When I was younger, I had a friend who was in a terrible relationship. He was really abusive to her and she knew that she should break up with him, but she didn't want to. We had suggested - many of us had suggested to her - to go to therapy and her defense was: No, no, no, I can't go. I know what they're going to say. They're just going to say break up with him. So I don't want to go. I imagine this is a fairly common perspective or belief of what people think - if they went to therapy, the therapist would say hey, you need to do this, this, and this and all these things are bad for you. I want you to know that's not true. A good therapist will not say do this. They will not judge you. Their main goal is to help you understand your own patterns and your own blind spots. They're going to help you understand what it is in you that wants to be with the abusive boyfriend and why you're drawn to him. They're not going to say you need to break up with him - that's not a therapist's place. We do not give very concrete advice such as do this, we sit with you and help you think through the different aspects of yourself, the different sides of you (one side wants this, but one side wants this) and we try to help you resolve the conflicts. That's sort of a general overview of therapy. If you get really specific: there are many different types of therapists and we all seem different sitting in the room. On one hand, you have what's called Cognitive Behavioral Therapy. If you go see CBT therapists, they're going to be much more active with you. They're going to be coming up with ideas along with you and they're probably going to give you homework. They're going to say let's figure out how to treat these symptoms in the most direct way possible. There's tons of different types of therapists, but let's go to the other end of the spectrum. Let's go to, say, a psychodynamic therapist. Someone like that is going to sit down and they're going to be much more laid back and their goal with you is to go over your life story - what happened in your life, things that happened before. Say your parents got divorced and your house was really upset for four years, but that happened when you were 14 and now you're 18 - a psychodynamic therapist is really going to try to look at that and realize how that affected you. Let's say right now your symptoms are: you tried drugs or you're cutting or you're depressed, you don't know what you want to do with your life. They're going to look at the whole big picture to say, Hey, you know what? I bet you that stuff back there really hurt and there's a possibility that that has to do with your drugs right now. No therapist is going to look at your bad behavior and judge you for it. They're going to see it as a defense and a band-aid for something that hurts underneath.
When trying to treat your own depression, I usually present to clients sort of a hierarchy approach - we need to knock off the most important first that could be most impacting your depression. Number one is sleep. You have got to go to sleep. You got to try your very, very best to get eight to nine hours of sleep per night. A way that I recommend clients to do this is either to get a FitBit that tracks your sleep or you can just use an app on your phone - it's really not that difficult. The second thing (once you've taken care of sleep) the second thing you need to do is you need to exercise. Research shows that exercise about 30 minutes, four to five times a week - it doesn't have to be super strenuous. It could be a bike ride, could be a run, it could be following a yoga video on YouTube. If you do that, research has shown that it's equally as effective for depression as antidepressants are. Sometimes you need both, but that's a really good place to start. The third thing I would go to is looking at your sadness and looking at your anger. Depending on why you feel depressed right now - you might be super sad about a breakup, sad about your parents divorce, sad about your friends abandoning you at school - if you feel particularly sad about that, what I want you to do is write about it. Paint it. Find some creative outlet to use it up. What we want to do is not avoid the sadness and run away from it and try to distract ourselves, but rather: okay, I'm really, really sad today. Let me schedule in my calendar an hour to lay in bed and cry to Grey's Anatomy or cry to sad music. We need to use it up - not all 24 hours, but just one hour a day. You've got to use up your sadness. And the same thing goes for anger. Depression can many times come from anger turned inwards. We're angry at our parents, we're angry at people at school, we're angry at our teachers, we're angry about a lot of things we can't control. And so - screw all of it. We get angry at ourselves. I'm awful, I'm bad, I can't do it well enough. My family's a mess because of me. We need to try and turn that anger back outwards. That doesn't mean screaming at your parents and other people, but writing - writing is my favorite way to do it. Write down a list of everything you're angry about. Journal it. Try and get as much of that anger out of you as you can. Anger is much easier to process than depression itself. And the third tip - if you've done all of those things and they don't seem to be working, next, I would look for a therapist. Talk to your parents, talk to your counselors at school, see if they're willing to get a therapist and bring you to therapy. If that still doesn't work, then what we do is we go to a psychiatrist. Psychiatrists can prescribe antidepressants or medicines that can help you feel better. If you're way up at the top and haven't tried any of these things yet and you feel really helpless, there's a lot of things you can still do that we can really try to tackle these feelings and get you feeling better.
Unfortunately a very common theme in our society is the idea that you could just snap out of depression. Sometimes this works, I guess, but then it wasn't really depression in the first place. Real depression has a really strong grip on you and it gets a hold of the chemicals in your brain. When you don't have enough serotonin or enough of the neurotransmitters created by your brain that you need to feel what we would call typical then that's when you have depression. To snap out of it doesn't make any sense because your brain would literally have to create more chemicals and we can get those chemicals sometimes by exercising or sleeping more or using healthy things for our body, but most likely you can't just snap out of it. You probably need to process through why you're depressed in the first place and go through all of the things making you sad and angry and go through that with somebody. Another thing is that many times with depression, you just have to have antidepressants. Nothing else has seemed to work and you could stay in that space for a really, really long time without the antidepressants to help you.
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