expectations and therapy for mood disorder

Post date: 2021-06-18 16:32:30
Views: 75
Trying to figure out what expectations are reasonable for someone whose symptoms keep returning despite 18 years of weekly therapy. Should my mental health have gotten better by now, or is something else going on? (discusses suicidal ideation)

I have a mood disorder "not otherwise specified" which for me means long periods of very high functioning stability punctuated by acute, severe depressive episodes that involve suicide attempts and hospitalization. These episodes happen even though I "do the work" (take my medications as prescribed, avoid alcohol & other substances, practice self care like exercise and socializing, and never miss a therapy session). The episodes never come out of nowhere; they're always triggered by the exact same type of external circumstance (interpersonal loss/grief or relational trauma).

I have lived like this for 18 years now and because there is such a clear pattern, I am wondering if I have not had the right therapists or type of therapy. Otherwise, I assume I would have seen some sort of improvement or progress, right? Or, is my problem that really terrible things (deaths, abuse) simply keep happening to me and would make anyone miserable? I'm in a grief support group where suicidal ideation seems almost universally common - I don't really know what "normal" looks like for someone who has had my set of life experiences. I do know that I don't want my life to stay this way, though. I guess a third possibility is that I have some sort of intractable, treatment resistant mental condition.

For reference, I have tried CBT, DBT, mindfulness, psychoanalysis, psychodynamic therapy, groups, and EMDR - everything but psychedelic therapy (which I would try if I could find an undergound provider). I have seen therapists with various specializations and backgrounds and usually stick with someone for at least 2 years before moving on. (Have also tried SSRIs, mood stabilizers, and anti-psychotics in terms of meds).

At this point I'm feeling a bit like a lost cause, but like I said I'm trying to determine what therapy can even do/what is in the realm of possibility - is it reasonable to expect it to reduce my suicidal thoughts when I experience a crisis or personal loss?
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