Total Despair in Perfect Conditions

For as long as I can remember, I’ve been prone to depression. Back in the day, I used to rationalize it by telling myself I was just "living in the future." I spent all my time obsessively mapping out these massive life plans, convinced that if I could just check enough boxes, my life would finally be settled and I’d magically be happy. Well, I’m 22 now, and on paper, I’m living the absolute dream according to those old criteria. I’m killing it as a student, I’ve got a solid job at a private firm, and music is my soul—I spend my weekends gigging with my band at various clubs around town. I eat clean, stay in shape, and hit the gym every single day. Most importantly, I have a boyfriend who truly loves me. And yet, despite having everything I thought I wanted, I have never felt more miserable or dissatisfied with my existence. Lately, I’ve started drinking way too much and I can’t sleep for the life of me. I don't know if it's some weird form of disillusionment because my life looks exactly how I imagined it two years ago, but I just don't *feel* the way I thought I would. It leads to this cycle where I hate myself for being selfish and ungrateful for everything I have, and honestly, there are moments when I just wish I didn't exist. This sense of total despair has been dragging on for about six months now, and things have gotten dark enough that I've actually had suicidal thoughts because I just can't cope anymore. I'm terrified of seeing a psychiatrist because four years ago, I had a horrific experience with one who turned out to be a complete nightmare, and it totally trashed my trust in the profession. At the same time, I don't want to burden the people around me with my mess; I know they can't actually fix it, and I don't want to cause them unnecessary stress—especially my boyfriend, who I know wouldn't know how to handle someone in this state. Has anyone else gone through something similar? How do you actually pull yourself out of a hole like this?

Dammit, I can't offer much more than this one little lesson: it's written witha space after all...though you aren't exactly illiterate, I suppose. 👍

OT: If I were you, I'd cut back on the drinks.

Yeah, quit stressing about the booze. I’m a few years older than you and I don't touch the stuff... honestly, I don't feel like I'm missing out on anything. I mean, if there's a special occasion, sure, I might have a drink. But that's it.
Seriously though, just be grateful for what you've got right now. Having a job at your age—and a relationship too? That's huge. You're young, you're healthy... just enjoy it while it lasts.
And as for that whole insomnia thing... maybe you're just not wearing yourself out enough during the day. Plus, you can't exactly head to bed with a brain full of worries...

Typically, you have to cycle through at least three psychiatrists before you find one who actually clicks. Don't let a single bad experience discourage you.
I went through two terrible ones myself before landing with my current doctor. Since I walked in fully expecting the worst, I have to say I was genuinely surprised by how good it turned out. 🙂

Timothy Cruz6 said:Typically, you have to cycle through at least three psychiatrists before you find one who actually clicks. Don't let a single bad experience discourage you.
I went through two terrible ones myself before landing with my current doctor. Since I walked in fully expecting the worst, I have to say I was genuinely surprised by how good it turned out. 🙂

I would personally opt to switch from a psychiatrist to a psychotherapist instead... provided they come highly recommended, because there are plenty of parasites in that field as well.

I’m not entirely sure there's a meaningful distinction between a psychiatrist and a psychotherapist. A psychiatrist should be trained as a psychotherapist as well, shouldn't they?

Timothy Cruz6 said:I’m not entirely sure there's a meaningful distinction between a psychiatrist and a psychotherapist. A psychiatrist should be trained as a psychotherapist as well, shouldn't they?

Not necessarily. Professionals from various other fields can complete specialized training in a specific school of psychotherapy.

driftinggull21 said:Not necessarily. Professionals from various other fields can complete specialized training in a specific school of psychotherapy.

So other professions can be psychotherapists? But aren't psychiatrists fully trained and qualified for psychotherapy during their schooling and residency?

The first two doctors I saw just pushed pills. No real conversation, no depth. Just a "take whatever you want" attitude. One actually asked me, "Just tell me what you need."

I didn't take anything from either of them, and I've avoided them by a wide margin for years.

Now I've seen a psychiatrist who prescribed medication immediately, but she also noted that therapy would be mandatory alongside the meds once we finalize my lab work and testing. I resisted the pills at first, but after a few more incidents, I realized I had to. I'm curious to see how her "psychotherapy" actually functions, given that this isn't a private practice, but part of the public healthcare system.

If my memory serves, psychiatrists undergo psychoanalysis training during their residency. However, in practice, they lean heavily on psychopharmacology for at least two primary reasons:

1. Their fundamental model views mental distress as a direct byproduct of neurological dysfunction—such as neurotransmitter imbalances—meaning they treat the underlying biological "glitch" with medication.

2. From a purely logistical standpoint, conducting psychotherapy limits them to just a handful of patients per day. By focusing on pharmacological management, they can manage dozens of patients daily.

Timothy Cruz6 said:I’m not entirely sure there's a meaningful distinction between a psychiatrist and a psychotherapist. A psychiatrist should be trained as a psychotherapist as well, shouldn't they?

There are distinct differences between these two roles.
Furthermore, significant variations exist between different therapeutic modalities, much like how specialists within a single field vary.

Ultimately, you cannot simply choose any provider at random. One should avoid the sweeping generalization that all practitioners are incompetent just because a specific individual failed to meet expectations.

Timothy Cruz6 said:So other professions can be psychotherapists? But aren't psychiatrists fully trained and qualified for psychotherapy during their schooling and residency?

The first two doctors I saw just pushed pills. No real conversation, no depth. Just a "take whatever you want" attitude. One actually asked me, "Just tell me what you need."

I didn't take anything from either of them, and I've avoided them by a wide margin for years.

Now I've seen a psychiatrist who prescribed medication immediately, but she also noted that therapy would be mandatory alongside the meds once we finalize my lab work and testing. I resisted the pills at first, but after a few more incidents, I realized I had to. I'm curious to see how her "psychotherapy" actually functions, given that this isn't a private practice, but part of the public healthcare system.

Not at all. Most of them aren't actually trained for it. They have to commit to many more years of additional schooling if they want to practice psychotherapy...

Raymond Wilson4 said:If my memory serves, psychiatrists undergo psychoanalysis training during their residency. However, in practice, they lean heavily on psychopharmacology for at least two primary reasons:

1. Their fundamental model views mental distress as a direct byproduct of neurological dysfunction—such as neurotransmitter imbalances—meaning they treat the underlying biological "glitch" with medication.

2. From a purely logistical standpoint, conducting psychotherapy limits them to just a handful of patients per day. By focusing on pharmacological management, they can manage dozens of patients daily.

There are distinct differences between these two roles.
Furthermore, significant variations exist between different therapeutic modalities, much like how specialists within a single field vary.

Ultimately, you cannot simply choose any provider at random. One should avoid the sweeping generalization that all practitioners are incompetent just because a specific individual failed to meet expectations.

Not really. There are maybe ten psychiatrists qualified as classical analysts in the whole country (plus a few more in training), and only a few dozen trained for psychoanalytic psychotherapy—maybe about 40 in New York City, and probably just a couple dozen more elsewhere in the US...

EDIT: @User22, if you're having suicidal thoughts like you mentioned, it would be best to reach out to a psychiatrist. One bad experience doesn't mean they're all bad. Since you sought medical help four years ago and the issue is still there—and even getting worse—it likely won't just disappear on its own...

Quinn:

Michelle Evans As specified by: That’s simply not the case. In America, you might find maybe a dozen psychiatrists qualified as classical analysts, with a handful more still in training. As for those trained in psychoanalytic psychotherapy, you're looking at perhaps a few dozen—maybe forty in New York City, and likely just a small group scattered across the rest of the country.

I am aware that there are various "analytical" branches. Personally, I have never found them particularly intuitive, nor do I see much point in distinguishing between the different schools derived from Freudian theory.
In Rhode Island, there are several distinct factions that I simply group under one single heading.

I personally favor alternative psychotherapeutic approaches.

By the way, I believe we have lost track of this thread's original author somewhere along the line.
Perhaps she should reach out and specify her location so we can direct her to the appropriate contact.
stormyfox13, you don't need to air your grievances in public; a private message would suffice.

There would certainly be plenty of people opting out.

@stormyfox13
No matter how many times I reread your opening post, I can't ignore phrases like "state of despair," "has lasted six months," "never been more unhappy or dissatisfied," and "suicidal ideation."
In my view, those are clear indicators that you need a psychiatric evaluation to establish a treatment plan. It doesn't strictly have to involve medication if you're against that; there are alternatives like psychotherapy, support groups, or outpatient programs. However, you have to start somewhere. And unfortunately, not everyone is lucky enough to find a psychiatrist they click with on the first try.

driftinggull21 said:There would certainly be plenty of people opting out.

@stormyfox13
No matter how many times I reread your opening post, I can't ignore phrases like "state of despair," "has lasted six months," "never been more unhappy or dissatisfied," and "suicidal ideation."
In my view, those are clear indicators that you need a psychiatric evaluation to establish a treatment plan. It doesn't strictly have to involve medication if you're against that; there are alternatives like psychotherapy, support groups, or outpatient programs. However, you have to start somewhere. And unfortunately, not everyone is lucky enough to find a psychiatrist they click with on the first try.

If we are pushing for a psychiatric evaluation, we are essentially assuming there is a clinical illness involved. Looking at stormyfox13, I don't see a disease; I see someone who is dissatisfied with life or a specific part of it.
In my opinion, there's no need for a psychiatrist... but then again, that's just how I see it.

Raymond Wilson4 said:If we are pushing for a psychiatric evaluation, we are essentially assuming there is a clinical illness involved. Looking at stormyfox13, I don't see a disease; I see someone who is dissatisfied with life or a specific part of it.
In my opinion, there's no need for a psychiatrist... but then again, that's just how I see it.

Everyone is entitled to their own opinion.😉
Furthermore, a psychiatrist might conclude after an exam that she is perfectly healthy.
However, she came here seeking advice for a reason. I believe that two heads are better than one, so you are welcome to contribute as well.🙂

driftinggull21 said:Everyone is entitled to their own opinion.😉
Furthermore, a psychiatrist might conclude after an exam that she is perfectly healthy.
However, she came here seeking advice for a reason. I believe that two heads are better than one, so you are welcome to contribute as well.🙂

If she cannot pinpoint the root of her dissatisfaction—or to put it in clinical terms, identify which unmet need or unfulfilled self-image is driving this—then I suggest she consult a psychotherapist.

The specific modality I would recommend is a non-deterministic approach. Essentially, one that doesn't view a client's current state as an inevitable byproduct of past trauma. Frankly, those deterministic approaches tend to be quite pessimistic.

So what actually went down with that psychiatrist who turned out to be a total piece of work? Like, have you ever had to see a shrink before because of your own stuff?

You said this dissatisfaction started creeping in about six months ago; did something specific happen in your life that could've triggered an emotional shock or some kind of major turning point?

I honestly think you should just tell your boyfriend that you've been feeling depressed lately.
Don't bottle it up—just let it out. He'll handle it way better than you think he will.
I feel like talking to someone close to you would really help so you don't keep everything locked inside, because when you hold it in, everything just feels way more intense and overwhelming than it actually is.
I know it’s hard to admit and that it changes things in your life right now, but maybe it’s what needs to happen for you to actually feel better.

And I really think you need to go to a psychiatrist and actually seek professional help.
Because you're struggling and hurting, and there's no reason for it to be this hard if you reach out for support.
I get that getting help is tough when you're in this headspace, but you've gotta find the strength to fight for yourself and get through what you're going through right now.

ps. I think you might be onto something when you say this could be a reaction to having achieved everything you set out to do, yet you still don't feel "amazing," and you're just hit with this sense of hopelessness or emptiness—like, you did "everything," so now what?

pps, after reading your post again, I see you've decided to handle this all wrong: you won't "burden" your loved ones because they'll just worry, but at the same time, you don't want professional help because you were burned once before.
Look, girl, I'm telling you again, you're young and vulnerable; there is absolutely no reason or point in trying to walk through these feelings alone. You can't carry "this" all by yourself.

Wishing you nothing but the best.

I wouldn't recommend psychiatrists. Every experience I’ve had is the same: they slap a diagnosis on you immediately and pump you full of pills until you're walking around like a zombie, completely disconnected from reality. Alternative medicine worked wonders for me—meditation, Reiki, bioenergy... I'm even looking into homeopathy and psychotherapy right now. It seems like a solid path 😁 and you have to work on yourself... read, research, experiment... You can't just let yourself sink into that state of despair and helplessness. That's a downward spiral. You need to snap out of it and find a way to heal—if that's what you want to call it—that actually works for you. Nobody is going to wave a magic wand and hand you a perfect recipe. This is a lifelong grind with its own ups and downs. Don't hide this from the people you love. You need someone you can lean on and vent to whenever life gets heavy. Don't isolate yourself. And remember, the goal isn't just keeping your head above water to survive; it's learning how to walk on water 😉 and fighting through this is exactly that... a small miracle 🙂

Look, lady, you need to stop drinking and go find a professional because it’s glaringly obvious that you need help. You can't just "will" your way out of depression; it isn't something you solve through sheer grit alone. You actually have to seek medical intervention. There are plenty of highly qualified psychiatrists and therapists out there who know what they're doing, and depression is a treatable condition. Stop just chanting mantras to yourself that everything will be fine and start actually undergoing treatment. Good luck.🙂

Like I said, everyone’s got their own thing 🙂 the point is, just trying stuff out... and grabbing a handful of pills and sticking a finger in your ear isn't always the smartest move. Not just talking to hear myself talk, either—I'm speaking from experience 🙂

stormyfox13 said:For as long as I can remember, I’ve been prone to depression. Back in the day, I used to rationalize it by telling myself I was just "living in the future." I spent all my time obsessively mapping out these massive life plans, convinced that if I could just check enough boxes, my life would finally be settled and I’d magically be happy. Well, I’m 22 now, and on paper, I’m living the absolute dream according to those old criteria. I’m killing it as a student, I’ve got a solid job at a private firm, and music is my soul—I spend my weekends gigging with my band at various clubs around town. I eat clean, stay in shape, and hit the gym every single day. Most importantly, I have a boyfriend who truly loves me. And yet, despite having everything I thought I wanted, I have never felt more miserable or dissatisfied with my existence. Lately, I’ve started drinking way too much and I can’t sleep for the life of me. I don't know if it's some weird form of disillusionment because my life looks exactly how I imagined it two years ago, but I just don't *feel* the way I thought I would. It leads to this cycle where I hate myself for being selfish and ungrateful for everything I have, and honestly, there are moments when I just wish I didn't exist. This sense of total despair has been dragging on for about six months now, and things have gotten dark enough that I've actually had suicidal thoughts because I just can't cope anymore. I'm terrified of seeing a psychiatrist because four years ago, I had a horrific experience with one who turned out to be a complete nightmare, and it totally trashed my trust in the profession. At the same time, I don't want to burden the people around me with my mess; I know they can't actually fix it, and I don't want to cause them unnecessary stress—especially my boyfriend, who I know wouldn't know how to handle someone in this state. Has anyone else gone through something similar? How do you actually pull yourself out of a hole like this?

"Happiness belongs to those who are mindful of their spiritual needs."
Best regards