Do I Need Therapy? Depression and Recovery

Do I need to seek medical consultation?

Hello, doctor: I would like to ask if, after leaving the environment that initially triggered my depression, I could recover without seeking treatment.
If I encounter similar environments or situations in the future, will I relapse? I have never seen a doctor, and my depressive tendencies originated seven years ago when I lost control of my emotions due to a certain incident.
Since then, I have been excessively busy with online activities and participating in class events to distract myself from my emotions.
I carefully observe others' attitudes towards me, wondering if they know about that incident and if they believe me when I say I feel like there is a heavy stone on my shoulders and a shadow looming over me, making me contemplate suicide.
However, I fear criticism from others, so I secretly hope for an accident.
I have often fantasized about standing on a very high building wanting to jump, and I have even planned accidental suicide but never acted on it.
In front of others, I always appear normal, so they are unaware of my emotional struggles.
Later, I became anxious about not graduating on time and escaping the painful environment, even wishing for death if I couldn't graduate.
I became restless and isolated myself, participating only in classes and necessary activities, avoiding social interactions and entertainment, feeling unworthy of participating in anything until I graduated.
Yet, when I couldn't focus on studying, I would constantly clean my house, seemingly to escape.
I considered seeking help at that time but ultimately took no action due to various concerns.
I did not graduate on time and had to take a break for an internship, but procrastination led to inner conflict; I wanted to complete my graduation report but felt repulsed by studying and writing.
Eventually, I did not graduate, which made me cry and contemplate suicide, feeling utterly worthless.
However, after one of those crying episodes, I suddenly felt liberated from that place and resolved to live my life better than before.
I have been trying to do so, but recently, that familiar anxiety has returned, and my mood fluctuates: sometimes I feel hopeful about the future, and other times I feel anxious, as if I will carry the shadows of my past for the rest of my life and never achieve anything.
I fear falling back into emotional turmoil, and I wonder if the belief that "I must live better than before" has quietly led to self-doubt.
Currently, I still present myself normally in front of others, and my inner turmoil is not as unbearable as in the initial years.
However, I feel some anxiety about whether I can live happily in the future and whether I can rediscover myself.
I am also very saddened by my parents' disappointment over my inability to graduate, to the point where I feel like I want to die.
Additionally, I feel that what I am doing now (seeking help online) is reminiscent of my past actions.
While typing "the sad past," tears inevitably flow, as I still feel sorrowful (though I can now view my past more objectively and rationally).
Therefore, I worry whether my current state is normal.
I would like to ask, did I truly have depression initially? What about now? Am I healed? Do I still need to see a doctor? Has the seed of depression been completely uprooted? Is my attitude towards my studies a form of avoiding pressure (though I used to love studying and writing reports), or is it genuinely due to my illness? (Doctor, I have written out the entire history of my depression, and it amounts to four A4 pages.
I intended to share it, but it seems too lengthy and detailed, which feels inappropriate.)

Qing Kong, 20~29 year old female. Ask Date: 2006/04/22

Dr. Ye Yuki reply Psychiatry

Dear Qingsky user,
I regret to read in your second letter that you have withdrawn from school.
I must apologize for saying that I cannot definitively determine whether you are suffering from depression based solely on online information.
Even in cases of depression, each individual experiences different courses and symptoms due to unique physiological, psychological, and environmental factors.
Therefore, it is essential to understand the individuality of each case to provide appropriate treatment.
It seems that you have many thoughts lingering in your mind, which may have troubled you for years.
The numerous questions you have written may have been self-posed and self-answered for quite some time.
Each of us has psychological mechanisms that help us cope with situations that cause emotional distress.
While these mechanisms can be beneficial at times, they may also be unhelpful at others.
For instance, you mentioned that initially, you isolated yourself.
On one hand, this can be seen as a form of self-protection; however, while this approach might work in the short term, over time, when the resources available to us—such as friends, family, professionals, or personal growth—are no longer providing support against psychological stress, it can ultimately deplete our initial defenses.
Therefore, it is not surprising that significant depressive symptoms may emerge after some time.
This is also why psychiatric treatment includes not only medication but also psychological therapy.
If I may suggest, now is not the time to question whether you have depression.
Rather, consider whether you are satisfied with your life as it is, even if it is not depression.
I believe the answer is likely no, and this indicates a signal that it is time to seek help.
Sending this letter is a step forward, and I recommend that you take the next step by consulting a psychiatrist or a mental health professional to move further along the path to recovery.

Reply Date: 2006/04/22

More Info

It's clear from your message that you are grappling with significant emotional turmoil and uncertainty regarding your mental health. The questions you raise about whether you need therapy, the possibility of recovery from depression, and the potential for relapse are all very valid and important to address.

Firstly, it’s essential to understand that depression is a complex mental health condition that can manifest in various ways, including feelings of hopelessness, anxiety, and a sense of being overwhelmed. Your experiences of feeling a heavy weight on your shoulders, contemplating self-harm, and fluctuating between hope and despair are indicative of the emotional struggles that often accompany depression.
You mentioned that you have not sought professional help in the past, and while it is possible for some individuals to experience improvements in their mood after leaving a stressful environment, this is not the case for everyone. Depression can be persistent and may require intervention to manage effectively. Simply removing oneself from a triggering situation does not guarantee that the underlying issues will resolve on their own. In fact, without addressing the root causes of your feelings, there is a significant risk of recurrence, especially when faced with new stressors or similar situations in the future.

Therapy can be incredibly beneficial for individuals dealing with depression. A mental health professional can provide a safe space for you to explore your feelings, thoughts, and behaviors. They can help you develop coping strategies, challenge negative thought patterns, and work through unresolved issues from your past. Cognitive Behavioral Therapy (CBT), for example, is a common and effective treatment for depression that focuses on changing negative thought patterns and behaviors.

You expressed a desire to understand whether you truly have depression and if you have healed from it. Based on your description, it does sound like you have experienced depressive symptoms in the past, and the fact that you are still feeling anxious and uncertain about your future suggests that you may still be dealing with some residual effects of depression. Recovery is often not a linear process; it can involve ups and downs, and it’s common to have moments of doubt and fear about relapsing.

Regarding your academic pressures and feelings of inadequacy, it’s important to recognize that these feelings can be exacerbated by depression. The pressure to succeed and the fear of disappointing others can create a cycle of anxiety and avoidance. Engaging in activities that once brought you joy, like studying or socializing, may feel daunting when you are in a low mood. This does not mean you are “failing” or that you are not capable; it may simply be a reflection of how depression can distort your perception of yourself and your abilities.

In conclusion, while you may have made strides in managing your emotions and have moments of clarity, it is crucial to consider seeking professional help. A therapist can help you navigate your feelings, provide support, and equip you with tools to manage your anxiety and depressive symptoms. Recovery from depression is possible, and addressing your mental health with the help of a professional can significantly improve your quality of life. Remember, seeking help is a sign of strength, not weakness, and it can be the first step towards a healthier, more fulfilling life.

Similar Q&A

Understanding Mental Health: Diagnosing Depression and Treatment Insights

Hello, doctor: I have a question for you. If a psychiatrist who has previously treated a patient prescribes some medication (the specific names of the medications are unknown) for the patient's reported feelings of "unhappiness" or "wanting to cry," does ...

Dr. Chen Wenke reply Psychiatry
Hello Tracy, regarding your questions, I would like to address them as follows: 1. I think it is not entirely appropriate to directly diagnose depression and prescribe medication based solely on mentions of feeling unhappy or wanting to cry. Mental illnesses have specific diagno...

Overcoming Negative Thoughts: Do You Need Therapy or Just Medication?

Hello Doctor, I have been subjected to slander, defamation, stalking, and entrapment by malicious individuals in the workplace. It's been over a year since I left that environment, but these negative experiences keep resurfacing. I'm unsure whether I should seek psychol...

Dr. Cai Qijin reply Psychiatry
Hello: Negative emotions and feelings of inferiority that persist after stressful events may need to be evaluated to determine if they have reached a pathological state. It is possible that psychological trauma could make medications for conditions such as major depressive disord...

Understanding the Struggles of Trauma and Identity in Mental Health

I'm sorry to hear that you're feeling this way. It's really important to talk to someone who can help you, such as a mental health professional.

Dr. Lin Niqi reply Psychiatry
Your letter describes mental distress and self-harming behavior; therefore, it is recommended that you seek treatment from a psychiatrist and consider undergoing psychotherapy.

Am I Sick? Understanding Depression and Seeking Help

Hello Doctor: Over the past year, I have noticed that I have very negative thoughts about everything. I constantly feel like I am not doing anything right. Additionally, my relationship with my boyfriend is not very stable; we often argue, and I frequently feel misunderstood or c...

Dr. Chen Guangpeng reply Psychiatry
Hello, Guazi netizen: Before formally answering your question, I would like to explain a few fundamental concepts in psychiatry. First, the brain, as the central nervous system, governs our entire body; it not only controls our speech and behavior but also determines our emotions...