Aug 4 2020

There’s No Downside to Trying Therapy

I got a note from someone who recently saw my Techstars mental health video. He said that could relate to how I describe depression as the “absence of joy.” He went on to write me a long, thoughtful, and brave note about his experience with depression.

One thing stood out to me was a statement near the end:

“I can’t convince myself to “speak to someone” because it feels wrong if I am paying them. It doesn’t feel whole.

I responded with a long note that follows:


When I was in my mid-20s, I had my first major depressive episode (it lasted over two years – very deep clinical depression.) I was functional at work, but that was it. Zero anything else …

I resisted therapy for about a year. I was ashamed of many things, including how I felt. I didn’t think someone would be able to help me. Early on, my dad, who is a retired endocrinologist, said to me, “Just shake it off” which was profoundly unhelpful, but just reinforced my shame.

Finally, my PhD advisor said something like, “Brad, there is no downside to trying therapy. If it doesn’t work, it doesn’t work. But if it does, it’ll make a big difference. It did for me. Give it a one year commitment. Here’s the name and phone number of my long-term therapist.”

It still took me a while to call. I did, and committed to a year.

It changed my life. I ended therapy in my late 20s, but started again (with a new therapist) at 47 when I had another major depressive episode.

The way I think about it is that I “go to planet Brad for 50 minutes a week.” (I now go every other week). My therapist gets to hang out with me on planet Brad. Sometimes he guides me into a new part of the planet that I haven’t yet explored. Sometimes we get out shovels and dig holes in the ground to look for buried treasure. Sometimes we sit on a rock together and just stare into the distance. And lots of other things that you would do with a guide on a planet as you explore around.

About a year ago, I had a massive depression for a short time (less than a week) that in hindsight was induced by ambien. I rarely take ambien, but was on a multi-week international trip, had a bad cold, and was having trouble sleeping. About 10 days into the trip I feel off an emotion cliff into one of the deepest holes I’d ever experienced. Fortunately, I was safe and with my wife Amy, and after about three days realized it might be the ambien after randomly surfing around on the web looking at depression+travel and other stuff like that. 48 hours I was fine. 

Three days of complete absence of joy was awful. But I knew I could call my therapist in an emergency if I needed to. I was a few days away from going home and had a session right after I got home, so just knowing he was there helped a lot.

Therapy isn’t “the only answer”, but – like my PhD suggested many years ago, there’s no downside to trying.