Stuck in Depression and Nothing Helps – Not Even Years of Therapy

Mental Health, Therapy

If you’ve been in treatment for years, but have seen little or no progress, you’re probably feeling pretty frustrated and maybe even hopeless. Maybe you’ve been doing everything “right,” but nothing seems to help – but you do have the potential to live the life you want to live. You may just have to try something new.

You Might Have Treatment-Resistant Depression

We all feel depressed sometimes. Depression can be a response to life events, problematic thought patterns, or chemical imbalances in the brain. Depressive periods can last days, weeks or even months, but if your depression has lasted for years, it’s likely that what you’re experiencing isn’t normal depression, but major depressive disorder (MDD). And if nothing seems to help, you might have treatment-resistant depression (TRD), a subset of MDD. 

Treatment-resistant depression “doesn’t respond to traditional and first-line therapeutic options.” That means that antidepressants or talk therapy on their own might not help. Instead, you may have to work with your care team to figure out a combination of therapy, medications or other treatments that works for you.

Related: Is Mental Illness Genetic? 

You May Have Been Misdiagnosed

In the medical field, diagnosis and treatment are often straightforward. If you have high blood pressure, you’re prescribed medication designed to treat it. If your cholesterol is a little too high, your doctor will recommend a diet and exercise plan to get you back down to a healthy level. However, in mental health, there is a little more room for ambiguity. Symptoms can present differently in each individual and research suggests that misdiagnosis and overdiagnosis are both common.

Dr. Robert Trestman, chair of the American Psychiatric Association’s (APA) Council on Healthcare Systems and Financing says “If I’m giving you an antibiotic but you have a viral infection, it’s not going to do anything.” You can compare this to an antidepressant not working well for someone who actually has bipolar disorder, which can sometimes be mistaken for depression. 

This doesn’t mean you can’t get help from therapy, only that it’s important to be aware of these potential concerns. Pay close attention to any symptoms you experience. Even better, keep a journal of your experiences, including thought and belief patterns you notice, social or relationship problems, issues at work or school and any other major problems you’re experiencing in your life.

You Might Not Be Taking Full Advantage of Therapy

Everyone’s experiences and challenges are different, but there are some common reasons that therapy doesn’t work for some people, even after years.

You Don’t Really Trust Your Therapist

Going to therapy isn’t easy for most people. Even if you’re an open book with your friends, getting to that level with a therapist takes time and, for some people, it never really happens. Having the conversations you need to have in therapy to make real progress requires a high level of trust, vulnerability and even intimacy.

Dr. Lisa Vallejos, PhD, LPC says that the relationship between the therapist and the client is “one of the necessary conditions for optimal therapy.” 

She goes on to say:

“This means a relationship of trust, honesty, respect, healthy boundaries, and mutual willingness to work together. If any of those conditions aren’t present, the therapy process will not go as well as it could.”

You may even think that your clinician is just doing their job by listening to you and offering help, but the truth is that they want to help you. It’s why they chose this career and why they continue to show up for you. It’s up to you whether or not you want to accept that help by making an effort to trust and be vulnerable.

Don’t feel like your clinician is someone you can ever fully trust? It might be time for a new therapist.

You Find It Difficult To Change 

Maybe you want therapy to work for you, so you keep showing up for sessions. Maybe you like your clinician, enjoy talking to them or even look forward to your sessions – but still find it difficult to change.

Change is hard for many people, but change is the entire point of therapy. Embracing change – in your thoughts, behaviors, and the way you handle bad situations – will set you free. Just keep one very important thing in mind: your therapist can’t make your life “better.” What they can do is help you to develop coping strategies that will help you better manage your life experiences and the emotions that accompany them.  

You’re Not Putting in the Work

It would be nice if you could just unload all your troubles on your clinician and then just be magically healed, but therapy requires some work on your end.

Doing the “work” in therapy might look like:

  • Keeping a journal, so you can keep track of and bring up certain thoughts and feelings in your sessions
  • Doing any “homework assignments” your therapist asks you to do
  • Being an active participant in your sessions
  • Making the effort to trust, be honest and build a relationship with your therapist

How You Can Make Therapy Work for You

Find the Right Clinician for You

If you don’t feel like you can truly be honest and vulnerable with your therapist, or you just don’t feel a connection with them (even after weeks or months of working together), it might be time to look into other options, since the client-clinician relationship is crucial to making progress in therapy.

Related: Neurodivergent? Why working with a neurodivergent-informed clinician matters

Make Sure You and Your Therapist Are Regularly Checking in on Your Progress Together

You can’t know if you’re making progress if you don’t measure it. That’s why it’s so important to talk to your therapist about what you want to accomplish through therapy and to keep those goals in mind throughout your time together.

Your clinician should:

  • Ask you about your overall goals for therapy
  • Work with you to determine if and when those goals need to change
  • Check in with you regularly about how much you feel you’ve progressed toward your goals
  • Ask about your priorities for each session
  • Assess the progress you’ve made from their professional viewpoint

Try a New Technique

If traditional talk therapy doesn’t seem to be working, ask your therapist about other types of therapies that may help treatment-resistant depression.

Some therapeutic methods that can be helpful include:

  • Cognitive Behavioral Therapy (CBT)
  • Solution-Focused Therapy
  • Eye Movement Desensitization and Reprocessing (EMDR) Therapy
  • Dialectical Behavioral Therapy (DBT)
  • Trauma-Focused Therapy
  • Somatic Therapy

You can also try supplementing therapy with a support group. A support group can offer a low-pressure way to connect with others who have shared some of your lived experiences. 

Get Mental Health Help in Region Five

If you’re in the Greater Tidewater Hampton Roads Area, also known as coastal, southeastern Virginia, we’re your central point of access to behavioral health support services in your community. 

We can help in two ways:

Our Community Suicide Prevention/Crisis Line 

The crisis line is available 24/7 and is manned by specially trained individuals who will listen, offer encouragement and support and, if you want, connect you with local resources that can help.

If you’re struggling with your mental health or substance abuse, or even if you just feel like you need to talk to someone, call the Region Five crisis line directly at (757) 656-7755 to reach someone local faster. You can also dial or text 988 to reach someone at the national crisis line.

Affordable and Accessible Mental Health Support

At our nine regional community services boards (CSBs), we provide comprehensive behavioral health care, including mental health, substance abuse and developmental disorder support, for our community members. Even if you think you can’t afford therapy, we will work with you to get you the help you need at a price you can afford.

In Region Five? Find your Region Five CSB here.

Somewhere else in Virginia? Find your closest CSB here.

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