

Ask HN: Depressed and I want to start therapy, but struggling - dprssd

I am a founder (in the UK) and suffering from mild depression (I believe) and have done so on and off for the last 2 years. The last few months have been particularly hard and I am considering therapy, but I am struggling to get started.<p>I spoke to my doctor about 6 months ago, who "diagnosed" the mild depression, and gave me a cd to listen to (I haven't), said do some more exercise and see how you go. Because it's "mild" it seems that free therapy on the NHS is not an option.<p>I would like to try therapy to see if it helps, but I have no idea where to start and the whole thing is quite daunting (not to mention expensive). My cofounder has recommended a therapist he has heard is very good, but I am having trouble evaluating things.<p>My biggest question is what kind of therapy is appropriate. The recommended therapist deals in "pyschodynamic and NLP techniques", which seems to be different to CBT which I have heard of, and I am sure there are more.<p>Does anyone have any thoughts on what kind of therapy is appropriate, and how to evaluate them? As always the google seems to just give me a bunch of "scientific" papers and lots of analysis by people selling stuff. Help!<p>If you would rather email me: dprssdctzn@gmail.com<p>Thanks.
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emillerm
I think it's difficult to simply recommend one type of therapy and expect it
fit everybody's needs. Having said that, I would recommend CBT just because as
far as I can tell, its effectiveness seems to backed by a lot of science.

I'm kind of in the same boat though. Finding a therapist takes a lot of work,
and building up the motivation to do the work is especially difficult when
you're depressed. It's a catch 22. When the depression passes, so does the
motivation to find treatment.

Maybe if you have somebody close you can confide in, you should ask them to
help you find a therapist. If you have any friends who are seeing therapists,
their therapists may be able to refer you to others. In the US, many have
sliding scales.

Good luck!

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vellum
Get your annual exam and see if you can check your vitamin D levels on your
blood test. Most people are lacking in it. I'd recommend taking 2000mg a day.
There are two kinds of vitamin D. D3, cholecalciferol, is the one you want to
take.

Also, like other posters have suggested, try going to the gym. It does wonders
for your mood.

You might also want to look into interpersonal therapy in addition to CBT.
From what I've read, it's about the same as CBT when it comes to treating
moderate depression.
<http://en.wikipedia.org/wiki/Interpersonal_psychotherapy>

There was a good article in the NY Times about evidenced based therapy. Tl;dr:
<= ~30% therapists do pure CBT.
[http://well.blogs.nytimes.com/2013/03/25/looking-for-
evidenc...](http://well.blogs.nytimes.com/2013/03/25/looking-for-evidence-
that-therapy-works/)

If you want to find an accredited CBT therapist, search here:
<http://www.cbtregisteruk.com/Default.aspx>

Resources:

Moodgym - free CBT course by Australian National University
<https://moodgym.anu.edu.au/welcome> A few studies show it reduced depression
versus a control group.

<http://www.bmj.com/content/328/7434/265>

<http://bit.ly/XexrR9>

Another free course, recommended by the NHS: <http://www.llttf.com/>

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goofygrin
Note vitamin d3 doses are in iu not mg. It is very hard to overdose.

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DanBC
> it seems that free therapy on the NHS is not an option.

This is a mistake! There is something like "community based psychological
therapies" which will be long term talking therapies for people with severe MH
problems.

But there's also therapies available under something called IAPT - improved
access to psychological therapies. Your local primary care trust should have
something called a PCAT (different name in different areas) - PCAT is primary
care and assessment team. They have publicity names - so in Gloucestershire
they're called "Let's Talk".

PCAT take self referrals, so you don't need to get access via your GP. But you
can ask your GP for details if you want.

There are a bunch of therapies. I'm a fan of CBT. This is not medical advice!
I'm not a doctor, and have no qualifications. I think a good working
relationship with the therapist is important.

You can also get private therapy. Check for BCAP registration.

Short version:

1) Ask a GP at the surgery where you're registered for information about the
local IAPT services (or do a web search for them)

2) Have a look at MoodGym (<https://moodgym.anu.edu.au/welcome>) or some
books. "Mind over Mood" is often recommended.

3) Consider private therapy. BCAP registration is good. CBT is good. £30 to
£40 per session, for about 8 to 12 sessions, seems good. (Depending on area
and stuff. )

Please feel free to email me if you want. And good luck!

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dprssd
Sadly it seems that IAPT isn't available in Scotland. They are working on a
similar scheme but it is yet to be launched.

Thanks so much for your other thoughts though, really helpful!

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terrykohla
1\. regular exercise (find something you enjoy): it's almost impossible,
biologically speaking, to feel depressed if you're active.

2\. meditation (if non-religious) or prayer (if religious): to steady and tame
your brain.

3\. Do some research about mood enhancing diets. Many pop foods can cause mild
depression in the long run.

4\. Therapist and/or friend to bounce your ideas off of. You need someone to
tell you that reality is not as bad a you think it is. It seems silly but it
makes a tremendous difference.

5\. Most important --> baby steps

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saltcod
I think your first step should be counselling. If you try one and it doesn't
'click', try another. Counselling can be unbelievably helpful.

Someone said to me once that she thought _everyone_ should see a counsellor
once every few years. She meant it as a joke, but after sitting with a good
counsellor once myself, I agree completely.

A good counsellor can help you put everything in perspective. One helped me
out of an EPIC rut a few years back. Really: JUST DO IT.

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jedimike
NLP has its roots in Ericksonnian hypnotherapy, and can be good for thinking
in new ways and a very effective tool for a therapist, but is clouded by the
claims of so many new-age bullshit practitioners that it struggles to gain
credibility, which is a shame.

CBT is good for mild disorders, but requires a lot of conscious effort to make
work.

The difference is, CBT works by "overwriting" the thought processes that
result in the depression by repetition of new behaviours and thoughts. It
takes time, and works.

NLP / Hypnotherapy works by discovering what leads up to those thought
processes (which, a lot of the time, is out of our conscious awareness) and
changing that, so the depression never kicks in.

From personal experience, both work, and both don't, depending on the
therapist, which studies you read, and how committed you are to making them
work for you. However, it's much more important that you find a therapist that
you can connect with personally and trust. If you have that, the exact
modality of a therapy will result in pretty much the same outcome - some kind
of turning point in your own thoughts and outlook which sets you on the mental
path you wish to go down.

(source: I train NLP and Hypnosis, practise CBT, and have seen hundreds of
clients.)

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gruseom
In my experience, the question "what kind of therapy is appropriate" is less
important than it seems. What matters more is the personal chemistry, or lack
of it, between you and the therapist. An empathetic connection creates a space
where things are able to change and heal. Conversely, lack of it makes the
work more mechanical and one can keep at that for years without improvement.
Not everyone can help everyone.

If I were you, I'd look around until I found a practitioner that I felt a
connection with. That doesn't mean finding someone who tells you what you want
to hear. It's more whether you have a grain of feeling that this person might
be able to help you through whatever process you need. That seems to vary a
lot with who _they_ are (edit: or rather with the tuple _< you,they>_). Best
of luck.

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jgeerts
The best therapy for me personally is taking some time off. Just go some place
where you can relax, leave your cellphone inside the safe of your hotel room
and don't try to think about work.

There were times in my life when I thought I had it pretty good and felt
pretty good. At that time we went on a vacation and there I noticed how
stressed out I really was. So being stressed was 'normal' for me. Just don't
go spiraling into a negative loop where you walk around thinking constantly
about how depressed you really are. Try to focus on the positive things in
your life (there are more than the negative ones, really).

If it's a light depression, my advice is to just get away from things for a
while and come back refreshed.

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mooism2
Which sort of therapy would be appropriate depends on your depression and on
your personality. You should get assessed by a mental health professional and
then recommended a particular type of therapy based on that. (I am not a
mental Health Professional.)

(e.g. When I had depression I was eventually given a course of Cognitive
Analytic Therapy, which is similar to Cognitive Behaviour Therapy, but more
suited to people which more analytical personalities, such as me.)

(Btw, I am surprised your GP did not offer you Prozac as a first resort.)

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politestranger
plesae go and see a medical doctor first before you get mixed up in some
strange unappropriate therapy that costs you an arm and a leg and enriches no
one but the therapist. they will do some tests to rule out things like vitamin
deficiencies or other things that may be causing these feelings. go to a
medical doctor and tell them everything and let them decide whats best for
you. it will be cheaper and youi will get where you want to go faster good
luck

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gesman
I solved it for myself by looking directly into depression for what it is,
looking into feelings and where and how exactly they are being felt.

This is akin Eckhart Tolle teachings, I guess. Worked magic for me.

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bird_in_hand
Depression is work. If you haven't done the things your doctor has told you to
do, and at least given them an honest effort, that should really be your first
step.

