this post was submitted on 31 Jul 2023
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Mental Health

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I have been living with depression since a teenager and after so many years, I recently finally started receiving psychotherapy (CBT). While I'm already seeing some modest changes in my thinking patterns, my therapist noted that in the last few weeks the severity of the condition is worsening and it might be a good time to talk with my primary care provider about antidepressants as a combination therapy.

This got a reaction out of me, specifically that I don't like the idea of chemically altering my mental state and losing access to what "I really feel" (as I perceive it).

I know that the logic behind this sentiment is not very solid, but we can't reason ourselves out of our feelings that easily. For me this is also challenging because I don't take any recreational substances that affect my mental state, so I can't tell to myself that it's like e.g. smoking weed only more targeted and supervised.

I'm curious if this sentiment is familiar to anyone else, and how you dealt with it (whether you decided for or against medication).

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[–] [email protected] 12 points 1 year ago* (last edited 1 year ago) (2 children)

What makes you feel that your current state is what you "really feel"? Who decides that? I tend to feel the opposite way; that my currently depressed, anxious self isn't the "real" me, and that any treatment I seek- whether through therapy or medication- is just a course-correction so that I can move closer to reality. Maybe it would help to reframe it that way? When you challenge your thought patterns and work on developing healthier ones, you are making changes but you aren't changing who you are, nor are you denying reality. Medication is just another tool/aid in the same way that therapy is.

It might be helpful to talk to your therapist about why you're worried about losing access to your current feelings. How are they serving you right now?

Maybe you'll find it comforting to consider that antidepressants generally aren't that powerful and aren't likely to change your mental state to the point I think you're worried about. Anecdotally, I've been on a variety of antidepressants; some made me feel worse physically, some made me feel worse mentally, some had absolutely no effect, and some have made me feel better or more functional but in subtle ways. I'm currently on medication that isn't the cure I'd hoped it'd be, but has enough of a positive effect that it's worthwhile for me. Not saying that medication is for everyone, but I hope hearing others' experiences helps you make the right decision for yourself!

[–] [email protected] 5 points 1 year ago

What makes you feel that your current state is what you “really feel”? Who decides that?

That may be the most crucial question my therapist should ask me. The answer that's top of mind is "this is all I ever was since I can remember, so it has to be real even if it's bad". I can tell how shaky the logic is but it's convincing to me.

Thanks, you provided me with some great questions and I'll discuss those with my therapist.