11th October, 2009
Question
I'm in my early thirties and have had enough of life. I feel I'm just going through the motions, without any purpose. Even if I do plan things, they don't turn out as expected. I was never the most confident person, but lately I have become even worse. I have absolutely no self-belief. I hate confrontations with people and am very paranoid about what others think of me. I don't want to do anything except stay at home and sleep.
I hate the job I'm in. I have no energy or interest, and it takes so much effort to do the smallest task. I would love to quit, but I have financial commitments. Given the recession, it wouldn't be the wisest move either. Anyway, my boss can't understand why it's taking me so long to do things, so it's only a mater of time before I get the boot. I get distracted along the way, or start thinking too much and put off the task. I get very anxious around other people, or where there's a lot of noise. I was never a very bright person, but I used to try my best. Now I've run out of energy.
I am afraid of growing old alone, but don't have the confidence to go out and find someone. I have never had anyone, but think a lot about it lately. I feel rotten inside about myself, so this doesn't help matters. I don't feel good enough. I'm trying to get over this, but every day my best intentions go very wrong. I've tried talking to the people close to me, but they just seem to give out to me, tell me cop myself on, and say they can't understand me at all.
I hope I don't sound selfish, but I really am very unhappy in myself. I would love to break the cycle, but as soon as I get happy, something happens to make me low again. I don't know how much more of this I can take.
Answer
You know I can't make a clinical diagnosis at this remove, but I think anyone looking in would recognise serious depression. Lack of energy, anxiety, difficulty concentrating, simple tasks seen as almost insurmountable, extreme loneliness, low self-esteem, helplessness, a sense of despair, and maybe above all, an almost complete absence of joy - that's just about a classic list of depressive symptoms isn't it?
As a young clinical psychologist, I was very insistent about the origins - and hence the cure - for depression. I saw it as an exclusively psychological problem, and therefore thought psychotherapy was the sole answer. I do still believe that depression needs to be treated by therapy - which means looking at the feelings, thoughts, beliefs, and behavioural patterns which keep the depression going. But I also now think that depression can be helped by intervention at a physical level - in other words working on the body, be that with medical drugs, serious dietary changes, an exercise routine, or some complementary therapy such as acupuncture. Body and mind work as one, and sometimes the body has to be helped first. You can get so stuck in exhaustion that you simply have no capacity for handling psychotherapy.
Of course you are not selfish. On the contrary you have been heroic in your struggle to help yourself. You've done that long enough on your own. Visit your doctor, if that's what makes you most comfortable. And then start searching for the pattern of treatment which suits you best. Depression is a real problem. You need real help. Go get it, tomorrow.
