I'll generally examine the context within which they present, asking myself whether the way they present is a reasonable or disproportionate reaction to their circumstances. Like all diagnoses, it's ultimately a judgement call. Like all diagnoses, it carries elements of social cachet and stigma, and one must be aware of this.
This is very wise, Ganesh. (Not that I'm surprised--I have found your perspective very valuable on this board more times than I can count).
Personally, I have seen two different therapists, US. The first one tested me (MMPI), told me I apparently had "disproportionate," to use Ganesh's word, anxiety bordering on depression (I was in graduate school, writing my dissertation, adopting relatives from foster care, applying for jobs, and freaking out). She said I needed to be on anti-anxiety/anti-depressant drugs, probably Paxil. I resisted. I did not want to be on drugs. I did, however, about a year later, have an MD prescribe some Lorazepam so I could sleep while I went through the serious job search/interviewing process. (Lorezepam's pretty addictive so I didn't stay on it too long.)
Then I got a job, moved away, and about two months into the new job pretty much stopped eating and sleeping and couldn't seem to speak without wanting to either break down into tears or scream. I couldn't swallow. I gritted my teeth and made it through the work days, but nights were the worst. I was so tired and confused yet sleepless. So, I pulled a therapist out of a hat (well, the list of preferred providers for my US private health insurance), and saw her for about, ummm, 5 or 6 years? Usually once a week, sometimes less. We worked through lots of shit.
She, too, said right away that I needed Paxil. So I got on it. I'm still trying to get off. I think--crossfingers--that I may be able to kick the habit. I worked my way off it slowly and have had none for several weeks now. It's not technically "addictive" i'm told, but it is hard to stop using.
My conclusions: 1) I needed therapy to work through the history of mental illness in my family, my own experiences, and my responses to all of this, and
2) I also have needed to end therapy at times because I felt sometimes "trapped" in the diagnosis. Like once I accepted "I am depressed," at some level I became my illness, and only my illness. And sometimes my shrink seemed to need to keep me there.
3) The drugs seem to have helped, too, but god knows. I'm skeptical, but then again, I am in a better place now. But I have had a hard time getting off them, which bothers me. I am a bit paranoid: if life as we know it ends, I'll be the one with a caffiene headache from hell weeping her eyes out as I simultaneously withdraw from the antidepressants.
I'm actually just recently returned to therapy again; for me it is mostly about my family; I have found I value my therapist's insight into mental illness/ family dynamics in order to think through how to deal with various members of my family and their crises, which I tend to feel entangled with, empathetic to.
Assuming you don't just run out of money or move, how do you know when you're through with therapy? |
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