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27 Mar 2003

Are these signs of depression / dysthemia?
I get really highly irratated at times - but it passes over - sometimes I can go weeks without any episode. I don't really show it. I also get quite angry - but never show it. I am mostly very withdrawn and quiet - although I get these energy spurts where I can make people around me laugh at my stories, like me and talk about what I've said or done months afterwards. It confuses them when I become excessively shy and withdrawn. My bedroom is always a mess - to an extreme. And for a women my age (twenties) I spend hardly any time on hair, clothes, make-up etc. I just seem to 'get by'. My friendships are short and intense - and I seem to always want friendships with 'older' women - where I'm desperate for them to love me and 'take care' of me and I get jealous of their own kids. I sit quietly for hours just daydreaming - not able to 'snap out of it' - normally about being loved, and saved and cared for. I have times where the only thing that makes sense is suicide. I've been for counselling, psychotheraphy, doctors, etc. and have taken medication for depression. But all of these caused me more anger, paranoia and disturbance - than anything else. I think I've felt this way since I was about 8 years old - and it got worst as I got older. My father has a very short and violent temper - and as children we feared his next 'episode' all the time. But it was never as bad as REAL abusive homes. I don't know if this could have anyting to do with it??? I was also bullied in highschool by a large group of boys. I've had all sorts of 'disturbances' over the years - but seem to hide it really well - and 'get over it' without much help, but the basics always remain and this weird niggling that everything is'nt quite right with me. Is there any sort of objective test that you can go for that would be able to pick up whether you're 'OK' or not?? Thanks for listening.
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CyberShrink
cybershrink

01 Jan 0001

Dear MissJokey,
Actually, a very complex question. "OK" is perhaps the hardest diagnosis to make ! Strictly Objective tests are limited in range, partly objective / partly subjective tests often more useful. Anyway, many tests are designed to test a specific theory --- is there a significant degree of depression here ? Are this person's arithmetical skills intact ? What range of sleep symptoms are present here ? amd so on. There are also some broader, screening questionnaires / tests which clinical psychologss can administer, that sample symptoms and possible problems over a wide range of areas, and can suggest whether there are likely to be problems in any particlar area, and one can then follow-up with more specific tests in those areas. Maybe you're actually more "all right" than you think and feel.
But much of what you seem to be describing doesn't sound like the sort of thing most tests would pick up, uncomfortable though these aspects of life might be. You seem to describe a pattern of living and presenting yourself to the world, from behind a facade --- hiding your anger, sometimes hiding your shyness and hurt behind a jokey, jolly front that others can enjoy, sometimes not managing to present this front. Maybe not a clear sense of liking yourself comprehensively. Feeling a strong need to be cared for, protected, saved from something maybe not even very clear what.
While all these features may be present in someone with depression, or dysthymia, none of what you describe is unique to these disorders, and they're often present without them. Perhaps parts of this lie within the personality you have formed, more in the set of beliefs and expectations ( about yourself, others, and how these should interact ) you have formed over the years. This is exactly the sort of feld where skilled psychotherapy ought to be able to help a lot.
I'm a little puzzled when you say you've "been for" counselling, psychotherapy, etc. If you're based in SA, then it is a problem that the standards of training for psychotherapy are generally poor, so one may see a person offering psychotherapy who, while able to help many people with basic and simple problems, may not be skilled enough to handle more complex issues. Also, sometimes, a person has developed unfortunate skills at sabotaging psychotherapy, which can acount for its failures --- some people start with impatience and unrealistic early expectations, and drop out unless these are immediately or promptly satisfied, for instance. Some feel both emotionally needy ( and perhaps expect more obvious and immediate nurturing from the therapist than it would actally be useful to provide ) ; and yet also feel undeserving, and so may in various ways sabotage and end the progress when they start to feel the experience is rewarding and progressing. It requires a skilled, well-trained, and experienced therapist to remain helpful in such circumstances.
I hope these thoughts are of some use to you. Suicide is not a realistic or beneficial option ; continued exploration of methods and gides to further self-exploration and self-understanding, is still probably the best option. Have you tried CBT ( Cognitive-Behaviour Therapy ) ? I know some local therapists are offering such treatment ( which has a weight of research showing it works ) though I don't know a reliable way for finding such therapists, except by asking potential therapists if they use this method.
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