I very nearly bottled out, but I managed to force myself to keep my doctors appointment this morning. I was dreading it. I have never been to the doctor about my depression before and I couldn’t help feeling like I had somehow failed by seeking his help. Admitting that my life is locked in some sort of downward spiral, felt like an admission of weakness and that didn’t feel good.
I was terrified that my GP would be less than understanding and that he would make me feel like I was wasting his time – my previous experiences with him (about regular medical stuff) had left a considerable doubt in my mind about how he would handle this rather delicate situation.
I had been going over and over in my mind what I should say, what I should mention and what I shouldn’t mention, how I should react if he said this or that, or if he reacted this way or that way etc. All of my planning however, went straight out the window the moment I set foot in his office. Nothing went how I expected it to, and all of it was a surprise. The walk from the waiting room to his office felt like the long walk to the gallows and I was filled with what can only be described as dread. I sat down and my doctor asked what I had come to see him about, but rather than come out with one of the dozen choices of opening gambits I had prepared, I froze. I found that I couldn’t look him in the eye or even in his direction, and I just froze. The only thought in my head at that moment was to stand up and walk straight back out of his office and forget the whole thing.
After what felt like hours but was actually probably more like seconds, I managed to stutteringly squeeze out the words ‘I’m not coping very well’. I think those were the hardest five words I have ever uttered. Everything that followed took me entirely by surprise. The first thing, was the realisation that my doctor was actually handling the situation with incredible tact and sensitivity. I think I was expecting him to be dismissive and irritable and I was therefore prepared for some form of battle. His actual reaction couldn’t have been more different and it totally wrong-footed me which I think led to the next thing to take me totally by surprise… to my absolute horror I started choking up. Tears followed and just as I started finding my voice and answering his questions, I lost the ability to speak again. I was mortified. I absolutely hate crying in front of people and never do, but I just couldn’t stop myself.
So there I am, sitting in the chair furthest away from the doctor, looking at a 90˚angle away from him, unable to even look in his direction let alone look him in the eye, trying to answer his questions and explain what I’m feeling…. and I started blubbing. Jesus what a bloody nightmare. All I could do was fall silent, look away and try to stop myself completely breaking down in front of the doctor. He really did handle the whole thing brilliantly (it must have been pretty uncomfortable for him) and he kindly filled in the weeping silences by talking as I struggled to regain my composure. The problem is once I have lost my composure like this, my nerves become very raw so it doesn’t take much to push me back over… I think I choked up about 3 times in total.
My 15 minute appointment ended up being a 45 minutes appointment and by the end it had been decided that I would come back the same time next week to discuss things further, which would give me a chance to think about what direction I wanted to go therapy-wise. I had taken a little test to give me a depression score and he had said that I had scored rather highly. He suggested 3 possible courses of action: Stepford Wives pills, Pavlov’s dogs therapy or cosy little personal chats with a nosy stranger.
The doctor did make it very clear that there were 3 available courses of treatment and he did a pretty good job of describing (in laymans terms) what each of them were and what they involved. At the time though, all I could do was sit gaping. I was in no fit state to make any kind of sensible decision, so I asked him what he thought should happen next (because I didn’t have a bloody clue!). After a little dithering he said that he thought I should try going on an SSRI antidepressant (Prozac). He didn’t explain his decision about which antipressant he thought I should go on, but then I don’t suppose any of what he said would have made any sense to me anyway. I did at this point say that I had reservations about antidepressants – about the fact that I’ve heard that they ‘space you out’, make you somewhat ‘distant’, a little zombie-like… etc. and also that I felt they had a lot of stigma attached to them. He said that it was true some people have said this, but that he believed that a positive attitude towards antidepressant drugs was important when you go onto them, and that if you actively looked for the negatives, they would ultimately dominate. He was basically saying that if you decide to take antidepressants, then you must also decide to ‘go with the flow’, accept the negative points and embrace the positives. Being a man of common sense, I saw this advice for what it was… incredibly inciteful. It still didn’t make me throw caution to the wind, jump in and agree to go onto drugs though.
The second course of treatment he said was available to me was Cognitive Behavioural Therapy, which unlike counceling type therapies, was more a ‘correctional course’. From what I understood, this meant that they didn’t delve into the past, dwell on it and try and rationalise every thought or emotion, CBT instead dealt with specific behavioural issues – rather than explore the ‘why’s’ of what was happening, it tackled the fact you were actually thinking about it that way in the first place…. trying to stop the mental vortex of internalised thoughts from even forming in the first place…. kinda thing….
The third course of treatment was what he described in laymans terms to me as ‘talking therapy’, where you do actively try to seek root causes to various ‘issues’, recognise them and then try to deal with them… kinda thing.
So what do I think I should do? I. Have. No. Fucking. Idea.
I think my gut is telling me to try CBT, if that doesn’t work then ‘talking therapy’, then if all else fails bite the bullet and go on the meds. My worry about that, is that I think at least ‘some’ attention needs to be taken to how I am actually feeling about a lot of issues. I worry that CBT will try and treat the issues more coldly than I am prepared to. ‘Talking Therapy’ I have my doubts about – I booked myself into see a private psychotherapist last year in July/August – I had about 4 sessions with him. I stopped because a) I couldn’t afford it and b) because I felt that although it was nice to talk about it, nothing we discussed was new to me – I had already made my conclusions about the effect certain ‘issues’ had on me – I already knew that these things weren’t going to suddenly get better by ‘saying them out loud’ – there were no revelations during these four sessions and actually in the short term, it made me feel even more shitty and emotionally drained (to be fair he warned me that it would). I ultimately decided that these sessions were not for me and put the failure down to this particular guys ‘method’ not working for my particular flavour of depression. The third option offered to me by my doctor was drugs – this option is currently lagging behind in third place. Over the years I have just heard too many worrying stories about antidepressants, some of which I know are founded on nothing but rumour, but still in my head, rightly or wrongly, there is a stigma attached. To be blunt and honest, I have ill-informed prejudices against antidepressants. I have a lot of research, re-education and thinking to do between now and next Thursday morning.
Why is nothing ever simple.