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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5334
Experience:  Dr. Mark is a PhD in psychology in private practice
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I am have a life long history of depression. I am now 50 and

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I have a life long history of depression. I am now 50 and take Prozac. Depression seems to be a natural part of who I am. Will this always be true?
Submitted: 5 years ago.
Category: Mental Health
Expert:  Dr. Mark replied 5 years ago.

Hi! You know, to give you the best answer, I think I should ask you a few questions first that will help define the problem and the situation.

Your question is very evocative that there is so much behind the simple few words you write. You've had depression for so long. Three possibilities: you have treatment resistant depression, you need to consider other treatments such as electroconvulsive therapy (ECT), or you may have an underlying disorder that hasn't been treatment and depression may be just part of that disorder.

Was there trauma or abuse in your childhood? What about alcohol or dysfunction in your family when you were growing up?

Are you interested in ECT?

Are you getting any psychotherapy treatment right now? If so, what type? How is it going?

If not, when was the last treatment? What type of treatment was it? Was it helpful?

Any extra information that will help, feel free to share.

Dr. Mark

Customer: replied 5 years ago.

I have had a variety of counselors and therapists since I was a teen. I have also been on antidepressents since my 30s. I am on Prozac now. The main issues seem to revolve around self image, self esteem and general worry about what people will think. I began dieting around age 10 and have had a weight problem all of my life. I am much less than my top weight but seem stuck and still need to lose much more. In general I am becoming more confident, maybe because of my age, but depression always seems looming. There's a lot more to the story, no physical or sexual abuse. I just wonder if depression will always be my way to cope when life is challenging. No ECT for me! Also, I have epilepsy and my neurologist thinks that the depression contributed to this.

Expert:  Dr. Mark replied 5 years ago.

Thank you for the added information. It helps a lot. I believe I can now be of help with this issue.

First, let me say I can imagine how confusing and distressing this situation must be for you. On the one hand you grew up receiving the message over and over that you are not worthy, not worth the bother. But on the other hand you have not only made a life for yourself, you have made a full life, even if you won't allow yourself to say that. That is a tremendous measure of the worthiness within you.

And this is actually the key to my answer to you that you need to consider and think about. Clearly, you are a worthwhile person. But not in your own eyes. The problem, then, is not in the REALITY of the situation. The problem is in your PERCEPTION. What do I mean?

The world is fine. Meaning, your life, you, the world all have value, worthiness, meaning, purpose, importance. The problem is in your feelings about yourself, in your attitude. You have assimilated and bought completely into the negative view of you that your parents offered and promoted. Your neurologist even believes your attitude has affected your neurological functioning!

So, will you live your life in such a way that "if depression will always be my way to cope when life is challenging?"

Most likely. But our goal here is not to live with the attitude as if this is being condemned to a life sentence in a penitentiary of some sort. That would be a jail of your own making. Most creative people, authors, painters, etc. go through periods of depressed feeling and mood as parts of their creative rhythm. My goal here is for you to realize that you may need to learn to integrate this inner rhythm into your functioning, into your positive life rather than into an attitude of lowliness and dysfunction and unworthiness.

Your whole video of life in your mind is negative, failure, hopeless, etc. Is this reality? Nope, you've coped with problems and have achieved successes. That's the definition of a worthwhile life. Now it sounds as though it's time to move forward. The problem is within you now. The solution, then, is within you. The problem is in your attitude. The solution, then, is in your attitude. And when it comes to ATTITUDE, the self help world is fantastic at it!

You would certainly profit from psychotherapy, but I also want you to commit yourself to apply the principles in the following videos and books to your worries about anxiety. So that you can be yourself with more confidence. Coach yourself. Be your own life coach! I want you to get really into motivational videos and books. In other words, accept your past fears, accept your past worries and hurts and traumas. Accept them and focus on becoming who you WANT to be now. Here's a simple YouTube search I put together on "motivational speakers":

Some like Tony Robbins are the classic big guys. Some are newer. There are now wonderful women speakers as well. There are now great women speakers as well. Watch them all. Get inspired. Buy a book or two. Here are some possibilities, but they are only suggestions as there are so many good ones.

The first book is the father of all these type of books. How to Win Friends and Influence People by Dale Carnegie. There are classes in these books now! It was written in the 1930s and still has something to say to us today that is very worthwhile.

I think very highly of the second book on my list, which is a real classic: The Seven Habits of Highly Effective People by Stephen Covey. It is the book that has helped more people than probably any other.

The third book is by Anthony Robbins. He's one of those speakers who fills up huge auditoriums. For a reason. He's a terrific speaker and writer. The particular book (if you like it, try his others): Awaken the Giant Within.

So the only thing separating you from your sense of positive value in yourself is your running mind video about your failure and shortcomings. Throw those out and replace them with motivation and commitment to your future.

Psychotherapy: the opportunity here is to gain a greater insight yourself toward yourself, who you are inside, and how you might want to project it toward others. Let me give you two directories to look at that are good. You should focus on finding a psychologist or psychotherapist in your area who practices in a psychodynamic orientation.

Here is the web address for Psychology Today's therapist directory. You can sort by zip codes and when you see someone who seems like they might be helpful (because they seem smart and not so easily manipulatable!) look at the listing and see if they list psychodynamic therapy in their orientations.

Good Therapy is a non profit directory. Same idea as the one above:

Again, my goal here is in the therapy for you to turn your story into your meaning in life rather than a weight of misery and unworthiness. You write, "There's a lot more to the story". Right. Therapy may help express it. The goal is to turn it into the story that moved you to who you want to become.

I wish you the very best!

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