David Rakofsky, PsyD

This is the second in a 3-part series for those facing depression and hoping for help. It may also be a beneficial read for those who have a loved one showing signs of depression. Previously, we discussed how to recognize the hallmark signs of depression and how to respond.

Progress isn’t always linear when it comes to mental health treatment, especially for people with depression. Even if you are receiving treatment, your depression may stop getting better or may even worsen. Depression hurts emotionally and physically, and your level of pain is a good barometer of its impact on your quality of life. Specifically, there are several ways to tell if it’s getting worse:

  • You have extended periods of time when you notice your mood is not improving
  • You’re unable to function in your daily activities
  • You are sleeping too much or not enough
  • You are eating too much or not enough
  • You feel restless
  • You have increased feelings of hopelessness
  • Activities that usually made you happy no longer interest you
  • You keep crying without an identifiable reason or trigger
  • You feel irritable
  • You wake up several times during the night
  • You are having difficulty concentrating
  • You are experiencing physical symptoms, such as headaches and upset stomach, lethargy or inability to just get off the couch or out of bed

If you are experiencing any of these symptoms, despite receiving treatment for your depression, keep plugging away and remember to advocate for yourself. It just means you might need a different approach.

 

Start With Your Therapist

 

If you don’t think your therapy is working, start by talking to your therapist. Be direct and ask if there is a different approach you can try or if there is anything you can do make your therapy more effective. Seasoned therapists are trained in many different approaches to help people struggling with depression. Perhaps, if you feel comfortable with your therapist, he or she can try to engage you in a different way that is better suited to you and where you are at this point. If you feel you require action items or “homework” to make progress, convey that. Effective treatment is certainly not a one-size-fits-all endeavor.

 

Consider Switching Therapists

 

Not every therapist is a perfect match for everybody. If you don’t feel that she or he is a good fit to help you, that’s OK. Trust your gut. Express your feelings, and your therapist may even refer you to another professional who will fit so much better. You can say, “I’d like your help in finding someone who’s a better fit for me.”

If your current therapist is unable to help you, why not check with your insurance company? They can provide a list of all the other therapists who are on your insurance plan. Discussing the discontinuation of your current therapy can be a tough conversation because you are already comfortable with your therapist, and you believe he or she has your best interest at heart. At the same time, if you are more comfortable making a clean break, go ahead. While I’ll almost always encourage having this discussion with your therapist, if you aren’t comfortable with them for whatever reason, you really don’t it owe to them. (Of course, it’s always good form to give someone the courtesy of learning in advance that you won’t be returning).

The idea of starting over with a new therapist can feel overwhelming and may even deter people from exploring other options. However, you don’t have to begin from Chapter One and retell your life story, if that’s your main concern about making the switch. You’ve most likely begun to process that material with your previous therapist, and you can allow the biographical information you previously shared to come out over time, session-by-session with a new therapist.

 

Explore Medication

 

If therapy alone isn’t helping your depression symptoms, you may want to consult your medical doctor (or your trusted therapist) about adding a medication. If you’re currently taking medication, it may be time to try a new one. While many medications are available today for depression, it often requires trial and error to find the one—or the combination—that works best for you. Medications also take time to work. Even the right one for you can take up to four weeks before any improvements are experienced.

 

Stay Busy Between Sessions

 

While trying different approaches, there are other things you can do to help keep your symptoms in check. Some suggestions include:

  • Stay active/exercise
  • Spend time with people you trust
  • Set realistic expectations. Your mood may improve gradually
  • Take time to educate yourself about depression

Remember, treating your depression takes time. Sometimes the first approach or first therapist isn’t the right fit for you. This is why it’s important to not give up, but rather, empower yourself by changing up your treatment plan when needed. Not everyone who suffers from depression experiences the same symptoms. Similarly, not everyone benefits from the same exact treatment. This is why it is important for you to learn what approach will best help you.

Dr. David Rakofsky is a Chicago-based clinical psychologist and the founder of Wellington Counseling Group in Chicago and the northern suburbs.