When to Step Away

I have written a lot about therapy in my blog the last few months and I think I owe my cohort of five to ten leisurely readers some context about why I even bother engaging in this activity, and why I’m now contemplating a gentle exit from the process.

About 10 years ago, I had an extended period of low mood and agitation that I perceived was depression. I went to therapy and spoke to a psychologist about it for several session, then went to my general practitioner and asked for an antidepressant. He chose Cymbalta, which others have told me was a very stupid choice on his part, probably driven by successful Eli Lilly marketing towards him and his vast inexperience with mental health.

Anyway, I didn’t stay in therapy long and decided to exit the drug about 16 months later. It was fairly difficult to withdraw from it. Things were fine for several months, but then I started to have panic attacks that were directly related to an awful job I took working communications at the Chicago Public Schools. I started seeing a psychiatrist soon afterwards and he put me on Lexapro to manage the anxiety.

I stayed with this psychiatrist off and on for the next five years, both for medication management and talk therapy. He was helpful in a crisis, but honestly, I thought he kind of sucked as a therapist on balance. He’d routinely forget things I’d told him and become noticeably bored in sessions. I felt like I had to come up with material for each session just to keep him engaged. He was also oblivious to my long-running concern that the Lexapro was damaging me, causing me to be emotionally blunted. I was gaining weight continually and that was making me more lethargic and disengaged from the world.

Roughly four years ago, I stopped therapy with him. I stayed on the prescription, however, for two more years. Then in May 2018, I suddenly decided that I was going to take my fourth shot at getting off Lexapro (previous attempts had been a disaster — weening off just didn’t work for me.) I went cold turkey and simultaneously went on a highly restrictive low carb diet, under the theory that my body would be so pissed off at the lack of food, it might not even notice the change in dopamine levels.

It worked and a virtuous cycle in my life commenced. I lost more than 50 pounds and have been able to keep it off due to diet and exercise. I had succeeded in the past with rapid weight loss, but never before had I been able to make is sustainable. My career rebounded shortly afterwards, I started to become more at ease socially. And then I decided, roughly a year ago, that it’s probably a good idea to keep an eye on the depression and anxiety even though I’m not currently suffering from them, so I sought out a therapist.

Yadda yadda yadda, I’m on my third therapist in that string now. But it’s ok, as a whole, the process has been helpful. Now, doing CBT work, I’m starting to think that I have a good enough tool box at my disposal to handle any future risks of depression or anxiety. With a little more practice, I think I’ll have the CBT skills down. Then the question will become, why keep doing this?

And the answer is — there is no reason. It’s time to stop. A return to therapy ultimately fulfilled its purpose. I’m no longer afraid of slipping back into a dark mood or setting off a series of panic attacks. I’ve overcome the emotional blunting — if anything now, I need to keep my emotions in check. There will always be big issues in my life to manage, but I don’t need someone to hold my hand as I confront them. I certainly do not need therapy to help manage other people in my life, especially those not in therapy. It is up to them to manage their own mental health.

I am a firm believer in the Socrates statement that the unexamined life is not worth living. But there are many ways to examine life outside of a clinical setting. I have become at risk of making psychology a hobby, and that doesn’t seem healthy to me. So, in the near future, I’ll walk away and I’ll feel good about it.

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