I have been dealing with depression on and off for about 10 years now. I have been on a few different antidepressants, but they make me sick. I have also seen a psychologist, but it makes me uncomfortable. It seems to have gotten worse this past year. I have gotten to the point where some days I just wish I were dead. I don't feel liked by people, only tolerated. I have tried to reach out to people, but I think it just scares them away. I don't know what to do at this point. I feel my situation is hopeless. Can you help?

Darcy

I can't make specific recommendations about your situation without meeting with you personally. But perhaps some of my thoughts in response to your question can provide you with options to explore or pursue.

First, many people do have negative reactions to antidepressants and other psychiatric medications. While they may alleviate symptoms for some folks, others find they feel worse, or at least no better. The good news, though,is that psychotherapy alone can be an effective means of healing depression. So can regular exercise, by the way.

You mention that you have seen a psychologist -- I assume for psychotherapy or counseling -- but it made you uncomfortable. One possibility might be to find a therapist (whether a psychologist or another mental health professional) with whom you do feel comfortable -- or at least more comfortable. It's perfectly OK to interview therapists (even over the phone, if need be) to get a sense of whether they may be a good match for you. Unfortunately, in these days of managed care and emphasis on medication and brief therapy for crisis stabilization, insurance companies or HMOs may want to assign a therapist to you regardless of how you feel about him or her, or they may push antidepressants. However, even in those situations you will usually have the option of appealing decisions that seem not in your best interest, and you can always seek out and pay a therapist on your own. (The latter situation actually guarantees you the most privacy and control over your therapy.)

Another possibility to consider is that your discomfort in therapy may be a manifestation of the problems or patterns that may be contributing to your misery. If you have never felt liked -- only tolerated -- by other people, then it makes sense that you would feel unhappy ... and uncomfortable in the close setting of a therapy relationship. Sometimes we project onto other people -- including, or perhaps especially, therapists -- how we feel about ourselves. They may actually like us, or at least feel neutral about us, but we may see them as rejecting or judging us because that's how we're used to feeling about ourselves. In that case, it can be very helpful -- although initially sometimes difficult -- to talk with the therapist specifically about how you feel in therapy, and whether that might be related to how you feel in other areas of your life. And if so, of course, how you might change those patterns of perceiving yourself and others.