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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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Help. I am depressed and dont know what to do. I have always

Customer Question

Help. I am depressed and don't know what to do. I have always been a leader in my town and am afraid to seek a mental health professional because I feel someone would know me or see me. I have been in the cycle of depression for many months. I have contacted my MD. He gave me another depression drug. Bupropion. I have been on Venlafaxine for several years. Could you please give me some direction? I look at my life and think I have everything I want or need. So I ask myself, why am I depressed?
Submitted: 5 years ago.
Category: Mental Health
Expert:  Dr John B replied 5 years ago.



I'm very sorry to hear of the situation. Before I proceed further can you tell me whether this recent experience of Depression is the first time you have experienced this? Is there a family history of mental health problems? Have you in the last year or two experienced any significant life events (trauma, loss, job change, illness, etc)? Has your doctor discussed any form of psychotherapy with you?

Customer: replied 5 years ago.
Would you please give me a plan of action. Oh, by the way my Dr. gave me a couple of names if I felt I needed someone to talk to. I called them, but did not have any insurance at the time. They wanted around $300 for a new patient. I stopped at that. Another thing that is depressing is my family is on Medicaid now. I hate that name! Medicare sounds so much better. I guess that is another thing that is bothering me. We have always been successful. Why can't I get over this?
Customer: replied 5 years ago.
I had sent another reply before the above reply. I don't know why that did not register. I had typed the following... There is not any history of mental illness in our family. This is the first time I feel that things are hopeless. I have felt this way since mid July. I called my MD at this time. My husband and I have had a successful Real Estate Business for 21 years. He is the second generation in this business. We have always operated as a family business. We have always had agents work for us but now we are just down to ourselves. We are on the verge of bankruptcy. I feel this has rocked me to my core. I want to get out of this hopeless feeling. I cry at a moments notice. I have always been in church a christian but feel to emotional to even go.
Customer: replied 5 years ago.
Hi Dr. Where are you. Do I need to do something else?
Expert:  Dr John B replied 5 years ago.

Ok, sorry for the delayed reply.


Given the situation with your business, the absence of previous Depressive episodes, and the absence of a family history of mood disorder we can probably assume that you are experiencing a reactive Depression (a reaction to life events) as opposed to an organic Depression (a biochemically based Depressive Illness). This is a good thing.


The recommended sequence of treatment for a reactive Depression is;


1) A Cognitive Behavioral Therapy (CBT) based self-help program

2) Intensive CBT with a clinician

3) Intensive CBT and an anti-depressant medication (usually a Selective Serotonin re-uptake Inhibitor)


It is quite common for family doctors to focus on using anti-depressant medication (as this is what the area they work in) but in fact the evidence shows CBT should be the first and foremost treatment with medication used as a second stage.


Start by working through this excellent CBT based self-help program here . I use this material with patients regularly and it will teach yo everything you need to know about Depression and how you can use CBT techniques to lift your mood. If after working through the program (it takes several weeks) you are still having difficulty I would then recommend you consult with a CBT trained therapist. CBT is usually offered by Clinical Psychologists (although not exclusively) and 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. I understand that finances are a problem and the APA will be able to locate clinicians who charge on a sliding scale. 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.


If the APA cannot find a low fee clinician in you area then you could try these following services for assistance with finding low cost services:



You can contact The U.S. Department of Health and Human Services here for assistance with locating federally-funded health centers in your area. These centers can provide services even if you have no health insurance. You pay what you can afford, based on your income. These centers provide health, mental health and substance abuse services. Type in your address and click the 'Find Health Centers' button to find health centers near you.


You can contact the National Alliance on Mental Health here. NAMI are a consumer organization that has a network of local branches that can provide a wealth of information on the kind of services offered locally.


You can contact Mental Health America here. The MHA website contains lots of information regarding mental health issues, treatment options and available resources.


You can contact the United Way here for assistance with finding mental health services in your local area.


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

Dr John B and 2 other Mental Health Specialists are ready to help you
Customer: replied 5 years ago.
Thank you so much for helping me this is exactly what I am looking for.Thanks again for listening
Expert:  Dr John B replied 5 years ago.
You are very welcome. Best of luck!
Customer: replied 5 years ago.
I just wanted you to know I did call an expert. I am seeing a therapist. This has really helped me. Thank you for making it easier to ask for help.

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