Enlivening Ourselves

Dear Dr. Norquist:

I have had problems with depression all my life. I knew for a long time it was depression, but kept putting off going to see a doctor about it. Well, I realized I was having more and more difficulty dealing with it and so finally went to a doctor. Because I have HMO insurance, my choices were slim. The doctor I went to seems very nice. However, I am concerned about the fact that he only spoke to me for approximately 20 to 30 minutes tops, and diagnosed me with depression, prescribed an anti-depressant (Wellbutrin), and sent me on my way. He barely asked me about my problems or my past. I only got as far as saying that my husband and I have grown apart and I am unhappy. He never went any further or allowed me to go further. I know enough that it’s never just one thing that causes someone to be depressed, but many different things combined that overwhelms a person. At first I thought, well this is my first appointment. He will see me in two weeks and we will continue with psychotherapy for a while and monitor my response to the medication. In two weeks I went back and told him I was feeling better, not tops, but I did feel an improvement. He said that’s great- it’s working. He asked how things were with my husband. I said the same. He said you know what you must do. You must leave him otherwise you will never be happy. He barely knows me or my problems. How can he just say that? I tried to add as he shuffled me to the door on our first visit that I had experienced severe depression in my teen years and tried to commit suicide, but this didn’t seem to interest him in the least. I’ve been seeing him once a month for the past several months and he never discusses anything with me. I spend about five minutes with him, he gives me a new prescription and I’m sent on my way.

Dr. Norquist responds:

You are looking for a therapist, and what you have found is a psychiatrist who prescribes medication and monitors its’ effectiveness. If this were what you were looking for, it would be fine. However, you have an inner need to understand and resolve certain issues in your life, and this need is not addressed by your current doctor. There are many different approaches and styles in mental health treatment. No one approach works for everyone. It is up to you to listen to what feels right to you and to search out a therapist that is a "good fit" for who you are and what your needs are.

Your HMO may have referred you to a psychiatrist because it is often less time consuming, and therefore tends to be more cost effective for them. However, they also have psychologists and LCSW’s (both of whom do psychotherapy) on their provider panels that they can refer you to if you request this. Some managed care companies and HMO’s are willing to contract on a case by case basis with an out-of-network provider at the subscriber’s request. Also, some therapists are willing to lower their fees for clients who pay out of their own pocket.

Talk with your psychiatrist and clearly let him know what you are feeling so that he has an opportunity to respond to your need. If he cannot do this in a manner that is helpful to you, then you can get your medication monitoring from him but you will need to search elsewhere for psychotherapy that is meaningful to you. Your desire to understand and resolve the concerns that feed your depression is an expression of a healthy innate drive towards growth. I see it as analogous to the innate force that leads plants to grow, flowers to bloom, and trees to branch out. You are at a juncture in your life where you are being called upon to grow.

Dr. Norquist responds:

If you are willing to be a victim, you will attract an abuser. If you do not honor and respect yourself, then you will allow others to not honor or respect you. If you believe you must accept criticism and abuse in order to receive love, then that’s what you will allow. This situation will only change when you take responsibility for what you allow in your life. Your husband’s treatment of you must in some way mirror your own treatment of yourself or you would not have allowed yourself to be in this situation. You are not tethered to this man. Loving and caring for yourself are essential first steps in attracting a loving and respectful relationship. This is the source of the problem, and therefore where you should focus your attention first. Abusers have a lesson to teach; the lesson of respecting and honoring yourself. You will continue to allow abusers in your life until you have learned the lessons they are here to teach you. Take comfort in the fact that you have control here. You do not have to depend on your husband to change for you to improve your life. You cannot dictate when he will choose to learn his lessons. You can choose to make changes internally to empower yourself here and not allow this treatment to continue.

Dr. Norquist and the staff of Chaitanya invite you to write them at Chaitanya Counseling and Stress Management Center, 51 Newark St., Suite 202, Hoboken, NJ 07030 or www.chaitanya.com or by e-mail at drnorquist@chaitanya.com, or by fax at (201) 656-4700. Questions can address various topics, including relationships, life’s stresses, difficulties, mysteries and dilemmas, as well as questions related to managing stress or alternative ways of understanding and treating physical symptoms and health-related concerns. Practitioners of the following techniques are available to answer your questions: psychology, acupuncture, therapeutic and neuromuscular massage, yoga, meditation, spiritual & transpersonal psychology, Reiki, Cranial Sacral Therapy, and Alexander Technique Ó 2001 Chaitanya Counseling and Stress Management Center