The Mental Health System

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I kept telling my social worker that I was depressed and he kept saying I should go in for therapy. I didn't want to ask the doctor. I thought he wouldn't believe me.

Eventually I asked him. He gave me his questionnaire I wasn't quite sure how to answer it because sometimes I feel very depressed and sometimes I feel fine. Afterwards I thought perhaps I was too mild with my answers, like I wasn't bad enough to warrant treatment. I answered that I feel depressed about half the time. Is that right? I'm not sure. Maybe half, maybe three quarters, I can't say. The doctor gave me a referral to a place. He said they were busy but they would see me.

The place is open 9 to 6, Monday to Thursday. Because it's not like anyone who needs to see them might have a job, right? The appointments last for an hour so I'd need to get there by pm. My work finishes at 4:30. I'd need to get there in half an hour. This place is too far away to get too in half an hour. And if they're as busy as the doctor says, they might slot me in at 1pm or something. I'll bet their 5 to 6 slot is their most popular slot because people work. It may already be booked out for Monday to Thursday. If the doctor had referred me to a psychologist in the city I'd be able to walk there after work in less than half an hour.

Some people have suggested that my sadness might be caused by my brain not making enough of the right chemicals. They said the solution might be antidepressants. I'd be willing to give them a try but I won't get a chance. None of the doctors I've been to have suggested it and if I suggest it they'll think I'm just trying to score drugs. Instead the doctors always refer me to a psychologist, who isn't authorized to prescribe anything. And the psychologist talks and talks and talks and doesn't actually fix anything.

If I went to a psychiatrist he'd be able to prescribe medications but if it's this hard to see a psychologist I imagine seeing a psychiatrist would be even harder. I don't even know how to get to see a psychiatrist. I imagine they're a rarer breed than psychologists.

I hope you will feel better soon.

They might not think you need medication.

Sometimes, medication doesn't yield the desired effect. Sometimes, it just makes people worse.

I would say, if you are working, that they very likely would be reluctant to prescribe medication.

Do they have a counseling service at your job.

On many jobs in the US, there is something called EAP, which means Employee Assistance Program. Perhaps they have something similar in Australia? It's a confidential service in the US.

The counselor at work told me I should be on antidepressants

I have never had any benefit from antidepressants, and chemical imbalance hypothesis has never been proven and most people in the business wihses it would go away without lawsuits.

Having said that, they do help many people, but nobody really knows why.

I have had better luck with regular counciling.

These are things to discuss with your doctor.

It took me a long time to feel OK asking for time off from work. I felt like everyone thought I was faking.

It is ok to do it.

The theory that depression is caused by chemical imbalance in the brain has never been proven.


“[T]here are no tests available for assessing the chemical status of a living person’s brain.” - Elliot Valenstein, Ph.D.


“Patients [have] been diagnosed with ‘chemical imbalances’ despite the fact that no test exists to support such a claim, and...there is no real conception of what a correct chemical balance would look like.” - David Kaiser, psychiatrist


“Biopsychiatrists have created the myth that psychiatric ‘wonder’ drugs correct chemical imbalances. Yet there is no basis for this model because no chemical imbalance has ever been proven to be the basis of a mental illness,” - Ty C. Colbert, clinical psychologist


“Chemical imbalance is a term that’s used as a marketing ploy as opposed to anything that there is scientific evidence to support.” - John Sommers-Flanagan, Professor of Counselor Ed., University of Montana


“Nobody has yet measured, demonstrated, or created a test to show that somebody has a chemical imbalance in their brain. Period!” - Dr. Thomas Szasz, psychiatrist, professor, and author


“The whole myth of a chemical imbalance was created to sell drugs.” - Dr. Rima Laibow, psychiatrist

Ok, no antidepressants for me.

This is going to sound sad but s days all I need is someone to tell me I'm not a total failure in life.

^ you're not a total failure in life.

^ haha, reminds me of:

^ Yep. That's about it.

Sometimes it takes two or three tries because I don't always believe people the first time.

I'm a skeptic so it's hard work for people to come up with a good enough argument to convince me I'm not a failure.

Why don't you talk/write to the therapy office and explain the problem to them; that you are autistic, that you are working, that you have trouble with executive functioning in addition to being depressed, and that you could really use some helpful suggestions on how to get to therapy. You can't be the only person with this problem.

Medications are always a tossup for efficacy. There are relatively new tests for chemical imbalance in the brain well one specific chemical and it requires a spinal tap to test. There are many treatments for depression or mood disorders that are not medications. Nothing is easy with the mental health system there is no one cure. From my own experiences I would say that DBT therapy was positive for me, I've been on more medications for depression than I care to count, I've underwent ECT. Of the many things I have gone through the thing I have found to be most consistent for me is some type of talk therapy.

Finding therapists or any mental health provider is difficult to say the least. Psychiatrists are rarer than psychologists as they are medical doctors. Have you asked your social worker for any referrals typically a social worker will have more contacts in the mental health field than a typical doctor.

Around here, good therapists are available to the wealthy who can pay out of pocket to doctors who don't take insurance.

The questionnaire you probably were given to fill out was the Beck depression inventory. It is a mostly useless questionaire with over simplified questions that assume depression is constant and doesn't take into account any circumstances or realistic fluactions in mood over time. It also frames it's questions poorly and doesn't even give a reference frame in which you are comparing your current mood to. It really is a scam as the person who created the useless questionnaire gets paid a royalty everytime it is used(and it is used by mental health professionals all over the world).

Even though the chemical imbalance root cause of depression has never been proven, and no one knows for sure how medications work, as others have stated they do help people and you might as well give them a try. A combination of meds and therapy typically works better than just one or the other. As mentioned above don't be afraid to ask for time off work to go to a medical appointment (which therapy is), just be prepared to provide documentation of the appointment if necessary.

RetroGamer, I see you making numerous inaccurate or biased assessments of reality, and for this reason, I think psychotherapy (talk therapy) might be very good for you, as you can learn to challenge your own assumptions and find healthier ways to think.

In 2017, I think it's folly to say no one has ever proved chemical imbalance in the brain causes depression. For one thing, they have now done extensive brain scanning with radioactive tracers and found that differences in chemical and electrical activity DO correspond to depression. The fact that drugs (i.e., chemicals) help some people is further evidence that there is probably a chemical problem in the brain.

A combined approach is probably best, as the drugs improve the chemical imbalance while the talk therapy teaches you how to avoid self-defeating thoughts in the future, as well as perhaps work on some social skills. Research has found antidepressants and talk therapy are roughly the same in efficacy, but that talk therapy is actually superior at preventing the next relapse.

But I suggest you just start somewhere, and work on treatment strategy from there. Others have suggested ways for you to handle the issue of being away from work. Good luck with your treatment, and I hope it is very life-changing in a positive way.