How Do I Get Better (US)

[dazed_dreamer]

I want to try all that I can to fix my brain. But I don't know what to do from here.
I've seen a therapist, on and off. It's nice to vent, to have someone know some of what's going on, without having to burden a friend. But I don't talk about the more serious stuff (suicidal ideation, past attempts, the worst of my depression, etc.), I don't know how to with her at this point.
I'm on Prozac. I think it helped some, especially at first. But now I'm not so sure. It helped with more intense negative feelings, but now my biggest issue is detachment, dissociation. I don't think the Prozac helps with that.
I want more serious help. I'm not exactly sure what to do though. I like the idea of more intensive individual therapy, that's the main thing. I'd love to just spend hours with someone, a professional who can really help me, just digging deep into my feelings now, all of my issues, my past. To process hard times from the past, learn how to cope and build a better life for myself now, discover my identity and feel human again, get a rough idea how to continue into the future.
This intense individual therapy would be the main thing, but changing meds and group therapy would be nice as well. Having a community of similarly-aged people dealing with adjacent issues would be comforting, like what I find here but in person. And I think getting properly diagnosed (mainly do I have derealization/depersonalization disorder), and changing meds if need be, would also help.
What should I look into? Outpatient, PHP, inpatient, something else? I'm scared of being selfish, a financial burden, trying something else that doesn't really help, but I'm desperate and selfish and I don't want to die but I can't live like this much longer.

If you've read this, thank you. Sorry that it's not the most coherent, my mind is messy at the moment, and I just want to get this all out there.
I also want t o get my diet, exercise, etc. in check. I have in the past, but it's hard now that my motivation is gone. I just want someone there with me, some accountability, but I'm scared to ask for it, especially from friends who aren't in the same boat of needing it to cope with chronic mental illness

 

[irregularreconcile]

I want to say, huge congrats on simply wanting to get better. This is a hard step alone, but I may be able to help. [I'm in the US, been to loooots of different treatment, so I have a little insight.]

I believe the first thing is take a deep breath. This won't happen overnight, and that's ok. Getting better isn't about "fixing" ourselves, it's about meeting ourselves where we are at and pushing forward. That push forward is going to be one step at a time, so try not to overwhelm yourself too much.

On the topic of Prozac: I've been on it before. Been. For me at least, it stopped working at one point and they put me on Duloxetine, which has done me better. A med change may be good for you.

I also do reccomend PHP. Research about the program first; Typically they'll have med discussion with you before you start the meat of the program, and you'll be able to request a change there. You should definitely consider being open about that, even if it's hard.

PHP was great for me for several reasons; Community and Consistency, which sounds like what you're looking for. I was able to stay at a friend's house while I did it for about 6 weeks, and I'm considering doing another one again. Some also refer to more intensive depression treatment, which is (sort of) how I started doing ECT. I never finished it so I can't give my input, but it has a high success rate nowadays if you're more debilitated with depression.

But again, take everything one step at a time. Keep trying to talk about your needs, and hopefully try to have more consistent therapy appointments. Each step is a step forward, and it's something to be proud of, but again- Just take one step at a time, and breathe.

You can do this, and I'm proud of you! Hope this helps some.