I am in my early 20s and have been struggling with depression for the past few months. I recently began a new job and moved to a new city, away from my friends and family. I am constantly stressed out and unhappy, and as I am often alone, my feelings continue to become stronger. I know that my job has contributed to my unhappiness, but I feel that I cannot leave it for a variety of reasons.
When I am depressed, I have a tendency to overeat. In high school, I was anorexic, and this evolved into episodes of bingeing and purging in college and afterwards. When I overeat, I experience intense feelings of guilt, which leads to greater feelings of depression. As a result, the cycle repeats. I feel that my behavior has gotten more out of control, and I often feel like I am punishing myself with food. I feel that I have lost perspective, and I no longer know how to regulate what I eat.
I have exhausted my options other than getting professional help. I have tried keeping a food diary, planning meals, and even ordering pre-packaged meals to keep my overeating in check. This has worked only temporarily, but within a few days, I am back to my habits.
I am a very independent person, and I am not sure if I am comfortable talking to a psychologist. I am more interested in possibly seeing a psychiatrist. I know that there are medications that have been proven very effective for depression. I think that this could help me solve my overeating problem and find more balance in my life. I would like to know whether you think this would be a viable option for me.
One thing I am concerned about is becoming dependent on the drugs to control my moods. Is this something I should worry about? I would like to have some way to get to the point that I feel in control again, but I do not want to feel like I rely on the medication. Thank you so much for your help.
You understand yourself pretty well. Now it’s time to take some action. I suggest a three pronged approach: First, you need to find a reason to get out of your house and out of yourself. You need to meet some people in your new town and begin to feel part of your new community. Even if you’re not a “joiner” by nature, you do need to be around people doing something positive to help yourself feel better.
Identify something you truly love to do and find people who like to do it. That could be singing in a chorus or attending a church or volunteering in a political campaign or going on hikes with a singles group. It almost doesn’t matter what you do as long as you do something that you remember you like to do and you do it with others. It also doesn’t matter if you don’t feel like it. Trust me. Getting even a little more active will help.
As far as professional help goes: I think you need both a psychiatrist and a counselor (psychologist or social worker or licensed counselor). Research shows that the treatment of choice for depression is a combination of medicine to elevate your mood and talk therapy to learn some ways to manage your life so you are less susceptible to depression. Especially since you also have a history of an eating disorder, learning and relearning ways to cope with stress is essential. Most people are able to phase out the medicines once they have mastered those coping skills and surrounded themselves with supportive people they care about.
I wish you well.
Dr. Marie
