Highly Sensitive Refuge
A highly sensitive person calls her therapist.

5 Essential Things to Tell Your Therapist If You’re Highly Sensitive

It’s normal to get sad, depressed, or anxious at times. This is true for everyone, including those of us who are highly sensitive. But sometimes, depression can sink in and take hold of your life. If your depression has become a permanent inner state or if you’re feeling hopeless all the time, it’s probably time to ask for help and visit a psychologist, psychiatrist, or therapist.

(Not sure? One way to evaluate if you should get help is going through the Burns Depression Checklist. If you score higher than 25, you should know that getting professional help is a must.)

Of course, not all highly sensitive people (HSPs) suffer from depression, but it is fairly common — and there’s no shame if you do. If you’ve reached the point of feeling hopeless or desperate, talking to a therapist is the most important thing you can do.

And when you make an appointment to visit a psychiatrist — whether for the first time or not — remember: Not all psychiatrists have had highly sensitive patients before. But there are things you can do to make sure your treatment is a positive, helpful force in your life.

Here are five things that you should tell to your therapist.

What to Tell Your Therapist If You’re Highly Sensitive

1. I’m a highly sensitive person.

Though it may seem like an obvious thing to say, it’s important to remember that it’s only between 15 and 20 percent of the population who are highly sensitive. This means that of all the patients your doctor sees, probably 8 out of 10 are not as sensitive as you.

Be frank and open about how deeply you feel your emotions, how sensations can drive you nuts, and how depression is making you feel — both emotionally as well as in your physical body. For me, emphasizing this has been a game-changer because it means that my doctor is more careful when prescribing medication. We take the side effects into consideration, as well as the right dosage and the progress I should make as an HSP.

2. This is what my real current state looks like.

As an HSP, it’s quite easy to feel ashamed of describing how depression can make you feel — because frankly, it affects us more deeply than others.

For example, depression has many obvious symptoms like:

  • Fatigue
  • Loss of interest in things you like
  • Loss or increase of appetite
  • Feeling sad all the time

But for a highly sensitive person, depression can look like many other things. Often, it feels physical. And your doctor should hear you say the stuff you’re experiencing. It’s your appointment, and it’s you she’s treating, so let her pay attention to your real feelings and sensations. For example:

  • I feel like my skin is on fire all the time.
  • After crying, I feel a strange pain in my ears.
  • My sadness is giving me cramps in my legs.
  • My hands have been going numb at night.

You may feel crazy while saying things like these, but I’ve learned that I’d rather have my doctor know the wild stuff I experience as a highly sensitive person than try to pretend I’m someone else. As an HSP, you feel the sadness and the sorrow depression brings, but bodily sensations, sounds, and pain can be even more distressing than the sadness itself.

3. I’m very sensitive to medication and its side effects.

The first time I took antidepressants, I was not prepared for the side effects. I’m absolutely glad that I took the medication and that I responded well to the treatment, but wow, those side effects. As an HSP, they were brutal:

  • “Mild nausea” felt like “I want to throw up 24/7.”
  • “Possible fatigue” felt like “I can’t move a finger.”
  • “Possible headaches” felt like “Please chop off my head.”

After my first experience with such issues, I learned my lesson well. I understood that I had to tell my doctor how sensitive I was to medication and that I was aware of how my body feels all the freaking time!

Telling the truth about extreme sensitivity makes things much easier as you to start psychiatric treatment. You will probably be given a smaller dose, slowly building up tolerance and making sure that you’ll stick to the medication. Remember, you want the benefits of the meds, so be open about your condition.

4. This is how treatment is making me feel.

For the first weeks of treatment, it’s good to keep a journal. Write down all the ups and downs and all the feelings and sensations. It’s a good way to track progress. Personally, I’ve learned to send the daily journaling to my doctor. She often doesn’t respond and she doesn’t have to, but it’s been a good practice because sometimes she’s noticed important patterns and has taken medical decisions based on them.

The importance of honesty with your doctor cannot be overstated. As HSPs, we’re used to being misunderstood, but in therapy, you don’t have to pretend to be someone else. So let your doctor or therapist know how you feel — especially when first starting your treatment.

5. I think this is not working.

Medical treatment for depression and anxiety can be extremely helpful when it’s needed. It can make you feel so much better and return to a normal life. But sometimes treatment doesn’t work as expected. What should you do then?

This happened to me recently when a new medication just didn’t work. I took a pill every single night for more than three months and kept expecting better results. The problem was that, as we sensitive people often do, I started second guessing myself:

  • Am I overreacting?
  • Am I making things up?
  • Am I well but focusing on the wrong sensations?
  • Is it all in my head?

Look, medication is meant to work. It should make a significant difference and bring relief to your life. The same is true of evidence-based therapy techniques like cognitive behavioral therapy, as long as you are doing the practices. So if it’s not working as you expected, it’s time to open up and be frank with your doctor.

In my case, I called her and told her that it was taking too much energy just to pretend that I was feeling better and that I needed something else. Her reaction was to immediately consider what we could change to improve things.

And it worked! But it required me to raise my voice and express my feelings.

Therapy Is the Time to Speak Up

Depression is not how you’re meant to live your life. Sadness is not meant to be your permanent inner state. Feeling sick is not how you should live. Get help, find a professional who can help you, and give you meds if necessary.

But remember that after you get help, it’s your turn to help yourself by talking honestly about all the details that you experience. It’s those details that matter — at least for an HSP. So make them count!

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