How I've Dealt with Anxiety/Depression Part III
May marks Mental Health Awareness Month and I thought what better time than to share a bit about my own journey and ways I take care of myself when it comes to my mental health.
Please note I am not a mental health professional/medical professional and I am not promoting a particular method of treatment, rather I'm sharing my thoughts and experiences.
Mental health and mental illness are areas of health that carries unnecessary stigma around them. We don't shame people suffering from illnesses like cancer or multiple sclerosis, so why do we shame people suffering from mental illness and mental health issues?
Therapy & Medication
Definitions and brief explanations of some of the different types of therapy that are available:
Counseling - Counseling is usually a more short-term form of therapy, for people who are basically healthy. It usually consists of 6 to 12 sessions and can be helpful when you need help coping with a current crisis such as: anger, relationship issues, bereavement, the onset of a serious illness, or being fired/laid off.
Cognitive Behavioral Therapy (CBT) - Cognitive Behavior Therapists work with individuals to help them develop coping strategies that target current situations, and change unhelpful patterns, thoughts, behaviors and better regulate emotions. A course of CBT typically involves 6 to 15 sessions, which last about an hour and it's focused more on the present, rather than the individual's past or childhood. It is the most widely used evidence-based practice, (guided by empirical research), for treating mental disorders, and though it was originally designed to treat depression, CBT can also help with: anxiety, panic attacks, phobias, obsessive compulsive disorder (OCD), post-traumatic stress disorder (PTSD) and some eating disorders, especially bulimia.
Psychotherapy - Psychotherapy involves the individual delving more into how their past influences what happens in the present and the choices they make. It tends to last longer than CBT and counseling, with many people continuing to see their psychotherapist for a year or more. Psychotherapy is an umbrella term, encompassing many different types of therapy. The different types of psychotherapy all aim to improve an individual's well-being and mental health, resolve or mitigate troublesome behaviors, beliefs, compulsions, thoughts, or emotions, and to improve relationships and social skills.
Family Therapy - Family therapy involves the whole family receiving treatment from a therapist. The different schools of family therapy have in common a belief that, regardless of the origin of the problem, and regardless of whether the clients consider it an "individual" or "family" issue, involving families in solutions often benefits clients. The therapist explores and examines the family dynamics to help them better understand the problem they are having, and better communicate with one another. Sessions can last from 45 minutes to an hour-and-a-half, and usually take place several weeks apart. Family therapy is usually explored when the whole family is in difficulty, as a result of one member of the family having a serious problem that's affecting everyone else. Family therapists deal with lots of different issues, including: child and adolescent behavioral problems, mental health conditions, illness and disability in the family, separation, divorce and step-family life, domestic violence and drug addiction or alcohol addiction.
Couples Therapy - Couples therapy is a type of family therapy in which a couple facing difficulties in their relationship, seek the help of a therapist. Sessions can take place with both members of the couple, or with each individual seeing the therapist separately. Sessions are usually weekly and an hour long. Couples therapy can provide tools to better communicate and work towards repairing whatever conflict or crises is occurring within the relationship.
Group Therapy - Group therapy can consist of up to around 12 people meeting, together with a therapist. It’s a useful way for people who share a common problem to get support and advice from each other. Some people prefer to be part of a group or find it more personally beneficial than individual therapy, because it helps individuals realize they are not alone with their experiences.
Psychoanalysis - Probably one of the most well known types of psychotherapy and also the most misunderstood, psychoanalysis, was founded by Austrian neurologist Sigmund Freud, and is rooted in the idea that the unconscious mind influences thoughts and behaviors. Differing from several other therapy types, psychoanalytic therapy aims to make deep-seated changes in personality and emotional development. Psychoanalysts are mental health professionals, (psychiatrists, psychologists, or social workers), who have received additional training to learn how to carry out this specialized treatment. It is often is a long-term treatment, and consists of psychoanalysts spending time listening to patients talk about their lives, which is why this method is often referred to as "the talking cure."
The psychoanalyst looks for patterns or significant events that may play a role in the client's current difficulties. Psychoanalysts believe that childhood events and unconscious feelings, thoughts and motivations, play a role in mental illness and maladaptive behaviors. The psychoanalyst offers an empathetic and nonjudgmental environment where the patient can feel safe in revealing feelings or actions that have led to stress and difficulties in his or her life. It has also been shown that this type of self-examination can lead to continued emotional growth over an individual's lifetime. There are many techniques that psychoanalysis uses which include free association, exploration of the transference, observing defenses and feelings patient's may not be aware of, as well as dream interpretation. Some of the major drawbacks of psychoanalysis are it can be time consuming, with patients seeing their psychoanalyst several times a week (ideally four times) for 45 minute sessions, and expensive.
There are many other types of therapy which I did not cover but can be beneficial. Finding the right therapist or style of therapy is a a matter of personal choice and personalities matching. Therapy is becoming increasingly more accessible for all people. There are even online therapy resources, like Talk Space, which offers therapy with a licensed therapist, for significantly less money than traditional therapy. These types of resources can be helpful when searching for therapists who practice in your area.
My Therapy Journey
I first started seeing a therapist when I was eight years old, around the time that my parents divorced. At that time, I started acting out and became a huge bully. I would bully other kids at school, and I would also bully my younger brother. Childhood can be an incredibly difficult time because you aren't in charge, so I probably bullied as a way to deal with my own anxiety, gain control, and make myself not feel so small and powerless. My mom, (who is a psychiatrist and psychoanalyst), put me in therapy, as a way to express what I was feeling to someone we could trust. I ended up staying in that treatment for two years. My once a week, 45 minute sessions, with my therapist usually consisted of me drawing pictures for her, and then explaining the stories behind them. I loved drawing as a child and would spend most of the day, if given the chance, drawing characters and building stories around their lives. Since children don't always have the words to express how they're feeling, child therapists usually employ techniques such as play therapy, or in my case drawing, as a way to understand what the patient is feeling. Not only did my relationship with my brother and friends at school improve, but I also felt less anxious and better able to regulate my anger and emotions after the therapy was done.
I started therapy again, when I was sixteen and a junior in high school. During that time there was a lot of conflict within my family (I talked a bit about this in Part I). I was constantly anxious, and experienced my first panic attack. Within a year of once a week sessions, my therapist, suggested that we should start psychoanalysis. Psychoanalysis as I mentioned above is a more intensive form of therapy, in which the patient meets with their psychoanalyst several times a week. At that point I probably saw my therapist three times a week. Some patients lie on a therapy couch facing away from their therapist, which is supposed to help you speak more freely without worrying about the psychoanalyst's facial expressions or reactions to what you say. I tried the couch for a while but found that as more time passed and my psychoanalyst and I got to know one another better, I felt safe enough and preferred facing her during our sessions.
Once I started college, my psychoanalyst and I would talk on the phone once a week, when I was on campus. I would then try to see her when I was home on the weekends, or during holiday breaks. We continued talking on the phone when I moved to Richmond, VA (more about that in Part II). Finally when I moved back home, I started a proper, psychoanalytic therapy (four times a week) which continued for the next four years.
I am incredibly fortunate and privileged that my mother is a member of the mental health community, and knows the value and incredible benefits that come with therapy. Therapy, and psychoanalysis specifically, has completely changed my life. The best way I can describe it, which I know is incredibly cheesy, is like the song, "I Can See Clearly Now", by Johnny Nash. It really was like a rain or fog that clouded my mind was lifted and I was finally able to see and experience everything that was happening within and around me.
It's like some people describe finally getting glasses after needing them for so long and being able to see the fine details of things like the edges of leaves, or individual blades of grass. Even now that I am no longer in psychoanalysis, I still find myself engaging in the type of self-examination my psychoanalyst helped me develop during my treatment.
My Experience with Medication
I want to preface this part of the post by saying that I believe that medication is most beneficial when combined with psychotherapy. However not everyone has access or the resources for both. Taking medication for your mental health is not a weakness, and just like any other medical condition in which medication is prescribed, medication to help an individual's mental health/illness can be necessary for treatment.
I have used medication, (Fluoxetine/Prozac), to deal with my depression and anxiety, on-and-off, over the past ten years. I first started taking it after my freshman year of college. I was incredibly depressed, to the point of not wanting to return for my sophomore year of college. I'm embarrassed to admit it now, but even though my psychoanalyst had been suggesting I try medication for over a year at that point, I thought that would really indicate that I was "weak" and couldn't deal with my depression on my own. When it all became too much and I was seriously contemplating not returning to school, I gave in and almost immediately felt more confident about going back to school. I stayed on the medication at that time for about a year and then, because I was still talking to my therapist regularly, and feeling more comfortable at school, I stopped.
I started taking the medication again last year when I was enrolled in my post-baccalaureate program. I was suffering from intense anxiety; about the program, about exams and though I was incredibly happy, also about my recent engagement. The anxiety was crippling, and getting out of bed and ready for class each day, was a battle. I was too distracted to study and would sometimes spend hours just sitting at my desk, staring at the wall or the same page of my textbooks. I was scared to leave my apartment most of the time because I was having panic attacks, and I was worried one would happen in the middle of class. Something had to give and again, I was stubborn about starting the medication, but knew things couldn't continue the way there were going.
I plan to keep taking the medication until after my wedding in October, but even if I have to continue longer term, I now truly understand that it's beneficial for me and keeps me at a level where I can function normally.
Thank you so much for sticking with me through such a long post! I hope the information that I gave and sharing my story can help other people feel less alone, and know that there are always options and ways to get help for whatever you're dealing with in life. I know there is a huge stigma around mental health and illness and it's not talked about enough, especially within immigrant and minority communities.
There is no such thing as a "small problem", and if you feel like your issues are impacting your life in a way that it takes you away from whatever you consider normal, then I would seriously encourage you to get help. Life is hard and traumatic, and I think that if we all had a therapist, just like we have a general practitioner, the world would be a much better place, with better functioning people.