Advice columnist

Adapted from a recent online discussion.

Dear Carolyn: I suffer from depression that has been fairly well controlled until recently. The past couple of weeks, I'm having a terrible episode, to where I'm really not sure I want to go on living. I know I need to see a therapist, but I've gone down the list of therapists in my insurance provider's directory and I can't get anyone to return my calls. I've called and left messages for over a dozen so far and I can't get an appointment.

I no longer live in the state where my original doctor was years ago, so I can't see her anymore. I can't afford to pay out of pocket. I don't have any friends or family who can or are willing to help me make calls and find someone.

It was so hard to get motivated to do this to begin with, and I'm at the verge of just giving up entirely. Is there anything else I can do?

— At the Verge

At the Verge: I’m so sorry you’re in the midst of a bad episode.


(Nick Galifianakis/for The Washington Post)

●You can send a quick text to 741741 — the Crisis Text Line — to be connected to a volunteer staffer. There’s a more detailed explanation here: crisistextline.org/texting-in.

●If you have suicidal thoughts, then please call the National Suicide Prevention Lifeline, 800-273-8255. Keep the number handy. More information: suicidepreventionlifeline.org.

●Don’t wait for a therapist; call your primary care doctor. Right away. Request a sick appointment — i.e., immediate — get an evaluation, learn what treatment options you have while you look for a therapist.

●Your regular doctor may also be able to get past barriers to your seeing a therapist. I’ve experienced it myself: I call specialists, and they’re scheduling six months out; my doctor’s office calls for me, and I’m in next week. It’s not true every time, but enough to make it worth trying.

●If you haven’t called your out-of-state “original doctor,” then do so. Some practitioners will do video consultations with prior patients.

●If this is all too daunting — health care is a lot to manage even for people who aren’t depressed — pick one contact and try it now: your primary care physician if you have one, the crisis text line if you don’t.

Finally, so important, don’t let yourself forget that depression responds to treatment and you have managed yours successfully in the past. Do not treat as permanent a crisis that is temporary: It is a symptom of depression to believe it won’t go away.

Take care, and trust yourself to get through this.

Re: Depression: I feel for the person struggling to find help because I've been there. Depression has a way of making even the most basic tasks insurmountable. Frustrating tasks like finding a therapist are even worse.

I don't have any silver bullet, or even any actionable advice. I just want them to know they are not alone. That there are people who understand what you are going through. And I hope they can see that every time they make a call is a triumph over the illness. Some days, that's all you can handle, or you might not be able to handle even that much, and that's okay, too. Some days you have more spoons than others.

— Anonymous

Anonymous: Amen. Thank you.

Write to Carolyn Hax at tellme@washpost.com. Get her column delivered to your inbox each morning at wapo.st/haxpost.