Do You Need Therapy

DO YOU NEED THERAPY?
SUICIDAL THOUGHTS
Certainly the most important indicator that you need therapy is if you are having suicidal thoughts. This is especially true if you have begun to think that there are no other options left and that suicide is the only way to end this pain. If you have formulated a plan on how or when you will kill yourself, I urge you to seek help now! Make an appointment with a therapist as soon as possible or go to your local hospital, if the crisis is severe call a crisis help line and let them help you make it through the night, seek help in the morning. Suicidal thoughts and depression are episodic, in that you will have periods which are worse than at other times, but the intense feelings will abate if you give yourself time and seek counseling.

LOSING CONTROL
If you are no longer able to control your anger, if you are no longer able to control your periods of despair, if it seems that your life situation is no longer under your control and you are entirely at the mercy of someone or something else, if your interpersonal relationships are falling apart and your are at odds with members of your family and your co-workers and you are losing friends, if these things are happening to you there is a good chance that your depression is beginning to take control of your emotions and it is taking control of your life situation. If you do not make the decision to intervene and seek counseling your depression will worsen and regaining control will become more and more difficult.

ARE YOU GOING CRAZY?
You may have the feeling that you are going crazy. This is not an uncommon thought when a person first experiences the symptoms of depression. Without defining what the term "crazy" means, a person who is actually going crazy probably does not have a complete realization of what is happening to them and will most likely blame their problems on someone or something other than themselves. They many times think that they are sane and it is the rest of the world that has gone "crazy". The automatic thought "I think I am going crazy" arises due to a reaction to the symptoms of depression. The confusion, the loss of memory, the anger, the despair, the ups and downs (especially for manic depressives), and the loss of control of our emotions, all are perplexing when we first become depressed. This feeling that we are losing our minds happens as our depression begins to take control, it is also a very good indicator that intervention is needed and that it is time to seek therapy.


DOES THERE NEED TO BE A CRISIS?
Most of us only begin to consider that we need therapy when there is a crisis, where our life has come to a point where we are no longer in control, or we are having strong suicidal urges. Yet our depression does not have to reach a crisis stage before we seek therapy. One of the main reasons I am writing this article is to help people recognize the warning signs of depression so that they begin to work on healing before the depression reaches a crisis stage. In fact my ultimate goal is to inform enough people so that most of us do not even need therapy, but are able to recognize that we are depressed and use improved self help methods to avert a crisis and heal ourselves.

HOW TO START
Anyone who knows or suspects that they are depressed would be wise to first have a complete medical evaluation in order to determine if there is a possible organic cause of the depression. It is possible that certain medical disorders such as hypothyroidism are the cause, especially if the onset of depression is sudden or cannot be explained by reaction to environmental influences. The problem may also be caused by an adverse reaction to prescription or illegal drugs such as amphetamines. If you begin your therapy by going to a psychiatrist (who is also a MD) he/she will give you a medical evaluation, if you do not start with a psychiatrist then a complete physical by an internist or family doctor is recommended. While I do urge you to rule out any possible organic cause by seeing an MD, I do have reservations about beginning your therapy choices with a visit to an internist or family doctor. My concerns will be covered in the section on drugs and again in the section on pitfalls later in this article. I caution you not to become overly optimistic and fixate on the possibility that the depression has an organic origin because for most of us this is not the cause, but it should be investigated.

One of the first considerations when we are trying to heal or improve our mind is with our physical body. If we abuse or neglect our physical body, our mind will be adversely effected. Whether or not our depression has been caused by the abuse or neglect of our physical body, or if our depression can be cured by stopping the abuse or neglect is not what I am addressing at this time. The point is that if we abuse and neglect our physical body and we are depressed, the depression will be worsened and our efforts to heal our mind will be more difficult and take a longer period of time. This is true even if the method of therapy is drugs only, because if we are physically fit our body can more readily assimilate the drugs and possible side effects will have less of an impact.

If you determine that you are depressed, I do not suggest you undertake a rigorous program of physical exercise for the express purpose of ending the depression, especially if exercise is the only method used to combat the depression. It is not uncommon for a depressed person to begin an exercise program by buying an expensive pair of shoes, an exercise machine or sports club membership, and a new exercise outfit, only to find that within a short time the symptoms of depression make it impossible to follow the regimentation, commitment, and motivation needed to insure the success of the exercise program. There is a good chance that I will be buying your expensive exercise machine for ten cents on the dollar at a garage sale next summer. On the other hand, I do highly recommend that you start a mild program of physical exercise consisting of walking, stationary bicycling, or mild aerobics, for 20 to 30 minutes a day, five days a week. This will help clear your mind, it will help you focus while investigating your mental health care options, and mild exercise will help with motivation and commitment when first beginning your therapy.