Does your depression go on and on? That means your depression is persistent. And, that’s a very hard thing to live with. It’s sometimes almost impossible to wake up in the morning to face another day. You finally get up, put on a good face, go to work or school. You do your best. But, the hours drag by and you can’t wait to get home and be finished. Life isn’t happy at all.

Maybe you’re even starting to wonder what it’s all about. Will you ever find anything interesting or fun? Ever have hope again? You’ve started to think, “Are there any answers?” There are. And, there is hope. Yet, it’s likely you won’t find the answers in what you’ve already tried. So, I will describe why and 4 things that a therapist must do to help you.

You’ve Probably Tried Many Things On Your Own

You’ve tried to talk yourself out of it. To think positively. Change your thoughts as soon as you have a hopeless one. You exercise. Eat a healthy diet. Take lots of supplements. Hang out with your dog.

You’ve even written affirmations; pasted them on your mirror; doing those “manifestation exercises” to call into your life all the things you want but don’t have. Nothing works.

No matter how hard you try; you end up in the same spot. Depressed. Worn out. Sad. In fact, really, really, sad. Lonely. But you don’t feel like being with anyone since you’re “such bad company.”

And, yes. You are very self-critical. On top of that, guilty about everything you do. Because it’s never good enough. Or you’re guilty about what you don’t do. Because you “should.”  You just can’t win.  And, you’re having a terrible time pulling yourself out of yet again another bad cycle.

So, what do you do now? Are there any answers? Yes, there are. Talking to friends is one thing. Turning to a relative is another. And, if you’ve tried everything you can do to turn your depression around; maybe now is the time to get professional help.

Getting help from a psychotherapist that truly understands what you’re going through is really the best option. Especially if your depression hasn’t been easy to solve on your own. And has lasted long enough.

What If Your Depression Is Persistent?

You keep asking – what to do if your depression is persistent? What about psychotherapy. It’s really the best option. But, If you haven’t tried psychotherapy, maybe there’re reasons why not. You might feel so hopeless about your situation you don’t believe anyone else could help you. So, you tell yourself, what’s the use? Why spend the money?

Or maybe you feel ashamed that you can’t help yourself. Thinking it shouldn’t be this hard. And, because it is, you are convinced that you’ve “failed.”

You have a critical voice in your head that attacks you constantly. There isn’t a single depressed person who doesn’t. So, since you believe you failed to help yourself, you are probably quite sure you’ll walk into a therapist’s office, and that’s what you’ll find there too.  Nothing but judgment.

Think about it this way, though. It’s more likely than not that this is your fear; since the psychotherapist, you are imagining is now a version of the voice in your head. It’s inevitable in any therapy that your fear of judgment (an assumption that you are hearing it) will be there.

Therapy is the place to work that harshly critical voice out, and to get it out of your head once and for all. You need to be relieved of it since it is a part of what keeps creating your depressions. And, therapy can help you do that.

So, if you feel judged, talk about it. See if your therapist can help you understand why you believe you’re being judged. And then begin to earn your trust. Again, don’t settle for anything less. But, if you do get back something harsh, or off the mark, and you feel misunderstood: Move on. 

There are many psychotherapists who are empathic and kind. And that is what you need to help you understand the ins and outs of your persistent depression. Including the origins of that critical voice.

What If Therapy Failed In The Past?

If you’ve already tried psychotherapy, had a therapist who didn’t understand, was unkind, or just wasn’t effective at all; it’s easy to understand why you don’t think therapy is a very good idea. And, also why you’d be hesitant to try again. Failed therapy is terribly discouraging and only adds to hopelessness. That’s not what you need.

This, unfortunately, can also easily stir up that critic in your head; who has countless reasons for why everything is your fault. So, even a failed therapy, which is about the therapist and not you, could also easily turn into an internal judgment. As if it is proof of yet again another failure.

Try not to listen to that voice. There are many different psychotherapists. Getting help is largely dependent on a therapist’s training, experience, and capacity to understand the intricacies of what you’re going through. That includes your fear of judgment as well as your distrust.

Plus (and this is very important) a therapist must understand any feelings you bring into therapy. Anyone that takes the chance to come into a stranger’s office and open up about their most private thoughts and selves, needs a safe space. With an accepting and understanding person who can listen to and work with any feelings you have.

Don’t give up.  If you can’t get out of the loop of your persistent depression, maybe it’s time for another try. Find someone that specializes in failed previous therapies. Some of us do. And, if you’d like, feel free to give me a call if you have any questions.

Why Is Psychotherapy The Best Option?

Persistent depression is almost impossible to resolve on your own. You’ve tried. And, then you get stuck with that critical voice berating you when it didn’t work. Thinking that voice knows what it’s talking about is one of the vicious spirals of depression. 

Plus, any symptom that has gone on a long time, needs a closer look. A psychotherapist, or psychoanalyst, trained to look more deeply will give you a chance to get out of the persistent depressive cycle you’ve been caught in.

No one can see themselves clearly. There’s such a thing as “an unconscious.” We all have one. For lack of a better word; our “blind spots” live there. There are things you know about yourself. But, there are also many things you don’t. That’s true for each and every one of us.

If you’re blind to something, you need someone who can shed a light. A psychotherapist trained in working with persistent depression can see and talk to you about things you wouldn’t come up with on your own. And, will get to the root of your hopelessness and negative opinions about yourself.

Most important of all? The negative lists you make in your head, of what you think you are or aren’t, are tainted by the very slanted view that critical voice has of you. And, this feeds persistent depression more than anything else.

What you don’t want is a “cheerleader.” Someone who overlooks your feelings and tries to get you to think positively. You’ve already tried that on your own. You also don’t need someone who isn’t able to “take” your understandable frustration and anger. 

Below are 4 very important things you need from a psychotherapist to get out of the relentless loop of persistent depression. Don’t settle for anything less.

4 Things A Psychotherapist Must Do

Having these 4 things in your mind while looking for a psychotherapist will help you. If you do, even in your first few consultations, you will (and should) have a sense if this is the right therapist for you.

See & Understand Your Critical Voice

Sometimes that critical voice is subtle and well-hidden. Yet, a therapist well-versed in the ins and outs of persistent depression will know it is there. And, since that voice is very convincing, you don’t want a therapist that doesn’t see it for what it is.

Any therapist you go to must be able to identify very early, even in the first session or two, that you are taken over by that harsh voice that won’t let you be. That voice is an intruder; an interloper into any good feelings you have about yourself. That makes it difficult to have hope.

And, any good psychotherapy for persistent depression must work on releasing you from anything that interferes with your hope and positive self-esteem.

Get To The Bottom Of Your Hopelessness

Your hopelessness is what needs to be particularly understood. You can’t be talked out of it, but you need help getting out of it. There’s a big difference. Anyone, including a psychotherapist, that tries to talk you out of it and tell you all the reasons you “shouldn’t feel hopeless” will only add to your frustration.

If this happens, you’ll feel misunderstood. And this, in fact, increases discouragement. What you need is a therapist that takes your hopelessness seriously. Listens to it closely. Is curious about your feelings. Allows your hopelessness to come into the sessions in whatever way or form it does.

In the right psychotherapy, this “allowing and listening” will increase understanding. And, if this happens, your therapist will be able to talk to you about your hopelessness in ways that will change it. That includes allowing all the anger and frustration you invariably have about being stuck in this depressive cycle for way too long.

Allow Your Anger & Frustration In The Session

You must be free to express your anger and frustration in any good therapy. And, if you’ve lived with depression for years on end; of course, you are angry and frustrated. Having a critical voice that attacks you is, in part, because you’ve never had your anger accepted and heard. And, that anger has turned against you.

Any psychotherapy that works to resolve persistent depression must be with a therapist that can allow and even encourage you to express these feelings. Even when they are towards him or her. Most likely, these feelings were threatening to you (or others) and not freely expressed in your childhood.

Link Your Depression To Childhood & Early Trauma

You need a therapist who understands how your traumatic and/or difficult childhood has an unconscious link to your depression. Early childhood experiences and trauma are always a part of persistent depression. It’s impossible for you to make the connections, on your own, to how these experiences live on now in your symptoms.

That’s what therapy should give you. But, not just the insight. The best of psychotherapy for persistent depression is with a therapist who understands the connections but also provides you a place to bring any feelings you have.

You need to be able to express your fears, distrust, sadness, loneliness, feelings of rejection and abandonment, hurt, and anything else you feel. Working these out with your therapist will release you from the depression you’ve been stuck in for years.

Most importantly: don’t let your hopelessness talk you out of giving psychotherapy a try (or another try). Have at least a few consultations to start. Give it a chance. You never know, it just might be well worth the risk.

I’m Dr. Sandra Cohen, a Los Angeles based psychologist and psychoanalyst. I specialize in working with people who suffer from persistent depression. If your depression goes on and on and you aren’t sure how it will ever stop, you probably haven’t had help with its deeper roots. Give psychotherapy a try.