Come to Canada, our treatment for depression is to maid people

What exactly are you looking for as a “treatment”?

Finding the right therapist can absolutely make a huge difference, but ultimately talk therapy can only do so much. It’s much more of a management process than a curative one. At some point, you need to look at other modalities or meds.

I’m looking for improvement with my depression. I’ve tried 15-20 meds over the past 20 years and am currently trying low dose ketamine which isn’t helping.

I need a therapist who can actually help patients who have depression who don’t respond to easy, quick fixes.

Maid?

Sounds to me like you need interventions beyond what a typical therapist can give, which is why you may not be getting what you need.

AHN has a center for Treatment Resistant Depression. I haven't had experience with them myself, but the fact that this clinic exists and seems to give patients access to a team of doctors that practice all kinds of different treatments seems like a good sign. It might be a good place to start at least without entering a residential program.

Sometimes it just takes getting in front of enough different kinds of professionals to identify the root of what is going on.

It sounds like you’re saying that no therapists can help treat depression in a typical out patient setting.

Following up on the above comment, you’ve tried a variety of meds, but what kind of therapists have you used? Cognitive behavioral? Trauma? Social? Talk based?

I’ve skipped around a bunch of different kinds of therapy, and agree with you that it’s hard to find a match (and then one that takes your insurance, ha!). You can swap out meds with a regular primary care physician, but the treatment you’re actually getting might not be right. I’ve ghosted more than one therapist that just wanted to talk about my issues with my mother, and not about why I was unable to get out of bed for weeks at a time.

I'm sorry to hear that it sounds like you haven't been having a positive experience with therapy. It can be quite difficult to find the right combination of therapist, treatment, medications, and mindset. Depending, it can also be difficult to identify the root causes of depression, triggers, and accompanying symptoms.

My recommendation is, as much as possible, try use a scientific approach to it. If you can identify what helps make a difference between "meh" and "just ok", that can help a therapist focus on treatment areas. Also be transparent with what works and what doesn't. Depending on your therapist and what they're qualified for, you might respond better to CBT, EMDR, IFS, etc.

Finally, the last thing I can recommend is understanding your own expectations with treatment. It may not be something that can be "cured" per se, but it can be treated and managed. Similar to a physical injury, you may not heal at the same rate or to the same level as someone else. It's important to focus on your own well being and not to try to compare yourself to others. Define what happiness is for you and then try to ignore the grotesque misrepresentation of "happiness" that social media and advertisers try to peddle.

Depression, like many other mental illnesses, come in a spectrum. It can be occasionally noticeable to debilitating every day. It varies a lot. Talk therapy may be a fine intervention by itself for folks at one end of the spectrum, but not the other. It may be a good intervention in conjunction with other treatments (trauma therapy, behavioral therapy, etc.)

Just because you may need something else, doesn’t mean therapists can’t ever treat depression.

I’ll get downvoted into oblivion for saying this, as the people on this sub like to do, but sometimes lifestyle changes are the key to curing depression. For me that meant moving to a warmer and sunnier climate and ceasing all alcohol and drug use and engaging in exercise daily. For you it might mean something else. If nothing else has worked to this point it might be worth the try. Best wishes.

Yes, definitely ask them their preferred type of therapy, their background in that, and if they would be open to exploring and combing different types. CBT and goal oriented were horrible experiences for me. DBT, IFS, and brain-spotting have been life savers though. You maybe also never be "cured" like how a wound would be, but you can be given tools to make it easier in a healthy way.

Can you recommend a therapist experienced in DBT or IFS?

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Ones that I am 100% that have openings right now no, but I have seen Kaitlin Hens Greco (Alliance Therapy) and she was amazing. Had to switch due to her being full and I do not know how long her waitlist is. I am currently seeing Hunter Helsel and she is amazing. I was able to get an appointment right away since someone left, but she did have a waitlist when I originally booked. I believe her waitlist was ~monthish when I made an intake.

edit: Hunter is also very trauma based therapy

Gotta love Pittsburgh. A depressed person really depressed hoping to get help by asking for a recommendation for a therapist trained in effectively treating depression and they get downvoted.

There is such a lack of humanity and compassion on this subreddit that's very troubling as a depressed person. It completely reinforces the depressed persons feelings of loneliness. It's literally the exact proof that says "see, you're never going to get support or compassion. There's just no point in even trying."

Thank you Pittsburgh for proving that the voice of Depressions is actually right.

I would like to find a therapist adept at having the skills to pull in different modalities and make adjustments if the patient isn't responding. Mine wasn't so I'm trying to find someone new who has more experience and isn't one size fits all.

For chronic depression, after trying so many medications I'd suggest looking into TMS. Maybe get a consult. Keep trying, and looking for a specialist too.

I agree that those things can help. The trouble with depression is having absolutely no energy to exercise. I need help in getting out of this hole enough to lift my mood and energy level just enough so I can start doing these lifestyle changes.

I completely get it because Ive been there. But if you can somehow get yourself to get some exercise it’ll release natural endorphins and dopamine that’ll make you feel pretty good for a little while. Its helped me with depression and adhd as well.

TMS scared me. There was a documentary on PBS about a guy who had brain damage from it and it freaked me out. I decided to go the Ketamine route but I'm on a low dose so I'm looking at other ketamine options.

I've read ketamine and psilocybin are promising treatments. The laws just need tho catch up with research. Like, allowing to research it.

Yeah I’m doing ketamine now. It’s low dose, at home oral treatment. I probably need a higher dose. Don’t think I can do infusions though since I have a phobia of IVs. Haven’t looked into psilocybin yet.

My husband and I both like our therapists from cognitive behavior institute

Do they have openings? I tried CBT with my previous therapist but it wasn’t structured enough. I imagine at CBI the main focus is CBT?

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I mean, they gave you a source for a clinic that specializes in treating treatment resistant depression. That’s a good resource, likely full of therapists and practitioners trained in effectively treating depression.

Downvotes are an algorithm and not even all real people. This is definitely your depression talking.

I hope you find the help you need.

It was frustrating that the first instinct someone had was to say you’re beyond what a therapist can help with. Depression is like the #1 thing people go to therapy for. I was expecting to get recommendations for good therapists, not that I needed to go to some special place. It seems like there must be people in Pittsburgh with depression who have a therapist who has helped them with their depression.

My friend, you are describing exactly what that clinic does.

So it’s a team of people instead of just one? Who cares?

Ok, you said you had been searching for an answer for 20 years and you said yourself that you’ve had a string of therapists who haven’t helped. So you’re what, just looking for more recommendations for people who will fail you? You didn’t come here being like I’m new to therapy and am looking for a good therapist.

That clinic could be a solution. It’s not a judgment. And that clinic is full of. . .wait for it. . .therapists! They may refer you to a specific therapist or suggest an approach that could help you.

It’s frustrating that your first instinct is that you can try the same thing over and over again and expect different results. There isn’t one magic person out there who is necessarily going to make you better, it might take a multifaceted approach. I don’t know why you’d close yourself off to help that might—what’s the word I’m looking for here—oh yeah, help.

Yes, I’m sure, but everyone’s depression is different.

Suggesting a specialized clinic doesn’t mean anything bad. It is a clinic designed for your specific problem that most places don’t have but we are lucky enough to have due to proximity to large medical centers.

I would try a CBT based practitioner, if you haven’t, and work on thought distortions. Good luck!

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Dude, why would you suggest that to someone looking for help with their depression!?