Friend has been on ADs and in counselling for over a year with little change

[Blondie556]

A close friend of mine had a breakdown at the end of 2019, triggered by a very bad relationship break up but she had previously had issues with anxiety in the past due to childhood trauma. She has been on ADs and in weekly private counselling for over a year now and whilst her depression and anxiety is not as bad as it was, I cant remember one time in the past year when she has seemed happy. I know it has been a rough year for everyone, but is it 'normal' for there to be so little change in her mental health after a year of treatment? I'm concerned that she doesn't seem to be improving much but also dont want to stick my nose in and suggest she maybe needs to change something either if this is just the new her.

Have you asked her how she’s feeling? Does she feel the therapy is helping, and like has she improved?

A year of lockdowns is a difficult time when you’re suffering with MH, it’s great she’s taking medication and attending weekly sessions.

She may also not feel “happy” but simply no longer as bad as she was, which is a huge improvement - but you’ll only know if you ask her?

I would also add, ADs and therapy isn’t a magic wand - it’s bloody hard work, and is an ongoing effort to manage the depression and anxiety.

I have generalised anxiety disorder and depression, and some days I’m utterly exhausted by using my coping techniques to manage it. It doesn’t disappear - you simply learn to live with it, some days that is easy to do, other days it’s really difficult.

Thanks flappityflippers1. This thread was prompted by a discussion we had at the weekend when she told me she was finding it difficult to get out of bed and motivate herself to do anything. I dont ask about her MH everytime I speak to her but when I do the response is usually that its not great or its up and down. The most positive thing she has said about therapy is that she no longer feels suicidal, which is obviously fantastic, but I dont think she likes online sessions.

That’s really good she isn’t feeling suicidal any more - if she is paying privately for therapy she could try another therapist if she hasn’t already? There are a lot of different types of therapy so it could be what she’s having doesn’t work the best for her.

(Only going off what I’ve found, I found CBT crap, EMDR sort of worked, but IEMT therapy has worked wonders for me)

I don’t think it’s good she feels she can’t get out of bed after a year of help - though you defo do get good and bad days/up and down, and Covid will be making it much harder - it’s so difficult to know if the progress is slow due to lockdowns or because the therapy/ADs aren’t suiting her

She’s very lucky to have a lovely friend watching out for her

I’m in weekly therapy have been for many years now. And I jusy want to say that the actual therapy work we were doing ground to a halt in 2020 because of Covid. There isn’t the privacy and trust doing the meetings over video that there is in person. My weekly therapy is now weekly check ins, sometimes 2x a week when I’m especially low.

So I think your friend may be in similar straits. The therapy if it is remote is probably to keep her in a holding pattern and not get worse at this point.

Thanks planderaccordement that's really useful to know.

Therapy is strange. You can spend months were you feel like you're getting nowhere then one day everything can shift and then other times it's a slow rise.

The type of therapy and therapist can also have a huge effect. I've had a lot of therapy and found that working with someone who really understood trauma and how it affects us has changed everything. You'd be surprised at how many therapists don't understand trauma. I've also found educating myself about trauma, reading etc has made me feel less alone and more understood.

I also wanted to say that you sound like a good friend and I'm glad she has you her in her life. It must be very difficult for you too.

I’ve had it for 52 years. Quite often it’s bad even with meds.

It’s normal. You often don’t ever ‘recover’. You have to adjust and accept it.

colourmeclear thanks. It's tough at times trying to find the right balance between being concerned but not trying to 'fix' her. Covid restrictions haven't helped. Whereas in the past I could invite her out to the cinema or similar low stress activity, now things are much more limited.

I understand completely. My default is to try and fix people. I've learnt to communicate that I'm open to support without reaching out to force it, if that makes sense. Its very easy to make yourself unwell trying to pick up others.

Could you bubble and go for walks? Perhaps both read a book and talk about what you thought of it? Or a film separately and talk about it?

colourmeclear we do go for walks although sometimes friend doesn't have the energy or enthusiasm, which I understand. Thanks for the other suggestions though. We dont have similar reading tastes but we do sometimes watch the same things and I could make more of an effort to discuss them with her.

I think that's right about therapy being a kind of holding pattern for now.

Also, its useful to think of therapy not as a "treatment" (where the therapist "gives" you something and you get better) but more as a "space" where you can think start to about yourself and how you relate to others in a safe relationship with a helpful other person. What happens in the relationship between the two people in the room is what is important and of interest.

It kind of mirrors how a child might develop if allowed to explore and experiment with things and ideas in the presence of a helpful and protective adult, who can help the child make sense of things.

A good deal of the work in therapy is actually learning how to use the space in the first place. It is certainly not a given that someone can trust the therapist enough to relax and explore/wonder about themselves. In fact I often think that once someone has reached that point, they are probably well on the way to being able to stop therapy.

The ultimate goal of therapy is, through the example of the experience of a therapeutic relationship with a real external person, for the patient to be able to take in and create inside them a kind and thinking "internal therapist", who they have always with them and who is able to reflect on what is going on for the person, and help them.

This is what children who have good enough caregivers are able to do.

covid has made it extra difficult for those with anxiety and depression.

One thing I have found surprisingly helpful is changing things and having goals.

We develop habits that support anxiety and depression and then it becomes associated with it.

For example. When I am not depressed, I get up and make my bed. When I'm depressed, I'll stay in bed longer and not bother to make my bed.

So what I did was create a new morning routine and many days I had to force myself to do it but I made myself do it.
A sample would be get up, make bed, wash face n brush teeth, do 3 stretches or yoga poses, get dressed, brush hair, put on mascara and lipstick.

Rearranging the furniture can help too. Changing things up like that.

Just a few suggestions.

Rantyanty

That’s basic CBT. Psychoactive l think the term is! Forcing yourself to do something.