ignored. The workflows were poorly structured, and it was impossible to influence them. It seems that this situation gradually led to exhaustion.

Search for a psychologist

First, I decided to turn to a psychologist with whom my friend worked. This psychologist ran a rather popular blog on one social network. I liked her capacious posts about work, and in general, she left a good impression. Julia, that was the name of the psychologist, spent four sessions with me for an hour. Each cost 6000 R, and this is an impressive amount for my budget.

One day Julia recommended her student to her subscribers. Her hourly consultation cost 1800 R. This amount suited me much more, so I immediately purchased a subscription for several months.

/psychotherapy/

How psychotherapy works

Consultations with psychologists were easy. Both Julia and her student immediately aroused my confidence. But I did not immediately tell them about all the problems. First, she shared her experiences related to work. I received the support I was counting on, and only after that I decided: I can tell the most intimate. That is, to show the psychologist the real self - not the refined version that I present to the world.

How to get free help from a psychologist: 11 support centers

Since August 2020, I have spent about 55,000 RUR on psychotherapy. My husband does not know about it. We maintain a separate budget and do not report to each other on expenses.

Sessions with a psychotherapist

I meet with a psychologist once a week on Zoom or WhatsApp. Offline psychotherapy is impossible in our case: the specialist lives in another country. But I know that I can ask for support at any time, even if it is out of my usual schedule. If something emotionally difficult has happened and I need to speak out, I write or call a psychologist.

First, the psychologist introduced me to the general principles of the approach followed in psychotherapy. Then we analyzed my attitudes and values ​​for a long time, and also worked with emotions through the body. For example, a specialist taught me the three basic elements of body-oriented therapy. They help me fight overwhelming emotions and stay in the "here and now", not lose touch with reality due to experiences.

Grounding, feeling connected to the ground. You need to go to a quiet place, abstract from thoughts and emotions, feel your body from the feet to the top of your head, find a foothold - primarily physical, for example, the floor under your feet. This allows you to gain self-confidence and feel protected.

Centering, that is, the feeling of the center of the body. You need to find a physical point of balance in order to stay inside yourself, to feel inner peace. You can try to mentally move the point - it causes pleasant emotions.

Borders, that is, a sense of difference between oneself and the world around. It is necessary to "remind" your muscles of the natural ability to establish boundaries in order to separate yourself from the outside world, and your emotions from those that came to me from other people.

When something happens that causes me strong negative feelings, I use these principles to regain self-control:

  1. Find a safe, quiet place. At work, I go to an individual meeting room, at home - to a loggia or to a car.
  2. I try to feel myself in the moment: I focus on what I see, hear, smell, feel tactilely and feel inside the body, scan the body from the bottom up, being aware of what is felt in each part of it.
  3. Imagine a situation that causes me a strong emotional reaction.
  4. I track what is happening in my body when I think about this situation: how my breathing and heartbeat change, which parts of my body tense up.
  5. Striking a pose. First you need to feel the support - how the feet rest on the floor if you are standing, or how the hips press on the chair if you are sitting. Then - stretch the top of your head up, straighten up and feel the spine. Sometimes you also need to relax the parts of the body that are tense. I know, for example, that in times of stress I often clench my jaw and I'm so used to it that I don't even feel the tension. Therefore, I strain my jaw with all my might, to the limit, and then I remove the effort - and the tension goes away. I raise my eyebrows and relax too. I tense my shoulders, clench my fists, and relax. At the end, I find balance, that is, the most stable position of the body, when I do not deviate to the side, do not fall anywhere.
  6. Then I put it all together: bodily sensations from the posture and the state that this posture communicates to me and the brain.
  7. Holding this position, I again return to the situation in my thoughts. I track my reaction of the body and thoughts to it.
  8. I let my body remember this reaction.

The psychologist gave me other tasks as well. For example, imagine what I would say to a person important to me if he suddenly appeared in front of me. The purpose of this exercise is to change the attitude towards the situation, and not to try to re-educate people.

So, once in a session we touched on the topic of hyper-responsibility and early maturation. I became an older sister when I was only a year and two months old. My father and mother paid more attention to my younger brother, and this upset me. But I never told my parents about it. Strong emotions that were not expressed outwardly remained inside me. They took a lot of energy. And they often determined my reactions. For example, the feeling that I was neglected as a child surfaced in any situation where I was not accepted with open arms. My reaction, most often silent resentment, was disproportionate to the occasion.

On the advice of a psychologist, I did the same exercise: I imagined that my parents were in front of me and told them about my feelings. In itself, recognizing emotions and translating them into words turned out to be therapeutic: as soon as I said what I felt, these feelings seemed to become more real than just sensations in my head. Now I could separate emotions from myself and decide what to do with them. I realized: only I am responsible for my feelings, it is in my power to manage them and turn them into certain actions.

And modeling the situation “I express my long-standing grievances to my parents” helped me to relate to these grievances more easily, as if I had really talked with my father and mother. After that, I began to perceive those ordinary everyday situations more calmly, to which I had previously reacted with silent resentment. As a result, the exercise turned out to be so effective that now I regularly do it myself.

/financial-trauma/

"I'm afraid of poverty like fire": 5 childhood financial traumas

Another example of a psychologist's task is to draw a person with whom I communicate. At one of the sessions, I drew my manager and HR director. At the beginning of the conversation, I portrayed them as big and myself as small. It immediately became clear how much I allow them to influence my life. I imagined the authorities in the form of balloons - and let go into the sky. After that, and in real life, it became easier for me to treat them neutrally.

This is how I portrayed myself, my manager and HR director on the instructions of a psychologist. The psychologist asked me to keep the drawing, to return to it every day and observe how my attitude to the situation changes. This is my notebook for therapy. In it, I write down the thoughts that come to mind during sessions with a psychologist. Sometimes, for the purpose of conspiracy, I make notes in English

It is difficult to tune in to online therapy at home. I explained to my husband and children that I had an online working meeting and asked them not to disturb. But it is hard for a child to understand why it is important to leave me alone for an hour.

Once, during a session with a psychologist, we touched upon the painful topic of my relationship with my husband, and I burst into tears. At that moment, the youngest daughter ran into the room: she wanted to urgently share something important with me. My daughter didn't understand why I was so upset. I couldn't continue the conversation with the psychologist and ended the session.

Now, if I know that I will not be at home alone, I act differently. I stock up on tissues, take a laptop, get into the car and go to a safe place, for example, to the nearest cafe. Then I sit in the back seat and talk to a psychologist without worrying that someone will see me in tears.

What to do if the husband does not take part in raising the child

Tatyana Poritskaya

psychologist

Author profile

Most Russian men grew up in an environment where all the responsibility for raising children fell on the shoulders of women. As adults, they transmit this behavior in their families. “A woman is obliged to devote most of her life to children. If the husband helps at least sometimes, it’s already good, ”such an attitude is no longer relevant. Especially when a woman earns more than a man and also gets tired at work.

To change the situation, first of all, you need to change the wording in your vocabulary: the husband does not “help”, but “performs his direct parental duties.” To understand your attitude towards a man's participation in parenting, ask yourself the following:

Do you feel awkward at the thought of delegating part of the responsibility for raising children to your husband?

Do you feel awkward when you start talking about it?

Women often complain that their husband does not help with the children, while they themselves are afraid to transfer part of their parental responsibilities to him. For various reasons: for example, because of the tendency to control everything, the fear of looking like an inferior mother, the assumption that the husband’s reaction will be negative. You need to figure out what kind of husband’s contribution to the family you are missing, what distribution of responsibilities will be comfortable for you, and then turn to your spouse with a clearer message.

The attitude “girls should be brought up by their mothers” can also serve as an “excuse” for evading parental responsibilities from a husband. It is important to understand here that the presence of both parents in the upbringing is important for a child of any gender. Mother and father complement each other.

Psychotherapy for me is like peeling an onion, layer by layer: the deeper you go, the more alive and the more tears. First, you talk about what worries you at the moment. Then you study the reasons for this anxiety and suddenly you understand: there is a lot of trouble in other areas as well. You start to analyze why this is so, and you sink deeper and deeper.

The most difficult stage for me was when we moved from dry onion skin to living: when I had to reveal my real self, and not just voice my ideas about myself to a psychologist. There I broke. I reached the moment of resistance, when I could no longer speak so freely either about work or about claims against my husband. It turned out that a lot of pain, resentment and vulnerability are hidden behind anger, irritation and anger.

The psychologist helped me clear the husk of my thoughts and beliefs and look deep into myself. I saw that I determine my value through the attitude of others towards myself. I live through the prism of someone's approval. I was praised - I feel good and loved. Criticized or rude - I get upset and shut up. We began to work on a sense of self-worth: ideally, it is stable and does not depend on other people.

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Now I am learning to accept the complexity and ambiguity of myself and others. I no longer feel the need to carry in my head a complete image of myself, a set of some nouns and epithets about myself: this is the kind of mother I am, that’s the kind of wife I am, that’s the kind of employee I am. My task is to learn how to express myself the way I feel. Not in the way that others expect from me, and not in the way that I myself expect from myself, having invented a certain image for myself. In order to no longer suffer from depression, I need to treat myself with love, interest and care, and not with endless demands. Do not drive yourself into a rigid framework, as I did before.

The psychologist and I even drew an analogy with Bechterew's disease. In fact, this is a petrification of the spine, the loss of its mobility and flexibility. It is very similar to my settings: keep your back straight, do not go beyond the limits that I invented and established. It's like a shell - with it it's not so painful and scary, but it's cramped and uncomfortable. It is difficult for me to get rid of this shell and admit my weakness, vulnerability, vulnerability, because life has always demanded to be strong, not to bend, not to become limp, not to give up, to hold on. But you have to learn this too.

So far, the result is this: I am already well aware when I misinterpret my own or other people's emotions. For example, that "no" in response to my idea is just a "no" to specific words and sentences, and not a rejection of my whole personality. And if someone yells at me, it's not because something is wrong with me, but because this person is scared and hurt himself right now. Understanding this allows you not to plunge into emotions, but to be, as it were, outside of them, above the situation, and remain rational. This is especially helpful in communicating with children.

An introduction to antidepressants

The therapy brought me immediate relief, but I was still depressed and cried a lot. The psychologist suggested taking a test for the level of depression on the Beck scale. The results were unequivocal, and the psychologist recommended that I contact a psychiatrist and get a prescription for antidepressants.

The psychologist sent me the diagnostic results and recommended that I see a psychiatrist

At first it was difficult for me to admit that I could not cope with my problems on my own, without a doctor. But then I realized that one session with a psychologist will not get rid of depression. Depression is not only a failure in thinking when everything seems dreary. It is also a failure in the activity of the brain when it works with errors. That is why a doctor and medicines are needed.

I didn't want to spend extra money on a psychiatrist's consultation, so I signed up for the district polyclinic under the CHI policy. The doctor talked to me for about an hour. He listened carefully to my health complaints, studied the results of tests and MRI studies, and then prescribed antidepressants.

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The very consultation with the psychiatrist inspired me: they understood me, supported me and gave me a prescription for a medicine that should help cope with a painful condition. Immediately after taking it, I went to the pharmacy, bought the drug and started taking it the same day.

I soon noticed changes, for example, in my communication with my daughters. I used to put the responsibility for the morning preparations for school and kindergarten on the children. The girls gathered for a long time, forgot things, returned and looked for them in their rooms for a long time. I started freaking out and screaming. But when the antidepressants began to take effect, I realized that the collection of my daughters is solely my responsibility, and you can demand something from children only when you have already taught them something. Morning scandals have come to naught.

Surprisingly, my physical problems also disappeared quite soon - back pain and numbness. I wanted to be physically active again. A colleague who goes swimming inspired me to sign up for individual training. Then I started painting with watercolors. Both drawings and swimming proved to be therapeutic. I realized that beauty and charm can be not only in the result, but also in the process itself.

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I took antidepressants for a year. I took my last pill in September 2021. In total, I spent 18,000 rubles on the purchase of antidepressants.

When are antidepressants needed and when can depression be treated with psychotherapy?

Vera Yakupova

psychotherapist, founder of the Good Point psychological center

Author profile

Depression, especially in its severe forms, has a strong biological component. These are changes at the level of functioning of the nervous system, and in order to restore it, drugs are sometimes needed. Especially if a person with depression also has sleep disturbances, lack of appetite, weight loss, suicidal intentions.

Mild to moderate depression, if there are no serious bodily symptoms, can be managed with psychotherapy alone. But the psychiatrist must make a decision about this. Psychotherapy helps you learn how to relate to your thoughts differently, process your feelings, support and take care of yourself - that is, learn skills that will help you stay in good condition for as long as possible. Crises, stresses, difficult events happen, but if we have the ability to support ourselves, respect our boundaries, form close ties with other people, it is easier for us to survive them.

Changes after psychotherapy

I continue to work with a psychologist. I can’t say that all the problems have already been solved, but slowly life is getting better. First of all, work life.

I initiated a difficult conversation with my manager and suggested changing the format of cooperation and my tasks. This decision was temporary, but provided the previous level of income with less blood. The indefinite employment contract lost its value: I did not want to belong to the employer completely from nine to six. It is more comfortable to do a certain amount of work for a certain period of time and not owe anything to anyone else.

I also took courses in computational linguistics to improve my skills. I also returned to the business that I always liked - teaching English and translations. I run a channel in Microsoft Teams - an English conversation club for children. In my free time I do trading, swimming, dancing and developing my social networks.

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When the fixed-term employment contract ended, I started looking for a new job and went to work as a courier. You can also wait for answers from potential employers in a car with a phone. And the opportunity to earn money without sitting within four walls is a wonderful experience. Although I had to talk to a psychologist to accept it. At first I said: "This is not about me, with my ambitions, with my experience - and in couriers!" But now I am terribly glad that I have humbled my pride, and I am sure: going where it is scary and uncomfortable is useful if there is support.

I did not find a job right away and I was nervous a lot. Some HRs said that I was too qualified, others simply did not give feedback. But the work was found - interesting and with an excellent team. Now I'm getting used to normal bosses again. There are no changes in relations with my husband, but I am much less obsessed with them. I realized that first you need to build relationships with yourself, and then with others, including your spouse.

How family relationships affect mental health

Vera Yakupova

psychotherapist, founder of the Good Point Psychological Center

Author Profile

Conflicted relationships with loved ones, lack of support and loneliness are among the risk factors for depression, as are relationships at work. A reader described how psychotherapy helped her feel more worthy and stand up for her boundaries. She was able to feel her needs better. And in relationships with loved ones, these skills are very important.

If we have these skills, then we are able to tell our loved ones about our needs: what is important to us, what kind of attitude we want. Also, ask them for support. If the relationship is generally warm, then it is possible to agree.

Sometimes a partner chooses a more difficult style of interaction, and this cannot be influenced. A person tries to negotiate with a partner, but he does not want to respect his boundaries, continues to devalue his feelings and refuse support. Then it’s worth considering whether to stay in a relationship or whether it’s time to get out of it. You need to understand which solution will be more conducive to psychological well-being.

After therapy, I became more patient with my children. Previously, my conversations with my daughters were more in an orderly manner: “Get up! Make your bed! Comb it!” And now I try to talk to them calmly and explain complex things in simple language.

For example, my eldest daughter became very ill a month ago and missed many classes. She relaxed and no longer wanted to do her homework. Instead of arguing with my daughter and forcing her to study, I talked to her and compared education to building a house. “In early childhood, you and I laid the foundation: we painted with finger paints, sang, sculpted,” I told my daughter. “Now, as a schoolgirl, you build the walls of your house brick by brick, theme by theme. If you miss something, a hole will form in the wall and the house may collapse.” My daughter liked the analogy, and she quickly made up for the missed material.

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I took the Beck scale test again the other day. Scored 9 out of 63 points - 14.29%. Here is what is written in the conclusion: “Your emotional and mental state does not cause concern. There are no signs of depression. However, if you scored 9 or more points, then we recommend that you devote more time to rest, an active lifestyle, meetings with relatives and friends. I absolutely agree with the recommendations and continue to work on myself.

My current Beck Depression Test results. The test showed: depression is gone, my mood is finally all right

I am convinced that it is necessary to fight depression not only with pills. Psychotherapy and self-care are important because you don't want to find yourself again in apathy and pain. My psychologist says that her main task is to help me become my own psychologist. And I think it works.

Before, I didn't think about how I feel, how I feel in my body, and what I did to make it different. Now I consciously pay attention to my mental well-being. I know that it's better for me not to read the news and not to check the drawdown in the investment portfolio - and I don't do it. I know that talking with friends, walking, dancing, massage, drawing help me feel better - and I consciously and purposefully arrange all this for myself. When a sense of helplessness began to overwhelm me, I seized the moment and immediately went to a psychotherapy session using the EMDR method, which struggles with the consequences of traumatic events, in order, like Baron Munchausen, to pull myself out of the swamp by the pigtail.

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How much I spent on therapy in 18 months

Expenses Amount
Psychotherapy in 2020 24 000 R
Psychotherapy in 2021 31 000 R
Antidepressants prescribed by a psychiatrist 10 800 R
Antidepressants prescribed by a neurologist 7200 R
Total 73 000 Р

Costs

Sum

Psychotherapy in 2020

24 000 R

Psychotherapy in 2021

31 000 R

ANTIDEPSANIENTS ON THE PURCH

9000 10 800 RE appointment of a neurologist

7200 R

Total

73 000 R

How to prevent the repetition of depression

Tatyana Poritskaya

Psychologist

Author

Far from the person that can provoke a new depression in a person, can be prevented. For example, illness of loved ones, job loss, natural disasters and economic crises negatively affect mental health, but our ability to influence them is limited.

The task of a psychologist, first of all, is to give a person an arsenal of techniques that in the future will either prevent the development of depression or stop it at the very beginning. The specialist helps a person to learn to better understand himself and his feelings and improve the skills of regulating emotions, including through various exercises, techniques and practices. And knowing yourself and managing your mood reduces the likelihood of a relapse of depression.

Judging by the story, the heroine is confidently moving in this direction. The skills she received in psychotherapy have already made her more emotionally stable. She learned to set boundaries in communication with superiors, talk about what working conditions she needs in her work, and mastered techniques for coping with emotions from a body-oriented approach.

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