therapy roulette

i'm also tired of the performative wellness cycle

depression has been a companion of mine since i was about thirteen. it has ebbed and flowed throughout my teens and my twenties.

if you haven’t lived with depression…it’s very easy to reduce it to just being sad. the best way i could describe it is as this constant, invisible heaviness that makes life feel like i’m sifting through a thick ass layer of fog all the time. it’s a heavy weight on my chest that lingers no matter how much i try to distract myself.

i hear (more often than not) that people who go through depression are using their sadness as an excuse to not make progress with their lives and are just attention-seeking leeches who get off on external validation. and as much as it makes my blood boil having my mental health issues be invalidated…i wish they were right. if i had the option to snap out of it and have this not be a lifelong uphill battle, i’d take it any day. but the reality is that this is a crippling disease millions of people go through that hijacks my energy, warps my sense of self, and makes even the most basic tasks feel impossible.

to the naysayers who might come across my substack and claim i’m talking about my mental health just to get pity and boost my engagement…to your surprise, i don’t enjoy sitting in my sorrow. so…as someone who actively wanted to get better (and still does)…i did the thing everyone tells you to do when you’re struggling: i sought out professional help.

but here’s the thing: we like our conversations about mental illness to be palatable and tidy: something that fits neatly onto a cute instagram graphic with phrases like “you’re not alone!” or “seek help when you need it!” a well-meaning sentiment that people can repost and feel good about, without engaging with the harsher realities beneath it. that advice (while well-intentioned) often comes from people who’ve never had to actually navigate it.

when i first started therapy and psychiatric treatment at fifteen, i always entered it as a last-ditch effort. in those moments of heavy vulnerability and desperation to stop feeling so sad all the time…i’d walk into a therapist’s office with high hopes of working with someone who would handle my feelings with care. but to my surprise…that isn’t always the case. and i wish someone had told me (before i ever sought help) how much trial and error it can take to find a therapist who really sees you.

the first psychiatrist i ever saw put me on lexapro after a ten-minute intake. my first thought was, “omg! a pill that can take my sadness away? sign me up!” but when i actually started taking it…it (ironically) made me feel even more depressed (which is such a funny side effect for a medication that’s supposed to curb suicidal thoughts).

when i told my psychiatrist how much worse i was feeling…her solution was to up the dosage. and then up it again. and again. and again. and again.

and granted…i didn’t know any better (it was my first time trying any kind of mental health treatment) so i kept following her advice for about six months… until it got bad enough that i finally put my foot down, ended my sessions with her, and went on my merry way. the crazy thing is that years later…i found out she lost her license for malpractice (and honestly…it tracks).

the decade following (give or take) was just me cycling through a slew of psychiatrists and therapists who (to this day) i genuinely question: 1. how they got licensed and 2. how some of them have managed to sustain long careers without getting their shit completely rocked for being objectively bad at their jobs.

i remember one time in college i was going through some stuff, and i ended up connecting with this therapist through one of my mom’s friends. she was this sweet, older white woman with the cutest little office on the upper west side, right by the hudson river. she always had sugar cookies out for clients (which in hindsight...was kind of genius. like, if you’re about to talk about deep, painful shit, at least you get a cookie to emotionally accompany you). but throught my time with her...i slowly started to realize that those sugar cookies were the best part about me working with her altogether.

when i told her i was feeling depressed (fully laying my heart on the line), her suggestion was that i start analyzing my dreams, claiming the answers to improving my mental well-being would show up there. despite being four failed attempts deep with therapists at that point, i was still naively trusting that all therapists knew what the fuck they were doing. so for three months i’d wake up, write down my dreams, bring them into our sessions, and we’d sit there trying to decipher what they meant in the name of healing.

and after three months of doing that bullshit, english-class-coded dream exercise, nothing was working. like, at all. not a single thing i “discovered” in those dreams fixed the chemical imbalance in my brain. so eventually (despite how good her sugar cookies were) i dipped.

more recently i fell out with the psychiatrist i’d been seeing for about four years. we met during covid. when i first started working with her…i really thought she was the one: the sweetest black woman with this warm, motherly energy who actually validated me…didn’t ask me to do any stupid shit like decode my dreams or overprescribe me any kind of medication. in fact…she actually got me on the right medication and played a huge role in helping me stabilize my mental health.

everything was fine until last october, when i reached out for a prescription refill. suddenly, she told me we had to meet in order for her to prescribe it (which i thought that was a little weird because it had never been a requirement before) but i shrugged and booked a quick 15-minute session…literally just to get my meds.

and then right after the meeting…she charged me triple the usual rate (without any kind of warning). the timing of the two raised some eyebrows and gave me a weird gut feeling…so i asked her why this was a “new policy” she randomly started doing. she kept doding the question which i found to be so weird…so internally i was like…is this even a legit policy?

so i did some digging and found the ryan haight act of 2008, which requires one in-person evaluation before prescribing meds online…but just one. i found nothing about requiring ongoing meetings to keep prescribing a med someone’s already stable on (and this wasn’t even a schedule ii stimulant or anything abusable). (for lack of a better term) the math wasn’t mathing and ultimately i realized that she was totally weaponizing my need for a very necessary medication for a check.

it blows my mind that so many of these professionals spend years in school, studying case studies, memorizing diagnostic checklists, and yet somehow still manage to leave people with more trust issues and feelings of helplessness. like i’m not supposed to be leaving my sessions feeling more broken than when i arrived. that’s not how this is supposed to work! and i hate that my experience isn’t unique.

i’m not saying this to discourage anyone from seeking help. i know that there are great therapists and psychiatrists out there…but i do think we need to be more honest about how uneven the landscape of care really is. it’s close to impossible to self-care your way out of a system that is actively fucking with you.

if we want conversations about mental health to mean something, they have to go beyond cute slogans. they have to include the reality of what it takes to actually find safe, competent care.

the hardest part isn’t saying you need help…it’s what the system does with your truth.

---

if you like what you read…here are other essays I’d recommend:

---

right now my newsletter is free but if you would like to support me…you can buy me a cup of tea :)