Getting access to therapy – not always easy

Sorry for the late posting – Telstra kindly cut my internet service off and I’ve only just managed to get it reinstated. Carrying on from yesterday’s post on how difficult it is to get help when you don’t want people to know you are depressed, it’s been my experience that it can be difficult to get therapy even when you do tell your doctor how you feel. In my case, way back in 1982, I was diagnosed with major depression after I became so unwell I couldn’t continue working. My family doctor put me on antidepressants, which took a while to kick in. After talking to a friend about how someone she knew had found therapy helpful for depression I went back to my doctor and asked to be referred to a psychologist.

His response was quite amazing. He told me that in his experience therapy didn’t help anyone and he wouldn’t refer me to it. So I had to find someone who would take me on without a doctor’s referral and pay for it myself. I found this therapy immensely helpful, but after doing research decided to change to a psychologist doing cognitive behavioural therapy as that was proven effective. I made sure to tell my doctor what I was doing. I later heard that this same doctor had refused to refer another young patient to therapy, much to the distress of his family, so I wasn’t the only one.

This story has a surprising ending. A few years after I started doing therapy I started seeing a new psychologist. Somehow we got on to the topic of my doctor. Then my psychologist dropped a bombshell. ‘He’s the highest referring doctor to our psychological service in the region,’ she told me. I was so shocked I asked her to say it again. Surely it couldn’t be the same doctor? But when I next visited him he told me it was true.
‘What changed your mind?’ I asked him.
‘I’ve seen such a change in you with therapy that now I refer a lot of my patients to the psychologists,’ he told me. He was a convert! I even lent him my copy of Feeling Good by Dr David Burns, and when I got it back it was clear from pages he’d marked that he’d actually read it. The upshot of this is that doctors may be more comfortable prescribing meds than referring a patient to therapy, but it’s worth getting therapy anyway and telling the doctor just how helpful it is. They may end up a convert too!

Putting a good face on it

In front of me is a picture of a smiling woman hugging a gorgeous blond headed little boy. Both of them are dead now – the woman by her own hand, the little boy – her son – killed by her. She left behind her two older sons and a husband. This can’t have been the future she imagined when she had her children or married, or the future she wanted for any of them. It shows that depression is a potentially deadly illness. But what I find saddest is that this woman could have so easily been helped. As I’ve discussed in previous posts there are so many effective therapies out there. Any one of them could have made the critical difference. But the difficulty is getting to them.

In this woman’s case she read self-help books but didn’t seek other help. In fact she pretended to her doctor and others that everything was fine. Meanwhile the illness was eating away at her. In some ways it would have been better for the family had she stopped coping and had a complete breakdown so she had to have treatment. But because she went on with the basics day to day it was possible for her to deny the seriousness of her condition, and difficult for anyone to make her get help. I’ve been through this with someone myself – knowing that they are very ill and need professional help, but having them refuse to seek treatment even though their life was at risk. Thankfully in that case a group of people who cared got together and wrote a letter to the person’s GP that led to him getting treatment. As a result he’s still around to care for his children today. But it could have been different.

The reason he didn’t want to seek treatment? The stigma of admitting he had a mental illness. So many of us with depression learn early on that people don’t like to hear about it. Pretending things are fine becomes our way of being accepted, and after a while it becomes second nature. But pretending things is fine makes it hard to seek help. What saved me was becoming so depressed that I couldn’t function normally, so I couldn’t pretend any more. The shame was huge, but not as big as the relief of getting professional help. That was the start of a change in my life that led to my current happiness. I’m just sad that this poor mother didn’t get that chance.