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EW YORK — In the last four decades, I’ve been to more psychologists and psychiatrists than I can count, from New York to California, from the East Side to the West Side. There have been so many that I’ve no doubt I’m serious competition for Woody Allen — or certainly one of his characters.

The first shrink, when I was a meek 20-something, prescribed lithium, used for manic depression (though no one I’ve seen since has diagnosed me with that), and required weekly blood tests I hated so much that I simply stopped going. The most recent doc is prescribing Prozac, for depression, and Klonopin, for anxiety, in ever-decreasing doses. I see her just a half hour a month. She thinks, as I do, that I’ve talked about myself far too often and for far too long and might benefit from shutting up.

These professionals have accompanied me through my entire adult life, while offering up a medicine chest full of pharmaceuticals: Zoloft, Xanax, Luvox, Ambien, Deplin, Remeron, Oleptro, amphetamine salts.

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Have the medications worked? The truth is I don’t precisely know what they’ve done for me, except for a few that had awful side effects. On the lithium, at first, I slept 20 hours at a stretch. Even at the lowest possible dosage, I felt like I had a paper bag over my head. The Xanax, a lightning-fast-acting drug, eventually stops working, and the anxiety comes roaring back at ever shorter intervals.

As for the rest, it’s been so long since I’ve been unmedicated, I no longer have a basis of comparison.

But I do know this: I’m paying a tiny fraction of what I once did — psychiatrists in New York City commonly charge $450 an hour — and maybe I’m happier because I can pay my mortgage.

For whatever reason, I’m now in a place where I feel I can offer advice to others searching for their equilibrium. So here are five suggestions:

Understand that discrimination persists

Despite all the well-meaning talk to the contrary, mental illness continues to be judged by a different standard than physical illness.

I’ve had employers concerned about my competence when they learned of my personal (and family) history — when all around me were untreated alcoholics with bottles of booze in their desk drawers and unexplained absences from work. I had named my problem and was taking care of it, but that seemed a strike against me.

Be prepared to educate your friends

I’ve had friends, otherwise good and loving people, who are ignorant of the difference between chronic depression and the occasional bad day. “Pull yourself up by your bootstraps,’’ was their advice. “Try harder.’’

Surely that would not be the response if I had diabetes or high blood pressure.

Some of these people remain in my life; most don’t. One I asked to read a short book, “Darkness Visible’’ by William Styron, a compelling description of this disease. Was I testing him? Maybe. (He passed.)

Don’t discount the value of talk therapy

Intimate and regular conversation with someone who isn’t a friend or a family member allows you to spare your loved ones stuff they don’t want to hear and may not understand. Within the four walls of a therapist’s office, there’s a safe and private space for the gloom and fearfulness that otherwise can infect “real life’’ interactions.

Another reason talk therapy can be effective: You’re paying dearly for it. How tempting it is to talk about the weather, to entertain the psychiatrist with amusing stories about your week, to come late or simply not show up. But it’s less tempting, for sure, when the meter is running. Waste your appointment or use it well. It’s up to you.

Be patient

Only a medical doctor has the expertise to prescribe and manage medications, altering the cocktail when what used to work no longer does. These are not medications you can stop or switch easily; they require gradually tapering off one and onto another. (So buy a pill cutter.) Some begin to work instantly and others take weeks. (So be patient.)

And, typically, changing them from time to time improves their efficacy, however onerous the transition.

Don’t commit to the first psychiatrist you see

My selection of providers has been shamefully random, given my skills as a reporter — usually based on a recommendation from a friend or a former doctor. Only once have I had the fortitude to conduct an audition: see several people, pay for each consultation, and then decide. That was in January, following a head injury.

Despite my compromised physical condition, and the fear I felt, I was determined to take the reins in a way I never had before.

So I made the rounds to a number of providers. I asked questions rather than answered them. I listened, instead of talking. I took notes. My explicit goal was to reduce my medications, perhaps eventually to do without them altogether. My implicit goal was to have a psychiatrist manage that process with a minimum of talk therapy, and to avoid anyone who suggested four times a week analysis, turning me from a human being into a full-time patient.

One of the providers I interviewed said right away, “I think you need less meds, different meds — and to see what it’s like to stop talking after all these years.’’ I went with her.

So far, so good.

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    • Couldn’t agree more! Daily exercise, both, in the morning and in the evening, has been my best & almost sole weapon against mental illness. Rest everything is mostly crap.

  • I have dealt with major depression since I was a teenager, some inherited from my dad, who fought with it his whole life, some of mine worse due to the relationship with my mom. I had ect treatment, 8 rounds, and have been on numerous meds..for years, I have been taking Parnate, an MAOI for depression not controlled with other meds..and trazadone..do fine most of the time, but meds are not a fix..lately due to family problems, I have crashed more times that I care to think about…do not know what I will do if the parnate stops..my husband has had to learn more about major depression that he ever cared to know..he is my rock…I get tired of it, know when I am falling, and sometimes, just want to hide..at least now, I know that it is going to take over…falling into that dark well, and looking up to see the sunlight and trying to climb wet walls to get out…on good days I am really good..just wish the bad would go away, do not remember the last time I really was happy

  • Hi Jane,
    I’m another person who has been prescribed many anti-depresants and antipsychotic meds not really knowing if they are helping or not but I guess the fact that I feel suicidal frequently proves they are not as for therapists I haven’t had the luxury of picking it choosing I got what I fought for it had taken years of begging and pleading with my Gps when I did get a chance if mental health professionals to help me it was extremely poor I knew more about my diagnosis of BPD / cpstd anxiety and depression etc than the physclogist I was allocated after a year of weekly appt I was told that’s it your time is up 4 pieces of paper with scribbled diagrams about relationship dynamics ugh … Where what do I do now I’ve always tried to educate myself about mental health as it runs in my family I have no confidence in the medical fraternity if I could afford to search out and find a therapist that I could feel at the very least comfortable in engaging with and who would make me work through it and have more knowledge and insight than I do that would be great .. Thanks Jane

  • Jane, Sorry for your experience. For startup companies, the road to bringing new meds to market is very rough. So, mentally ill people suffer with meds that might not work or find their own alternatives.

  • Spent 10 plus years jumping from one anti-depressant to another with Xanax tossed in. The side effects ranged from bad to unbearable. During another bout of depression decided to take another approach. Started doing accupuncture and yoga and added probiotics to my diet. Been off antidepressants for 2 years and feel great. Accupuncture to pull me out of depressions and yoga and probiotics to keep the depression at bay.

  • Virtual reality use in anxiety and depression is in its infancy of development but show promise it treating mental health!
    Christopher L Snyder D.O. ?

  • How can you give advice when you admit you don’t even know what’s going on with your own mental health? Finally after years of polypharmacy of antipsychotics, antidepressants and antianxiety meds I want to McLean Hospital, got diagnosed correctly and have been lithium and an antidepressant for 22 years. I got my life back and blood tests are only every 6 months. And I don’t make it a habit of whining about my condition. I do not want to be a Woody Allen character. Most people don’t even know I have a mental illness.

    • We all have our own paths to recovery and, in my experience, they can be quite convoluted. I don’t read this as complaining about a situation, simply a recounting of the circus to healing. And “so far, so good” is worth a lot to me. The number one way to fight mental illness stigma is to share our stories and humanize the diagnoses, so thanks to Jane for sharing hers.

  • i wish that I had been/was/will be able to afford $450/hour therapy sessions. Sounds like the writer is a lot like Woody Allen in other ways too (affluent)

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