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Dr John B
Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience:  PhD in Clinical Psychology, registered clinical psychologist.
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Im often in a cycle in which I feel discouraged, do word puzzles to distract from t

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I'm often in a cycle in which I: feel discouraged, do word puzzles to distract from that feeling, then feel worse(useless#; try to counteract that by starting to study math #the field in which I tutor), then think "If I'm energetic enough to do math, then I'm energetic enough to resume writing the rap song I want to perform"; then feel overwhelmed by how hard that seems; get discouraged, and return to crosswords. How can I work my way out of that cycle?

It's complicated by sleep apnea and lifelong dysthymia.
Submitted: 3 years ago.
Category: Mental Health
Expert:  Dr John B replied 3 years ago.

Hi,

Sorry to hear of the situation. What kind of treatment have you been receiving? Does the therapist provide a specific form of therapy?

Customer: replied 3 years ago.
The therapist provides cognitive-behavioral therapy. Im also under the care of a Kaiser psychiatrist, who prescribes the same meds I've been taking for several years, namely Prozac, Wellbutrin, and Lamictal. But when this or any other psychiatrist asks "How have you been doing this last period (usually 3 months)?", I really can't remember other than vaguely having the continued 'blahs'. I wish I could monitor my moods and record them accurately so I could really see if the meds are helping, but this again seems too much for my energy level.
Expert:  Dr John B replied 3 years ago.

It certainly sounds like the treatment is not working that way you would like it to.

The type of treatment you are receiving is the correct combination (CBT and medication), however one therapy session is too infrequent. How do you think the therapy is going? Mood monitoring is certainly something your should be doing as part of CBT and it is your therapists job to work out how to get you to do it.

Customer: replied 3 years ago.

While I think the therapy is not helping me, that might be because I have not been reviewing my notes from the sessions, nor following through on homework assignments. I keep neglecting my homework as well as everything else in my life. I come home from work just wanting to plop in front of the TV. I do get bursts of energy during which some dishes get done or some laundry gets washed or a few square feet in my apartment gets decluttered, but overall it feels like a very tough go.

 

I agree that I need to see someone at least weekly. I'm just finding it very difficult to follow through on the steps needed to get that done.

Expert:  Dr John B replied 3 years ago.

You are probably right.

The therapeutic effect of CBT comes from implementing the strategies on a daily basis and if you find that your motivation and low energy is making that difficult to accomplish then it unlikely that the CBT will have an effect.

Weekly sessions is certainly the frequency with which you should be attending therapy at the moment, is it possible to increase sessions with your current therapist or will you need to find a new one? Also, do you have any support from family or friends at the moment?

Customer: replied 3 years ago.

OK, I will tell my therapist that I need weekly sessions, and if he says he can't provide those, I'll do what I have to in order to get a private practice therapist.

 

I do have a father and cousins and one friend who could help me. And I will overcome my reluctance to ask for help (again).

Expert:  Dr John B replied 3 years ago.

If you do need to find another therapist you can contact the American Psychology
Association (APA) for assistance with locating a Psychologist; take a look at the APA locator service here. You can use this to find Psychologists in your area and there is a
phone number you can contact if you want a referral arranged for you. Also, take a look at an article published by the APA here. It's an interview with a senior Psychologist and covers some of the things you should consider when you looking for a Psychologist.

You've probably been provided with plenty of CBT material but just in case you haven't take a look at this excellent CBT based self-help program fr Depression here http://www.cci.health.wa.gov.au/resources/infopax.cfm?Info_ID=37 . The strategies and techniques included in the program will certainly be relevant to your situation.

The loss of motivation ad energy associated with low mood is a real obstacle to engaging in therapy and perhaps you could use some help arranging increased therapy sessions. Once you start going more regularly it will be the therapist's job to worry about how to overcome these symptoms.

I hope this has been of some help. Please let me know if yo have further questions or would like me to clarify any part of my answer.

Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience: PhD in Clinical Psychology, registered clinical psychologist.
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