I am a 42-year-old divorced stay-at-home mother with three teenage children. My husband left me five years ago for his much younger secretary. I was awarded a large divorce settlement and child support, so I don’t have to worry about money. I have suffered from depression for most of my life, beginning in my early childhood. I’ve been to many therapists over the years and have been prescribed a variety of different kinds of medication.
So far nothing has really helped. I think of ending my life often, but know that I couldn’t because of what it would do to my children. I have been reading your advice column in Dan’s Papers with interest and thought that maybe you have some ideas about what I might be able to do to begin to finally feel better.
Barbara G., Southampton
I am so sorry for your pain and suffering. And I am very moved and impressed that you have tried (and are continuing to try) to get the help that you deserve. It’s impossible for me to know what kind of therapy you have had in the past and what kind of connection you have had with your therapists. As you know, all therapists are not the same and every therapist has a very specific way of working, depending on his/her training and theoretical orientation. For whatever reason(s) the therapy that you have had in the past has not worked for you. Don’t blame yourself for not yet finding the right therapist and therapy.
THE INITIAL EVALUATION
Let me tell you how I work and what I would do to try and help you to feel better. Perhaps my approach will make sense to you. I do very long sessions, frequently lasting several consecutive hours. My initial evaluation with you would begin at the beginning, namely with your childhood. You say that your depression began in your childhood, so I am curious what was going on or not going on during this period of time that triggered or caused your depression.
I would ask you to describe your childhood in detail, beginning with your earliest memories. Were your parents having marital problems? Did one or both suffer from clinical depression or substance abuse of any kind? Was there domestic violence in your family? Were you sexually abused as a child? Did your parents divorce or separate during your childhood? Were you bullied at school? Did you have any learning disabilities that would have caused you anguish?
I would want to know everything that may have contributed to this little girl’s depression. I would ask you lots of questions about your relationships prior to your marriage and of course would want to hear all the details about your marriage — the good, the bad and the ugly. I would ask you questions about your current relationships with friends and family and I would want to know about your physical health, diet, sleep and any substances that you may be using, including prescription and over-the-counter medications.
As a single mother, you clearly have your hands full. Are you being good to Barbara? Do you do things that are in your best interest, whatever they may be, or do you engage in destructive, self-destructive or self-sabotaging behavior? Do you have interests and hobbies? And if you don’t, are you open to exploring some possibilities that may excite you? These are only a few of the questions that I regularly ask patients when they first come in to see me. I want to find out everything about the people I treat, which is why I have never prescribed to the traditional 45 or 50 minute therapeutic hour.
Although we can’t change the past, I have for over 35 years treated thousands of men and women and children of all ages and stages in life, sexual orientations and socioeconomic backgrounds and have discovered a methodology that has worked very well for the majority of my patients. I take people on a journey through their life. This journey is often very painful. However, I’ve found that in order for people to be able to move forward with their lives, they need to emotionally work through (as best as they can) the various challenges and traumas that they experienced and continue to experience.
It takes a lot of courage for people to be willing to try and deal with their skeletons in the closet and unfinished business. Some believe that the past is the past and why bother reexamining things that we cannot change. However, the reality is that this ‘unfinished business’ frequently keeps us from being able to live well in the present. I often tell patients that in my personal life, I am probably one of the most impatient people that I know. If I had found a way over the years to fast-forward the past and avoid having to deal with our skeletons, I would have definitely done so a long time ago.
After my patients go through this process, they tell me that for the first time in their lives they no longer have one foot in the past and one foot in the present. They are now mostly able to live in the moment. They can now begin to imagine the things that they would like to do and try to improve the quality of their lives and relationships. Does this mean that people no longer feel pain? Of course not. However, the pain becomes manageable.
Some of my patients do take prescription medication for depression, while other have found that other remedies like St. John’s wort, CBT, DBT, magnetic therapy, vitamin therapy, yoga, exercise, taking courses, exploring new hobbies and meeting new friends have all had profound healing effects. It’s our inner fight to ‘never give up’ and our willingness to take ACTION that ultimately determines how well or how badly we do in our lives. And remember: We don’t need to take this journey on our own.
I hope that this is helpful to you and to all the men and women who are suffering from depression.
Beatty Cohan, MSW, LCSW, AASECT is a nationally recognized psychotherapist, sex therapist, author of For Better for Worse Forever: Discover the Path to Lasting Love, national speaker, national radio and television expert guest and host of the weekly “Ask Beatty Show” on the Progressive Radio Network. She has a private practice in NYC and East Hampton.