Asklemmy

For me, personally….

Exercise has made the absolute most impactful noticeable change in my depression/anxiety. Hands down- no question. More than any behavioral therapy, medication- or anything.

Just exercise.

I appreciate the question.

As someone else pointed out, dbt is quite helpful if someone never learned to cope and receives trauma/stumbles in life. This helped me a lot.

Additionally, it was my own curiosity and drivenness.

Watching and reading for countless hours and actively being aware of similarities to stereotypes helped me get a feel for situation.

Then learning about things I suspected I might be struggling with, then pointing therapists and psychiatrists in the direction until they either confirmed or denied it with evidence backing it up.

This led to a very tailored diagnosis and therapy which now helps me feel more in control than I‘ve ever been in my life (I never thought I lacked control until I found out how little I had).

Being allowed and accepted in my way of existing has changed practically everything. It even showed me that I‘m lucky to be alive since my condition, combined with mx childhood usually spells doom.

It’s still a ton to think about and a burden of sorts but it’s no comparison to the self doubt I had before without realizing.

TL;DR: I think the best therapy is enabled by a thorough diagnosis, fueled by an interested patient.

Disclaimer: Obviously I‘m talking about actual science allthough it can be frustrating. Fringe science and esoterics provide easy and comforting answers but it is not the way imo.

I hope this helps.

I was psychotic with delusions of grandeur for close to five years.

What saved me was a 9-month mindfulness based coaching course that taught me about presence, emotional self regulation, introspection, reflection and proper interpersonal communication. In the end they allowed me to see my delusions for what they were and that i had built my life on lies. These tools are now an integrated part of my personality and have helped me immensely in the years after, both in my personal relationships and in managing my mental illness (bipolar disorder type 1 and C-PTSD).

You should be able to learn the same techniques around emotional and reflective work if you look into certified MBSR (Mindfulness-Based Stress Reduction) courses. Preferably in-person and at least 8-12 weeks long. Please note that these are scientific techniques detatched from the glorification and the muck that gets thrown around a lot in "spiritual" circles.

Today I'm studying public mental health work and do some work on the side of advicing researchers in the mental illness field, working to make training in these techniques into an integrated part of mental illness treatment.

I fully believe that if everyone was taught these tools as part of public education we would wipe out most of our political and societal issues withing a generation or two.

Other than that I've adopted a "listen to what the science says" mindset and make decisions based on what's good for me such as getting regular exercise in ways that work and that i find fun and eating healthy within reasonable limits (the mind needs relaxation too, sometimes in the form of treats and indulgence). Getting an active dog has also helped me to secure a minimal level of activity for myself when things get tough.

Acceptance and Commitment Therapy (ACT, pronounced "act") not only helped me with generalized anxiety (which I no longer suffer from), but it also opened the door to fascinating research that I have been reading about ever since.

It is transdiagnostic because it exploits the fundamental building blocks and processes of cognition. In other words, it helps everyone who has mental health problems, as long as they are verbal (so nonverbal autistic people may require other therapy).

It is also 'superdiagnostic', because it improves peoples lives regardless of whether they are diagnosed with a mental health disorder.

Anyone who wants to have more flexible cognition and change their behavior, all with an empirically validated approach, could benefit from ACT.

Quitting my full time job has been the best thing I ever did for my mental health.

Regular exercise, especially hiking.

I have an app that asks me how my day was, I have like 7 years of data based on a scale of 1-5. It colors it from a gradient of red to green and gives a relative emoji from happy to sad.

For 3 years, I challenged myself to go on a nearby hike once a day for a whole month. It's not huge. Like 2 miles out and back, about 800ft vertical gain.

I can see so fucking clearly the three best months of the those entire 3 years were the one month of each year that I hiked nearly every day.

Talking like 2.7-3.1 avg vs 4.3-4.7avg. frown literally upside down.

Now I try to go on hikes like once a week.

Feeding into existential dread, studying philosophy and trying magic mushrooms. YMMV

I think it really helps if the therapist understands the subject matter surrounding my problems. Having significant vocabulary known in common is critical to understanding.

A patchwork of things has helped me acquire and maintain a more balanced life. I’d say the largest contributor was adopting ‘radical acceptance’ as a way of life. Basically, I’m constantly, consciously accepting whatever is happening to me. It doesn’t mean I don’t try to change things but it means that I’m not always resisting everything.

I don’t know their style actually. Some therapists have been more effective, and those have basically been the ones I most trusted to open up.

Drugs. Not medication, illegal drugs. Ymmv. I am not endorsing anything and this is legal nor medical advice.

Education and anecdotes. I work a therapist for about 30 mins every two weeks and honestly, I find much of their suggestions kinda neutral. I often ask how they fit to that suggestion. That's where they recommend a book on the topic.

Reading their book recommendations is better for me, because their advice is now given in a format where I can read and review over and over. The books have anecdotes about other use cases. It has studies. It has research paper I can personally dig into.

Honestly, my therapist is less of a "let me explain" and more of a librarian who helps me find resources myself.

watching Tony Soprano go to therapy and thinking "i wish therapy was really like this"

Hi, Clinician here, just popping in to say that all theories of therapy basically say the same thing in different ways.

Don't worry too much about treatment modality. Build a relationship with your counselor and put in some effort into bettering yourself.

Positive outcomes are something like 30% external factors, 40% counseling relationship, 10% therapist efforts, and 20% client effort.

I will always be thankful for Dialectical Behavior Therapy by Marsha Linehan. I have never been diagnosed as borderline, but the lack of basic coping and interpersonal skills was obvious. It wasn't a cure, but it has given me a foundation on which I was able to move forward with deeper, therapeutic processes. Frankly, I think everyone should go thru all the modules at least once.

I did Radically Open DBT (RO-DBT) which I found to be helpful with dealing with excessive perfectionism and hyper independence and it also helped me open up for other types of therapy. I'm currently doing a mixture of DBT, CBT and ACT and it's painful but useful for traits of BPD and social anxiety.

MBCT or Mindfulness-Based Cognitive Therapy. Basically, it's some of the core principles of Buddhism without any of the karma/rebirth woo-woo, practiced by a licensed psychotherapist, either individually or in a group. It was recommended to me for anxiety and depression and it has helped me stay grounded, recognizing and avoiding spiraling into hopelessness and resentment.

CBT for actually getting out of a rut and sitting meditation (zazen) for staying out of it. There are many more things that help, like reducing alcohol and caffeine, regular exercise…. but meditation is what really changed the game for me.

I’d just recommend you start it with a qualified teacher. Or at least read up on it (I recommend https://www.mctb.org/ and “the mind illuminated”).

My motorbike fixes my issues whenever I go on it. And the thought of going for a ride can calm me down sometimes. But it's usually more powerful when I actually get out.

Years ago, someone suggested a book called 'Discover What You're Best At.' by Linda Gail.

I had hated pretty much every job I'd ever had, then found one where I used my talents. Being able to get up on a rainy Monday and not be miserable was a life changer.

Taekwondo. Cooking. Creative projects. I've also done therapy on and off, 1-on-1 conversational therapy as well as Psychodrama in a group therapy setting. Therapy is nice but I wouldn't say it is the thing that helped the most.

Psychoanalysis.

I’ve been reading books by Gabor Mate - recently finished When The Body Says No and almost done In the Realm of Hungry Ghosts. Lots of stories and insights into how others cope with what has happened to them. It helps to look at your own experience and coping through a new lens.

I wonder if anyone has had any experience using psychedelics in therapy? Not sure if this was in one of these books or if I read about this elsewhere.