Understanding Why Your Brain Does What It Does When You Struggle with Anxiety and Depression

By Carissa Weber, MA, LPC, CSAC

As we near the end of mental health awareness month, I have heard story upon story of when therapy hasn’t worked. “It didn’t do anything for me,” “all I got was homework,” “none of what the therapist said helped.”

Has this ever been your experience with therapy? If so, then today’s post is for you. We are going to uncover why therapy hasn’t worked for you in the past (P.S. – be ready for some truth bombs and gut checks)

1. Did you actually commit to therapy?

Committing to therapy is more than just going to your appointment and talking. Commitment to therapy means that you are practicing what you learn outside of therapy.

It is hard to change how your brain is rewired in one hour a week. Believe it or not, therapists are not miracle workers. If you have signed yourself up for therapy, but did not actually commit to the therapy, this could be why it hasn’t worked in the past.

The fix: the next time you sign up for therapy, pull out a realistic affirmation:

• “Therapy works as well as I make it work”
• “Therapy is a commitment to living the life I want”
• “Accepting help means participating in my journey”

By participating in your therapy everyday, not just while you are in session, you get the opportunity to feel and see the changes that therapy has to offer.

2. Were you taking notes?

At the beginning of therapy, it can be very overwhelming and chaotic. Your therapist is asking you a bunch of questions to gather information, they’re throwing a lot of new terms at you, and potentially, showing you new coping skills.

How do you keep all of that straight? How do you remember all of this information? When you were in school, and we’re learning a new subject or topic, you took notes. These notes were there to help you reflect back on what you were learning.

These notes help your brain learn in a few different ways:

• Your insula is engaged in sensory information with writing
• Your prefrontal cortex is reviewing the information as it is coming in
• Your hippocampus is turning the information into a memory it can recall and use later
• Your Darn Amygdala is preparing to release neurotransmitters (like glutamate) to help you learn a new way to do thing

It is very easy to get overwhelmed and forget information that you were hoping to remember and use the last time. To actively participate in your therapy, taking notes in session is not only awesome, but highly recommended by many therapists.

The fix: Bring a notebook and pen with you to every single session. Write down the concepts you and your therapist are talking about. Not only will this help your brain remember, but it will help you to refer back to this when you’re practicing the skills at home. Keeping a notebook specifically for therapy also allows you to write down questions you want to ask about information from previous sessions. Dare I say it, journaling works!

3. Did you do your homework?

It is not uncommon for therapist to assign you to practice certain things outside of session. We don’t do this because we love homework assignments and want to increase your to-do list.

I’ve said this in so many posts, but practice makes progress. Therapists will assign small assignments (like practicing a new skill daily) for multiple reasons:

• To engage your brain in new, repetitive skills. This builds the new pathways your brain will use after it is done rewiring
• Make the new skill or way of thinking a new habit. Remember, it takes 66 days of doing something consecutively, to make it a new habit
• Doing homework (and completing it) releases the feel-good neurotransmitter, dopamine. This not only rewards your brain for completing something, but helps your hippocampus to remember what to do in the future

The fix: Just do your homework. Your brain doesn’t rewire itself in 1 hour a week. Heck, I bet you don’t perfect any new skill the first time you use it. Plus, you are investing in a life change, so why not use what you are paying for?

4. Were you honest with your therapist?

There are memes everywhere about how people are less-than-honest with their therapist so they can “get a good grade” in therapy. If there is anything that is NOT helpful in therapy, it is not being honest with your therapist about what is really going on.

Little secret: despite popular human belief, therapists are not mind readers. Even though we may have hunches about what might be going on, we cannot make assumptions about them. As therapists, we can only help you with the information you provide us. Struggling with anxiety and not able to sleep? Let us know. Feel like you want to crawl into a hole and die? Tell us. You are not going to tell us something we haven’t already heard (plus, we are trained to be unbiased and nonjudgmental).

The fix: Sharing what you are experiencing with your therapists allows you to:

• Release the feel-good neurotransmitter, oxytocin, which helps you feel connected while validating your experiences
• Move your brain from functioning in the triple-F response that your darn amygdala uses to moving to using your problem-solving, fact-based, proactive prefrontal cortex
• Identify the root cause to the mental health symptoms you are experiencing
• Start the healing process

Along with all of that, being honest with your therapist also allows you to:

• Build upon and improve communication skillshange the stigma of mental health within your own mind
• Reassure your darn amygdala that you are indeed safe in this chaotic world
• Gain confidence in handling situations that increase the presence of not-so-nice feelings

Being honest will help you get the progress you want from therapy. Yes, I know it can be scary to share some pretty vulnerable things. Remember, you are not going to shock us or make us think less of you.

5. Were you working with a therapist that was a good fit for you?

We covered this in the last post, How to Find a Therapist that Works, but it is an important reason why therapy might not have worked. There are a lot of factors that go into knowing a therapists is the right one for you:

• They are knowledgeable about the circumstances and troubles you are facing (for example, I specialize in neurodiversity, rural health, and substance use. A friend of mine specializes in body image and eating disorders. Specializing in something allows a therapist to have the best approaches to help you with your specific need).
• They listen to your needs and help you participate in building a plan to help your therapy be successful
• They explain and educate you on any potential diagnosis and treatment modalities they will use

The fix: It is okay to take time to search out a therapist that works best for you. It doesn’t mean that you are being difficult, it means you are taking your health seriously. Therapists do not take offense if you say “I’m just not vibing with you.” Often times, therapists are willing to help you find a therapist that will help you the best. Why? Because we want you to get better, even if it isn’t with us.

There are many other reasons that therapy may not have worked in the past. These are just a few that you (yes you) have control over. Thank you for taking the time to read about the variables that are in your control to help make therapy work for you.

To recap this post:
– There are a lot of factors that go into therapy being effective
– There are factors in your control to make therapy effective

Image Sources

• Carissa Weber at www.thatdarnamygdala.com
• www.pexels.com