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TherapistMarryAnn, Therapist
Category: Mental Health
Satisfied Customers: 5807
Experience:  Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
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Hi, I was diagnosed as depression last year. And since it was

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Hi, I was diagnosed as depression last year. And since it was on a car accident in January this year, my voice has stopped coming out at all, and has been diagnosed as aphonia. My doctor gives me venlafaxine and xanax. Even though I'm having those medicines, I have a certain cycles of depression, mainly I feel strong downtrend mood once for two months. Those downtrend time I have no energy at all , I say my body function and thinking function are out of control during the time. My question is ,should I push myself or should I take a rest during those energy loss time of MDD ? I have a problem , when I have to go to a therapy for voice training for aphonia, sometimes I 'm in out of contol time of MDD. One doctor says I should take a rest without going to the therapy, and another doctor says I should push myself and keep the voice training even during exhausting condition of MDD . Please tell me which one is better .

Hello, I'd like to help you with your question.


It depends on how much progress you are making with therapy. If you feel you are doing well and are on schedule or ahead of schedule, then a break is acceptable. It would be the same as if you were sick and needed a day off. But if you feel it's important to attend each session because missing one would slow your progress, then trying to go is the best option.


The issue to be concerned about is whether or not you feel taking a break would prevent you from returning because your depression would take over. But if you feel you can manage your symptoms and make your next appointment, then a break is ok. Also, taking to many breaks may imped your progress. So it's finding that balance of attending your appointments and taking breaks as you need them that is important.


What is preventing you from going is your depression. In treating your depression, you mentioned that you are on medications, which can help you manage your symptoms. But you may also want to consider individual therapy and self help. While medications are great to keep your symptoms from getting worse, they will not deal with the underlying issue. Therapy can help you with that. And self help will allow you to learn more about your diagnosis so you are better equipped to help yourself. The more you know, the better you will feel.


Here are some resources to help you:


I hope this has helped you,

TherapistMarryAnn and other Mental Health Specialists are ready to help you
Customer: replied 5 years ago.
thank you for your replying. Sorry, my English writing was not good enough for expressing what I like to say. At the moment , I'm having Venlafaxine and Xanax for my depression , and taking a THERAPY FOR APHONIA=voice training. I'm not taking any therapy course for my depression at the moment. Do you think I should take a therapy for MDD without voice?

You're welcome!


Yes, therapy for the MDD would help you address the symptoms as well as any root cause that might be underlying the MDD. That would be separate from the therapy you get for Aphonia. Aphonia is therapy for a physical issue. The MDD therapy would be for mental health.


Your English is very good! I didn't have any problem understanding what you were trying to say.



Customer: replied 5 years ago.
thank you so much .I'm Japanese , but live in London last 8years. I was in Tokyo two weeks ago, and a Japanese psychiatrist in Tokyo said I shouldn't go to the voice training when I am in out of control time. However, today I had a consultation with a psychiatrist in London, he said I should start taking one part of CBT and IPT for MDD ,with voice training for aphonia. Bit confusing me now, then my German husband says that Japanese way is always trying to be cute for anything ... I should follow Enlish psychiatrist instruction, I think, and I will decide depend on the situation if or not I should go to a therapy when I had out of control time, as you advised earlier. Anyway , Kate, thank you so much for giving me lots of good hints and advice for me. I'll come back to you when I had some problem again.Wink

You're welcome! It was nice to get to know you. Thank you for sharing your background.


It is always a tough call when you are handing two different diagnosis like you are. And MDD can be hard to cope with. But each time you are faced with what to do, it is always best to do what you feel would help you most at the time.


I would be happy to help you again in the future. I look forward to hearing from you!


Take care,