When I was diagnosed with depression 20+ years ago, I went online to find other people who were also LDS and depressed. It was a huge relief to find people who felt the way I did, and who were also confused that God had somehow created a physical illness that kept his faithful child from feeling his love.
I noticed we had differing responses to religious experiences. Some were comforted, even if only temporarily, by religious actions such as asking for a priesthood blessing or attending the temple. Others of us either felt no relief, or felt worse, when we tried to bring the spirit through faithful living. I was emphatically in the latter category. When I felt depression start to seep in, I redoubled my efforts to live faithfully. I went to the temple twice a week instead of once; I quit reading novels and spent more time pondering Ensign articles; I worked across the street from Temple Square, so I spent my lunch hour in the shadow of the Salt Lake Temple, searching for peace. Everything I tried made me feel worse. Had God rejected me? What on earth had I done wrong??
Years later, I figured out two reasons for my Religion-Resistant Depression.
The first reason is that the Spirit is the “spirit of truth.” If the truth is that you’re a hot mess, that’s how you’re going to feel in the presence of the Spirit. The Spirit was basically trying to tell me: “you have a problem and being more righteous isn’t going to solve it. Pay attention to yourself and get to work.” (This was during the time when there were frequent reminders of President Hinckley’s story about being discouraged while on a mission and his father wrote to him and said, “forget yourself and go to work.” I needed to do the opposite: “pay attention to yourself.”)
The dialogue about depression has changed since the early 2000’s. Back then, it was almost verboten to say that there might be a reason for depression besides a brain chemistry imbalance. Since then, mental health professionals have linked depression to many different life experiences, such as being bullied in school, being abused as a child, being a victim of abuse as an adult. Depression is also common during the grieving process. Some may experience depressive symptoms and can address them by being more mindful, changing careers, or focusing on doing something you love. The point is, brain chemistry can cause depression. But life experiences can also cause depression. Or a combination of both factors.
The second reason that faithful behavior made me feel worse is that I was using that faithful behavior as a coping mechanism to try and ignore the life experiences that contributed to my depression. For me personally, my depression was linked to some childhood trauma, and some unhealthy relationships that I was tolerating without being able to change them. If I had been able to feel the spirit by going to the temple more often, I might never have taken a long, hard look at the pain I had internalized. If prayer and scripture study could have soothed me, I might never have taken concrete steps to end bad relationships. If serving in a calling had helped me to forget myself, I might not have prioritized my creative hobbies that bring me so much joy.
Once my faithful-behavior coping mechanisms failed, I was forced to address the real issues that were causing my self-hatred, despair, and feelings of worthlessness.
I give the Church credit for normalizing medical treatment for mental illness, including therapy. I also hold the Church responsible for contributing to some of my disordered thinking, most specifically perfectionism and misogyny. Church was not all good for me, but nor was it all bad for me.
Today, I’m mostly symptom-free. I’m on a low dose of a common antidepressant. I’m aware of my triggers. I’ve been through many rounds of therapy. EMDR and cognitive behavior therapy didn’t help much; dialectical behavior therapy changed my life; talk therapy – where I got to word vomit things I’d kept in for decades – was also very helpful. (Did you know there are different types of therapy and they can be prescribed depending on your diagnosis?)
Treating mental illness is often a matter of experimenting to find a treatment that works. This post is just my own personal experience and your experience may be very different. Some people go through several types of medication before finding one that helps. You may respond better to certain forms of therapy than other forms of therapy. Other behaviors may help or harm, depending on your personality and what might underlie depressive beliefs and feelings. Some people may feel better if they socialize more; others may feel worse. Some may feel better by doing something nice for someone else; others might feel emotionally exhausted at the thought of trying to meet someone else’s needs. Some benefit from prayer and meditation; others don’t. The point is, the activities that the Church encourages (like socializing, service and prayer/meditation) are simply activities that may or may not help a depressed person feel better. Religion-Resistant Depression is not an indicator of whether or not you are a faithful person.
Discussion questions:
Mental illness and its treatment is a touchy topic. Comment only if you feel comfortable.
Have you experienced mental health struggles? Did religious activity help or harm or do nothing? Did you expect religious activities to help you feel better?
Have mental health struggles redefined your faith and spiritual expectations?
What do you think of the way Church leaders address mental illness?
Wheat & Tares 
I vividly remember a RS lesson in the early 90s on depression. The point of the lesson was if you were depressed, you clearly needed to repent. This was an instance where I spoke up and pointed out that there were many other reasons for depression other than guilt over sin. The teacher doubled down on her point and would not allow alternate options. This while I knew there was a specific woman in the class (no doubt one among many) who suffered from depression. She had admitted to me previously that the only thing that got her out of bed in the morning was that she had to “feed” her Tomagotchi electronic “pet” or it would die. Repenting was not going to treat her depression. While I had several women approach me after class to thank me for saying something, that lesson still remains with me and was a major fail. I am glad that the Church has improved in this regard, though the damage is done.
In my own life, I found over the years that the harder I tried to be more faithful, valiant, obedient, etc. the more depressed I became. It was mystifying because my experience was the opposite of what I was continually taught. When I backed off a bit, things were better. I went through the cycle several times before I figured out that I needed to stop trying that failed experiment (for me) and allow myself to be more relaxed.
I suffer from a variation of social anxiety disorder . I feel serious anxiety at being in an LDS group setting. I dread Saturday evenings, because they always lead to Sunday mornings. I know that Sunday will be full of anxiety and stress and will normally result in a migraine headache. The only good thing about the pandemic was home church. No headaches or anxiety!
So I have literally had to limit my exposure to Latter-day Saints in groups. I am not a fan of ward parties and rarely attend, but generously contribute to them because I know those events are so important to the well-being of others. I attend every service project the ward has and volunteer in community organizations. I clean the church. I am an avid reader of scripture and LDS studies but have not attended Gospel Doctrine in years. I love the temple conceptually, but much to the chagrin of my wonderful wife, I decided that temple attendance was a semi annual event, and yes, I count family weddings as temple sessions. (Thank heavens for the numerous nieces and nephews!) I skip Stake Conference and attend meetings of other denominations or religions. Other religious groups don’t affect me in the same way. Reformation Sunday is spent at the local Presbyterian Church where I have some friends. Christmas will find me attending Mass at a local cathedral. I am fairly certain that local leaders view me as “less-than-faithful” because I do the minimum to keep a temple recommend. But I am immensely happier with my limited attendance and focus on service.
MENTAL HEALTH STUFF: Yes, I swim in mental stuff as a neuro-diverse individual in an obedience-driven community.
A) “Help or Hurt” – Both and Neither. The community kept me from being taken advantage of a fair amount as a teenager and post-teenager.
B) Expectations from Religion regarding Mental Health – I expected my mental health issues to be covered by God’s teaching. I also expected that I would have to figure out ways to manage my mental health because I had the biggest skin in the game (as it were).
When I get depressed, my experience is more effectively defined under the “Atypical Depression” umbrella because I can compartmentalize to do what needs to be done while eating myself alive. The church teachings were not necessarily relevant because “I was fine” (not depressed with the common depression markers) and also “not fine” (not at peace and having comfortable spiritual experiences). There really wasn’t room for my life experience in the community of the church experience – and learning that was both the hardest pill to swallow and the most liberating experiences in my life.
Church teachings in the D&C and the like do not cover my life experiences period. While I could/do/did make a local community for me in my own ways at different times (and on my own terms) – the guts (aka perceived arrogance) required to resist the lure of obedience and to insert the “AND” between church teachings and my awareness is pretty impressive and draining (and only made possible because of my neurodiversity).
The church teachings and community culture skirmishes pale in comparison to the non-communicative relationship I have with God at the moment. According to religious folks in my life, it “shouldn’t exist that way” – and “I’m the one with the problem”. I did the “pray, read your scriptures, go to church” deal pre-COVID half to resolve my problem/half to “Dare God” into showing up. Those actions made my problem more invasive in my life (and it’s still unknown whether God showed up and I missed the memo) – so I dialed them back considerably.
“I give the Church credit for normalizing medical treatment for mental illness, including therapy.” That is generous of you given that the Church was behind schedule on this normalization vs. the rest of society. It seems like the Church eventually comes around once the difficult work has been done by those outside of the Church. I’m thinking of racism, sexism, LGBTQ acceptance, etc. It would be amazing if just once we could look back and see how the Church lead the way. Maybe food storage? Maybe genealogy?
I think that a culture that focuses on personal righteousness often exacerbates anxiety and depression instead of ameliorating said problems.
The main problem is simply that people sometimes imagine that they have the answer to all problems. They imagine suffering is caused by sin and if you repent suffering will go away.
This just isn’t reality. Reality is that bad things happen to good people all the time. Depression can happen due to many causes that are entirely out of a person’s control. The body (and the brain as part of it) is an intricate system that can be set off by many physical factors, some we can control and some we cannot.
We can always pray and ask the Lord for guidance. But for that to help we have to be willing to listen and hear answers that we can be led to in other places besides the scriptures. If depression is directly caused by medical physical problems (and it often is) than we need to be open to medical advise to find answers. This kind of advise simply isn’t available through the scriptures and the Spirit cannot call upon information you haven’t studied to guide you.
It’s a real problem when we believe we have all the answers and we don’t even open our minds and try to understand. We just check off the boxes. If we get a good result we imagine that applies to other people when often it doesn’t. This is a kind of blindness. We need to humbly be open to more information instead of imagining we already have the answers or we can’t hear and understand.
Reading the scriptures and praying can make things worse for some people. For instance if they have a bad relationship with their father, and they can only picture a father when they pray, then praying may make them feel judged and condemned rather than loved and supported and forgiven. This is one good reason why the church should encourage more flexibility in prayer. For some people picturing a Heavenly Mother, or a more sexually indefinite God, may allow them to feel the acceptance they need to connect with God.
Often at church we try to force people to accept a paradigm that just doesn’t fit and isn’t helpful. It’s very discouraging to sit in church and hear talks and lessons that I know are hurtful to people’s mental health and spirituallity but to be unable to do anything about it.
I have found speaking up to be helpful for me personally in class. After a sacrament talk there is little that can be done and this is discouraging. Probably the very best thing for me has been to fully admit the fallibility of church leaders, teachings, even the scriptures which were also written by fallible prophets. The scriptures and teachings conflict, so I have my choice of what to believe. I choose to believe in loving Heavenly Parents. Anything I hear that I feel conflicts with that relationship, I dismiss as a false teaching. This has really helped my mental health.
I’ve been dealing with depression most of my life.
I had a Mission President, who was big on the on the “Iniquity causing Despair” means depression caused by one’s sins. Then, I later had a Bishop who felt that there could not be depression, since you can’t be tempted above which you can endure.
In retrospect, both of such ideas are misunderstanding of the scriptures. Strangely enough, that Bishop later had a son come home early from a Mission, due to depression. I don’t know why members of the Church can’t be objective about mental illness as they are about other illnesses. I also have 3 sons with autism, it has been difficult to tell them to be faithful despite how they have been mistreated by others in the Church.
I am glad that there is are more enlightened ideas about mental illness in the Church, but, it’s hard to forget the harms done by incorrect ideas put forth in earlier times.
I think depression-prone people are unlikely to rise in the ranks of GAs, and when you add that to the GAs’ advanced age, meaning they came of age and formed many adult opinions many many decades ago, it’s not surprising that the Church has been slow on accepting the reality of depression as a thing that actually happens to people for reasons other than sin. For all his other failings, I appreciate Elder Holland at least working to normalize it a bit by talking about his own depression in General Conference.
I’m a depression-prone person. My experience in the Church definitely exacerbated it rather than helping. My first serious depression occurred on my mission, when I felt trapped between high-pressure leaders who were determined that if I couldn’t force some baptisms out of an area, the only possible reason was sin, and the reality that the people in the area were by and large just not interested in Mormonism. Even before that, as a teen, when I read the writings of harsh people like Bruce R. McConkie and Joseph Fielding Smith, it definitely didn’t help my depression-leaning self. I remember being especially appalled when they (I don’t recall who exactly–it might have even been Spencer W. Kimball) even condemned suicide. The clear message was, to me, that God was determined to make my life miserable, and I had better not dare think I could get an early exit ticket, because he was only going to let me die when he was damn well done torturing me.
I realize that my experience isn’t everyone’s. Lots of people have good or indifferent experiences with the Church. I do suspect, though, that the combination of high demand and fundamentalism-leaning isn’t good for people who are prone to depression or anxiety. Not surprisingly, I’ve become much more mentally healthy as I’ve pretty much given up my belief in the supernatural, since it’s meant I no longer have to imagine the God that Bruce R. McConkie and David A. Bednar so love, who’s always peeking over my shoulder to keep track of all my sins so he can be sure to punish me sufficiently for them.
Funny (not really) how the mission comes up with some regularity when talking depression. Ziff, I believe your experience in the church is very common, but many members don’t feel comfortable admitting to anyone, least of all themselves, that the faith is the primary source of their self-loathing. It also tracks perfectly that abandoning a belief in the supernatural–this can go anywhere, of course, and range from a belief in God to thinking that an image of the Virgin Mary appeared in my toast this morning–improves mental health by presenting an explicable (mostly) world where random angry deities don’t present arbitrary challenges.
My first mission president was a kindly, loving man who believed he needed to both protect us and motivate us to work hard. When I told him I was struggling (I could have slept all day, given the opportunity), he suggested counseling. I went to a church-employed counselor, which was a disaster. He said pray and read the scriptures and everything would be fine. He never asked if maybe I didn’t believe what I was peddling, which was the problem. I said I was much better after 3 visits just to be free of whole charade. My remarkable mission president suggested an actual PhD counselor a little while later when the sleeping and lethargy did not correct. That guy’s understanding and wisdom walked me through my mission, even after I stopped seeing him.
If the church deals directly and honestly with depression now, I would not know it, and I guess I wouldn’t believe it either. The church created a circular logic of belief long ago in which all roads lead back to the organization as the solution to challenges. This is intellectually dishonest, cultish behavior, which exacts a huge toll on those who tend toward depression. For some people, intensifying their church activities is the WORST thing they could possibly do. It’s a bottomless pit that can never satisfy the lack of self worth many live with.
Mental health struggles have defined my faith because I tend toward scrupulosity, making me intolerable as a person of faith and deeply, deeply unhappy when trying to be one. I think it’s also relevant that I watched my mother go through a years-long bout of depression in which she slept a lot and generally neglected the family, but still found the energy to condemn our watching of R-rated movies and lack of enthusiasm for Sunday meetings. She was and remains devout, and I have never been able to disconnect her mostly performative faith from never being able to shed the black cloud that follows her around. I think there are many women in the church like her.
“Are you ever burdened with a load of care?
Does the cross seem heavy you are called to bear?
Count your many blessings; ev’ry doubt will fly,
And you will be singing as the days go by.”
So I counted my blessings. And counted my blessings. And counted my blessings. I had a healthy newborn after a planned and uncomplicated pregnancy, stable finances, loving husband. So why was I so miserable? Obviously I was an utterly horrible person to be miserable in light of the many blessings I had, but others wished desperately for.
Or it was common post-partum depression and treatable with time, caring friends, and mild medication.
Generally, I do believe that it is important to cultivate an attitude of gratitude and be appreciative of our many blessings. I’m in a better place when I do remember the “tender mercies” and admire the sunsets. Several hymns speak to my soul. But only offering platitudes about counting blessings does not solve larger issues.
There is peril in the one-size-fits-all treatment. For some, avoiding harmful media improves mental health. For some, the Word of Wisdom as presently practiced improves mental health. For some, serving others improves mental health. For some, church leaders and “ministers” provide sufficient counseling and support.
Any religious person I know, upon breaking their leg, would proceed to the hospital while also praying. Severe mental health also needs medical intervention.
Amy and I have much in common. I also functioned by compartmentalizing my depression, and going through all the motions of life, while planning my exit. I didn’t let any symptoms of depression show, in the very same way I had learned to hide all my feelings while growing up in an abusive family. And like Amy, I am neuro-diverse (although they didn’t recognize such in girls when I was growing up, so I have never been officially diagnosed, but since I am well trained to diagnose others I suppose I can diagnose me)
But for me, the church has had few positives and a lot of negatives. I would get to a certain point in the healing process and see that church and the perfectionist, obedience, extrovert culture was damaging and I would go inactive. Pretty soon my therapist would say that I was doing well, and they didn’t see that I had anything left to do in the healing process. But because I still believed in Christ, although I had serious doubts about the rest f Mormonism, and my husband would not ever accept me attending a different church, after several years of doing great, I missed the community worship of Christ. So, knowing I was a lousy fit to the Mormon community, I went back.
After about a year of listening to perfectionism (a big part of the emotional abuse of my childhood) and how any doubt or problem you had was because you were defective, and loads of misogyny, and things twisted into victim blaming (if you are offended it is you who has the problem) and purity culture, would become depressed again. I couldn’t keep fighting all the negative messages I got about myself at church. I knew enough to get myself back into counseling.
After repeating this pattern several times, I have realized that I simply cannot function in Mormon culture. It is a sickness that is too big for me to fight.
But at the same time, I see that it is good for some people. Mostly male people, of course, because I don’t think the purity culture, the misogyny, the servitude of women, none of that is good for women. But for men who recognize all that as crap, the church has a lot of good.
And, I also thought it was very generous to give the church credit for its attitude toward mental health. While it has improved, it hurt a lot of people back in the days of Richard G Scott saying sexual abuse survivors needed to look at their responsibility for the abuse. It hurt people by recommending that people avoid it as something that would destroy their testimony in the 90s to back to the 1930s when psychology was first invented. It hurt people by teaching that all depression was due to sin, that service to others cured depression. It hurt people by teaching that people changed behavior better by studying religion than by studying behavior (psychology and counseling). The got all bent out of shape because psychology was saying gay people were born that way, and maintained for 50 years that, no being gay is something that can be changed, because God didn’t make people that way.” The church couldn’t stand that psychology was saying things like masturbation were normal human behavior and not at all harmful, that moderate porn use was normal and not harmful. And the church REALLY couldn’t stand that psychology said that too much guilt was harmful, that too much shame was harmful, because shame and guilt were the very favorite tools the church uses to control people. For years and years the church fought against all mental health by such teachings.
I have clinical anxiety and have struggled my entire life with it. Like others here, I take a well known anti-depressant which I describe to others not as a happy pill but as something that takes the edge off.
I was adopted as a small child with medical history available, but not mental health history. Thank you LDS family services. A few years ago I found my birth mother and she revealed she was depressed to the point of not functioning and at times suicidal (some of this due to trauma because she was forced to place me for adoption without her consent, but that’s a different story). Frustrating that mental health wasn’t considered medical history at the time.
I grew up in a staunchly orthodox LDS home in which my parents openly mocked people who “blamed” their problems on depression. I remember specific examples of them making fun of certain medications. I just hope that my wife and I have changed this attitude with our kids.
That said, I think the brain chemistry aspect of depression is still not well understood. Two studies came out last year highlighting that the chemistry is more complicated than we thought. https://www.nytimes.com/2022/11/08/well/mind/antidepressants-effects-alternatives.html
Studies notwithstanding, I take meds every day and they do help. Exercise and sleep also help – if only I could actually sleep! There are still echoes of “pick yourself up by your bootstraps” sentiment in the church but it seems to be improving.
I see this post as a continuation of the previous one about empathy or the lack thereof. If you can convince yourself that people are depressed because they aren’t trying hard enough, you don’t have to extend them empathy which we are already extremely uncomfortable with as a people.
A couple thoughts:
Mormons will have to rewrite their doctrine if they really want to fully sever the connection between personal righteousness and depression. Mormon leaders and scriptures teach that righteous living brings joy. (Man is that he might have joy. Wickedness never was happiness.) People who aren’t experiencing joy and happiness because of genetics and brain chemistry or because of the realities of being human and living among other imperfect humans in an imperfect world will hear in the doctrine that they personally control their happiness and can achieve it by trying harder, being purer, increasing their commitment, repenting more, giving more to the church, etc. I know. This has been what I did for decades. Despite living righteously, being fully committed, and serving in leadership positions, I would regularly think: If only I were more [fill in the blank], I would be happier. I actually would tell myself the lie that this was God helping me to draw closer to Him.
There’s no question that Mormons have made significant progress addressing depression and other mental health issues. The progress is a generation late, but it is welcome in that it permits members to seek professional help.
Despite the progress, my experience is that Mormons as a collective fundamentally lack empathy. The pandemic and subsequent years have been brutal. I helped my spouse and children navigate depression, anxiety, etc. Church leaders and church friends were aware of my family’s challenges (though perhaps not the full extent). Their support and empathy were nonexistent. It has been hard and lonely helping my family navigate the process of finding professional help and healing. This experience was pivotal in allowing me to realize the church does not offer a true community or even true discipleship. It helped me to finally make the decision to leave and never return
S is correct that it will take doctrinal change to really fix the problem. I think it all goes back to one cultural aspect of the church that impacts gays and doubters as well as those who are depressed. The church has this sort of philosophy of when ever something is not how the church wishes it, to blame the individual member. So, if you doubt the church’s truth claims, you must be into porn. If you are having marital problems, you must be into porn. If you get raped, well what were you wearing? If you are depressed, there must be some sin. If you are gay, well, it is your choice, just do a better job controlling your feelings. If you can’t pay your bills, you must be lazy. If there isn’t money for groceries, well you are not paying enough tithing. If the ward restroom stink, it is because the ward members are lazy and didn’t clean it. If your husband goes out and commits adultery, well the wife must have refused to have sex. Or maybe she didn’t let him look at his porn. If your wife goes out and commits adultery, …well, I haven’t heard that discussed in priesthood because I always attended RS, but I am sure that they find a way to blame the victim. They always do. And I guess if you are as cynical as I am, you must be a democrat.
Long story but we had a 5th Sunday with a presentation from the stake and the speaker was pitching prayer as the cure to all teen mental health issues.
My wife protested to the Bishop and the next 5th Sunday was a better presentation from a licensed therapist in our ward.
President Nelson, from a video that was republished in the Church News a few days ago:
“Our job is to teach people about these eternal laws. They’re called commandments, but they are just as true as the law of lift, the law of gravity, the law that governs the heartbeat. It becomes a rather simple formula: If you want to be happy, keep the commandments.”
If it were that straightforward, then antidepressant companies would be out of business. And which commandment was God breaking that made him weep in Moses 7?
As someone who let scrupulosity rule many years of my life, I’ve found that I’m happier if I more exact in taking my meds and less exact in keeping the commandments. I used to make myself miserable just trying to figure out exactly what the commandments are. (Am I really supposed to keep the law of consecration as it’s spelled out in the temple? Should I avoid laughing too loud? Am I sinning by not always turning the other cheek?)
I have lived with low-grade depression most of my life with pockets of deep depression. I take my “happy pill” every morning, which brings me up to zero. My advice from personal experience: do not go to the bishop for personal counseling. It is a waste of both of your time and is often counterproductive. Get bishops out of the counseling business. Go to a professional. There may be/have been good counselors through the Church’s Family Services (don’t want to disrespect anyone), but I never found one. It was more of “read your scriptures, pray…etc.”. What I needed was good therapy and pharmaceuticals. As has been noted repeatedly above, trying harder doing the same things that don’t work still won’t work. Yet, that is the counsel too many of us have received.
I just wanted to comment and say thank you for the post. The beginnings of my faith crisis had more to do with the incompatibility of average church discussion on mental health and my own experience than anything else (history, hard doctrines, etc). Ultimately, it was decisive in my decision to leave as well. While the church proper has changed it’s tune on mental health over the years, the average discussion of it in Sunday School remains the same unfortunately. It’s an important conversation to have, so I appreciate you raising it.
I just wanted to second LHCA. Bishops are often good men doing their best to follow the hand book. They really aren’t trained in mental health and they can do a lot of damage when a vulnerable person in pain trusts them.
Attending church can be positive for mental health in that social interaction can be a positive if you are in the right place to receive it. But many concepts preached in the church can have a negative impact on mental health. A person has to be in a position to let those mistaken comments blow on past. Not everyone can do this.
I appreciate this message. I’ve left the church, but I have a long history of depression.
I was depressed in the church, I’m depressed out of the church. My depression since leaving has probably gone through the worst moments, but I’ve also been dealing with horrific health conditions and the struggles of trying to make a mixed-faith marriage work.
The church made some aspects of my depression much worse and some better. I’m prone to guilt, bordering on scrupulosity (I don’t want to diminish actual cases), so the intense guilt I felt for always being unable to live up to the ideal was crushing. But it did help me find meaning in suffering that wasn’t my fault (if such a thing existed). So it was a bit of a mixed bag. Since leaving I’ve felt less of that guilt and perfectionism, but also less meaning to my health challenges.
I also thought if I were more righteous it would fix it. And it was confusing because to the degree my depression was due to guilt it DID help when I could live up to the standards more. But there was always some way I wouldn’t measure up.
I’m almost the opposite of you: years of talk therapy did nothing, most medication did nothing (with the exception of duloxetine, which was miraculous until it faded), I never really “got” DBT, but self-help CBT exercises were amazing for a good 10 years and made a huge difference. TMS also helped a lot. When things were really bad I considered ECT, I may yet do it someday. Honestly, having good health, the moments I’ve had it, seems to help a lot.