I've heard people say, "I've tried therapy, and it didn't work." The fact is, sometimes it doesn't, and there are various reasons why. I had to go through several therapists before I found one who was really helpful. When we moved across the country, I had to go through another search for a therapist who realized what I needed.
If you haven't had a thorough physical exam before entering therapy, a depression that's due to a simple physical cause like a low thyroid may go untreated while you spend time and money talking about your feelings or taking antidepressants, neither of which will make the underlying problem go away.
Different kinds of problems require different kinds of solutions. Sometimes a therapist will first try what has often worked with other patients without realizing that your problem may be different. A good therapist will see pretty quickly that a method isn't working, and try something else, but a certain amount of patience is necessary, because depression often doesn't respond to treatment overnight.
If your depression has been coming and going for a long time (you might even be labeled a depressive personality), therapy may become a lot like an archeological dig to discover where the problem really began. In my case, I first entered therapy a few months after the birth of a child. As I had decided to leave my job to care for the baby, it seemed obvious the resulting financial strain plus the loss of my professional identity as well as the loss of camaraderie of my co-workers might be the root of my depression. Even though several sessions of discussing my feelings with the therapist did make me feel better, depression returned with a vengeance a couple of years later. By then we had moved again, and once more I had to go through several therapists before I finally found one who realized that I had repeatedly suffered from depression from early childhood. Thus began a long dig to uncover the memory of the incident that began my depression. Finding the right therapist is only part of the solution. You have to be willing to stick with it for the long haul.
Sometimes therapy doesn't work because the patient isn't doing his or her part. Often fighting depression requires you to make significant changes--in your thinking, in your daily routine, or in the way you view other people in your life. If you've made up your mind that you'll never be happy unless someone else changes, you're doomed to be depressed. The only person you can change is yourself, and making major changes in yourself isn't easy. The therapist can't make you change--YOU have to do it, and that takes work.
Therapy also doesn't work when the patient is blind to the truth. Sometimes we don't want to see the role we've been playing in our own unhappiness. You have to be willing to take a deep and honest look at your own thinking and behavior. I've known people who quit therapy because the therapist had the "nerve to suggest" that the patient's behavior was part of the problem.
Finally, sometimes we remain depressed because we want to hang onto unrealistic expectations when what we really need to do is accept reality. If you hear the word, "acceptance" and believe it simply means "quitting," I suggest you give some thought to the Serenity Prayer:
God grant me the serenity to accept the things I cannot change,
Courage to change what I can,
And the wisdom to know the difference.
Stephanie Kay Bendel is the author of EXIT THE LABYRINTH: A Memoir of Early Childhood Depression – Its Onset and Aftermath, MAKING CRIME PAY: A Practical Guide to Mystery Writing, and A SCREAM AWAY, a romantic thriller published under the house name, Andrea Harris. She has also written numerous short stories and articles on writing.