View Full Version : Biting the bullet: CBT
Hi all,
I am arranging CBT through Anxiety UK although I have started considering the CBT4PANIC programme instead. I have a few concerns about CBT though as I have never had it before.
Basically I have had a blip which I am starting to come out of. This is the first time I have ever beaten a blip without medication since I became ill 3 years ago. (I always said I'd cry with joy if I came out of a blip without citalopram! Well it might be crying time soon!)
This blip has made me realise a lot of things. One, that I was genuinely recovering from the illness; two, that counselling had reached a "plateau" where it was no longer productive; three, that my anxiety is probably the result of behavioural problems that started when I was very young.
I am pretty sure I would have been diagnosed with ADHD if I was a child today. Also I suffer from intense separation anxiety, massive time management and procrastination issues, and my entire mental workings are geared towards a negative outlook. The citalopram did help a lot and I've done loads of things to help myself but I know that I need to make fundamental changes and I need support with that.
My question is, will CBT help me with this, or should I consider some other type of treatment? I have not touched a dose of cit for nearly 2 months and do not intend to go on it again unless there is no alternative. I feel that if I do not get the right type of help I will probably spend the rest of my life in therapy seeking reassurance.
Poet
I had CBT and found it to be very useful. It addresses all those thinking habits that come so easily to us that we don't even notice them. It helps you to look at how your thinking affects your outlook on life and how you feel about things. I think that face to face counselling is better if you are not familiar with the techniques and it can be tailored to your needs.
The other thing it does is to look at now and the future, what has happened in the past has, no doubt, shaped your personality and behaviours but those things cannot be changed so you need to look forward now and work with what you have now. You have identified several areas that you want to work on and CBT will certainly help you to do that.
Good luck, xx
Thanks Mirabelle for that reassuring post. I'm now in brand new territory and your explanation was very helpful.
I just spoke to my new therapist. She is a qualified psychotherapist who has extensive experience with bipolar disorder, so I proceeded to freak out about being bipolar. She said I am definitely not bipolar I or II but may be vulnerable to developing some type of bipolar illness, or I could simply have personality traits that resemble it. I had to bring the session forward from 2nd Jan to tomorrow night because I was pretty upset. She did reassure me slightly by saying that once I've had a handful of sessions I won't be reacting anything like this, and she said this proves I have bad health anxiety even after all this time.
In the space of a 2 hour (yes, 2 hour) phone call, I have gone from being "extremely optimistic" to "very optimistic with awareness this is gonna be ridiculously tough". I did tell her this won't put me off. I told her there is nothing I won't do to get better, and she says she can help.
So we'll find out tomorrow then.
Sounds promising. Although not sure if I like the sound of all the labels she was giving you. My feeling is that you have identified areas where you need work and are prepared to put the time and effort in. This proactive attitude shows that you have the motivation to get well. Good luck tomorrow.
xx
We do not have such extensive healthcare coverage so CBT is not covered by my insurance for example.
I have a book by folks who used to practice it but are not sold on its long term curative effect. Their new kick is this:
The Mindfulness and Acceptance Workbook for Anxiety: A Guide to Breaking Free from Anxiety, Phobias, and Worry Using Acceptance and Commitment Therapy [Paperback]
John P. Forsyth (Author), Georg H. Eifert (Author)
Hi everyone, I will bear in mind what you've said and I have had mindfulness recommended to me a few times so I will look into that.
I've had quite an anxious night; my talk with the therapist really upset me, but like she said, once I've had a few sessions I won't be like this - hopefully! My girlfriend and my family are quite annoyed that the talk with my therapist upset me so much. Maybe though, it's a good thing. She knows pretty much where to start with me. My dad agreed that health anxiety could be the underlying issue.
Unfortunately I woke early and couldn't sleep due to the usual racing heart. My girlfriend said she hopes I get better to the point where the anxiety doesn't rule my life. Me too.
Hi Poet
I agree with your family, that she shouldn't have left you upset. I know you will benefit from CBT and fingers crossed you will feel better.
Also, look at the things you are doing now that you couldn't have done before. Remember that a blip is part of the recovery process.
Claire Weeks is spot on when she says that the only way forward is through the anxiety.
Gotta love that woman.
xx
Hi, thanks for the reply! I buggered up by talking about the actual session in another thread. The session was really, really good, and the therapist said I'm already good for the exposure therapy. She is highly confident, but what we're going to do at first is half theory, half therapy, while we explore the painful roots of the illness. We are starting on the health anx due to its frightening grip on me (as in, nearly everything that's wrong with me relates to it in some way). She did say it might be quite surprising how many other issues might clear up when the health anx is gone. My next session is the 2nd of Jan and I hope to keep the rest of my sessions much closer; 2 weeks at this stage might as well be forever!
Hi PP,
You have done good coming off citalopram, and you recognise you need some support system . I had intense CBT last year, which really made sense. Mindfullness is the key to our thinking patterns.
Sadly for me, I was too full of negative thinking pattern to fully stay with all that I learnt in CBT. You seem so focused on wanting to get better, I feel you will stand a great chance utiilising the techniques.
If you need any literature on my CBT sessions, let me know. You have my fb details
Reg
Ash
Thanks Ash, I'll take you up on that shortly. How many sessions did it take before you got any benefit from CBT?
Can anyone tell me how long CBT takes to start having an effect?
Hi PP
I have done two lots of CBT:
The 1st was via NHS some years ago, where I had weekly group sessions. To be quite honest, these never took off for me, as a couple of hours of 'altered thinking' once a week was not sufficient to override my default thought patterns.
My 2nd and far more useful was a couple of years ago where I attended a private day hospital. I was fortunate to have a company medical insurance. I spent almost a month with the same group, constantly given various sessions on CBT. Being away from the usual 'real' issues that come iwth having a job/family,and also being part of a group who all had the same need to feel better helped me immensely. Apart from pure CBT, I was also offered counseliing, meditation, relaxation sessions which should have formed a package to turn to.
I came out feeling a lot happier and also more aware that all my problems lie within and controllable. Sadly, in the euphoria of a new 'me', I slowly started slipping back to the default behaviour.
Today, I am not in the best of places,but I have a much better awareness of what is wrong with me. I still am on medication, which in itself brings different issues to my mental/emotional welfare. You are probably in a better place, since you are med-free for now.
I do follow your 'blog' on Citalopram. You seem to have sussed a lot of your issues out, you are in a good place to take that 'one more heave' to move into a more normal living.
Take care
Ash
Ash, thanks for the honest reply.
In your reply, I noticed something straight away. Do you have any kind of support network? I.e. helpful and considerate friends and/or family, the Samaritans, Anxiety UK, a sympathetic doctor etc? Or do you simply deal with your problems on your own? It is very easy to "relapse" or fall back into bad habits when you feel you're alone in life; during a spell of anxiety I am a totally different person when I'm with friends or my girlfriend than I am when I'm alone. Also, in a closed environment like your second CBT course, it is very easy to start feeling on top of the world. The trouble is, we need to operate in the real world, and being insulated from the world only gives us a brief respite. A core component of CBT is exposure therapy and this seems to have been lacking.
I am actually considering going back on the meds. Blowing my trumpet about coming off cit (again) was a conceit and I should have been better prepared. However I am actually starting to see a possible return to meds as a simple choice rather than a scary admission that I'll never get better. Citalopram has a proven record of relieving some of my anxiety symptoms and I now know my issues with cit were simply related to health anxiety, although that doesn't make the health anxiety any easier to bear at present.
I've changed my CBT to this Saturday instead of Monday. At present I am waking quite early (around 7ish) and not being able to get back to sleep, making me stressed and less resilient; my anxiety goes through the roof when I'm alone at home; I am suffering from tension headaches; I am finding it hard to believe that I can get past this, despite having done it before (albeit with meds and therapy over a period of time).
I am quite keen to know how much of a difference CBT can actually make, cos at the minute I can't see the wood for the trees.
Hi Poet
In my experience you get out of CBT what you put in. It takes time and repetition but you will get there. As for the meds? So what if you go back to the Cit? Do you feel that you will have wimped out if you go back to the meds?
If so then maybe you need to think about how you are viewing you illness. Would you say a Diabetic wimps out by taking insulin?
It is what it is, my friend. Do what you need to do to get by.
All the strength you have gained will stand you in good stead, believe me.
I was ill with anxiety 20 years ago and recovered completely with CBT alone. Once I had got thru that I was never afraid of anything again, it puts things into perspective and it also made me more understanding and less judgemental.
I am now ill again with anxiety and using meds and CBT. It's not easy but I know I will recover and be invincible once more. I wish the same for you.
xx
Hi Mirabelle, thanks for the reassurance. One aspect of the illness we identified is my reliance on other people and outside factors to feel better, hence my partial desire to get back on the cit. I am feeling anxious to varying degrees pretty much all the time these days and it is wearing me out. I guess I see cit as a way to get rid of the anx but I am prepared to try CBT alone for now. I just don't know at this stage, I want to get better and am prepared to work hard but I hate feeling like this and I don't know how long the CBT will take to start working. I know that with support and guidance I can overcome the worst of the anx, I just wish I could believe that day was coming!
Poet
By taking the Cit you are merely facilitating your recovery, we both know that meds alone will not do the job. If only they could! The CBT is a process and as such takes time. You need to be able to practice what you have learned and also for the thought habits you have developed to be changed. This will take time, try not to be impatient. We all want the horrid feelings to go away, and they will, but by focusing on them you give them power over you. Remember Claire Weeks says 'let time pass '
I know you are a dynamic man who prefers action to inaction and that is good but also remember that you are looking for a lifetime change and not a sticking plaster.
Look to the process and not the outcome, you are in the process now, the outcome is in the future. Now is all there is.
xx
Hi Poet
I think you hit the nail right on it's head, about the lack of any support system after the CBT.
One of the big issues I have, you may even resonate with me here, is when I do feel well, I am quite happy to fall back in to the life I am most comfortable with. Upon finishing my CBT, there were weekly aftercare meetings, which I did attend for a few weeks, but then found it unneccessary. Big mistake.
One of my 'feed the anxiety' behaviour is that I tend fight it alone, to the point that no one at work are even aware of my current condition. I do need support, but having lived with a anxious person for a long time, my family tend to be sympathy-fatigued now. What we need is a person we can relate to. This can be difficult for us blokes at best of times. Talk to me about the pro and cons of a Beemer being the best drift machine, I will quickly become your best mate.
As for using a med as a support system whilst working on your self, I applaud you. You are well read and certainly have a very strong belief in yourself. As Mirabelle rightly says, that recovery is an inside job, no quick fixes, but a long hard but ultimately satisfying journey. If this requires someone to hold your hand, be it be therapy, meds or whatever, hold it tightly.
btw, your post contents seem to suggest that you may not need to start CBT from scratch. You have a brilliant understanding on thoughts, behaviours, emotions....
On a different note, I too am looking for a local CBT therapist. I have nothing to loose, My short love affair with Mirtazipine is finally over and I am speking to my consultant on a review of my medication. I have had some pretty good times whilst I was with Cit. I have had many meds over the years, but Cit was probably the best tolerated for me. Sadly, like all meds, they ultimetely poop out on you
Hi, am back at work using my phone so short reply!
Regarding the meds, I realise I have a big problem with them, a health anxiety-related knot that must be unbundled. I phoned Anxiety UK for some reassurance and advice regarding CBT and general health anx. Once again it was a fantastic call which considerably cheered me up. I'm not even bothered about being at work today!
Ash, it sounds like you respond well to therapy. It's a crying shame that you slipped back a bit but it's entirely understandable. Loads of us stall our own recovery by quitting therapy, self-help etc when we start getting better; who wants to carry on using coping techniques when they're feeling good? It just reminds us of times we felt bad, which makes us think we're gonna relapse. (This is what I am hoping CBT will help to resolve.) You are very far from a lost cause mate. Get in touch with Anxiety UK.
Mirabelle, I will reply more fully when I get a chance, but thank you!
Quick update to the above post. I've got my first support group meeting tomorrow at 10am-12pm, then it's straight to work from there. It's gonna be tiring, especially as I am waking up early most mornings, but if it helps, I don't care about being tired! Today has been the most anxiety and tension free day since I last had CBT. I totally relate to Ash's post about slipping back into anxious habits and I hope to learn how to stop that from happening. It's mostly the lack of tension which has made the difference today; it's been the tension that has been the worst part.
Mirabelle, I discussed something similar to what you said with Anxiety UK this morning. I am always leaping ahead in my thoughts, usually to unhappy conclusions, and if I can stop doing that... Well, it'll be a better life, that's for sure!
Hi Psychopoet
have you tried out the online cbt4panic program recommended here on NMP?
it helped me more than I can put in to words
http://www.nomorepanic.co.uk/showthread.php?t=91696
it's simple to understand, even funny with the illustrations, and you get sent a mini booklet to help you when your out and about incase you have a panic attack. Absolutely brill.
Hi Poet. It true that we are fortune tellers of the worst kind, always foretelling the bleakest outcome.
I think you had a good day today because you are looking at your issues in the CBT sessions, sometimes the ideas need to 'sit' with you for a while, your mind works on them in the background. It's the same mechanism that causes the anxiety, this is why thoughts seem to come out of the blue; they rise up from your unconscious where you have been working on them. Give your mind chance to work on the CBT and repeat the exercises as often as you can, I think that this blots out the anxiety thoughts.
Glad you had a good day, I wish you many more.
xx
theharvestmouse
28-12-11, 19:39
I'm over half way through my CBT and I have made some progress already that I have applied to life situations and it has benefited me. Although I am taking Citalopram, but I do not have a problem with this, I do wonder how I would be without it now though. But as people have said the meds and CBT are a helping tool to help us on our way, what we do in our lives is down to us.
My therapist has told me to do things that I have been avoiding, and I have already started doing this, so progress is being made. However I also fear that it will be a short term recovery, I have recovered to a decent level before and then suffered a setback, hence why I am now taking meds and doing CBT.
Its difficult to say how I will be when i finish the CBT sessions, that will be a testing time. What scares me the most is thinking about when I finish the CBT and then start trying to get on with life. But my therapist said the last session is all about how to cope with a relapse, so I hope that I will be able to deal with setbacks. Deep down I know that theres a good chance that I'll suffer one because thats the way this illness has been for me.
Hi Harvestmouse
keep in mind that every session of CBT is part of how to cope with a relapse. Everything you are learning will be useful later on. Don't worry - even if you slip now and then you will never totally forget what you have learned and can pick yourself up again. This is also why it is so important to take lots of notes during your treatment so that you can read over them after therapy is finished.
The aim of CBT is to turn you into your OWN therapist. Think about what you have learned so far and imagine explaining it to someone else who is going through similar difficulties - you probably could. All you need to do is to go over it all again for yourself whenever you need to.
Anyway - glad that the CBT is helping :)
Robin
Hi everyone, again I am having to sneakily text at work so please accept my apologies if it seems I am ignoring your replies. I went to the No Panic self-help group today. At first I was highly nervous and my anxiety increased a lot in the first fifteen minutes. We all had a chat and a cup of tea, then we introduced ourselves.
Then the facilitators gave us a brief overview of CBT and Mindfulness. We discussed how thoughts, feelings, behaviour and our physical responses keep us in a negative, self-reinforcing loop, and used a visit to the dentist as an example. Then we had a 15-minute relaxation session listening to a Mindfulness cd.
I actually learned some important things about my anxiety:
* I don't fear my own thoughts, it's just the negative ones (obvious perhaps, but today actually demonstrated it).
* Taking 10 mins out of the day to relax is not scary or impossible and in fact offers tremendous benefits.
* I haven't "lost" the ability to do things, I NEVER HAD THEM due to the anxiety being so long standing.
theharvestmouse
30-12-11, 09:01
As part of my CBT I have to fill in a thought diary daily as well as a positive log where I write down my progress. This has helped me, often when you read it back its sometimes as though it was written by a different person. Even on the Citalopram I still find that I am very up and down, I suppose it depends on events in that day. But even if I do the same things, one day I can feel positive and the next like everything is hopeless and the suicidal thoughts come again.
I also sometimes get triggers from things that can change my mood, these are the worst because I can be having a good day and bosh one of these triggers hits me and it then changes my whole day.
Hi Poet,
I am glad you have 'discovered' some things about you at your session. Isn't it great that small but vital parts of our behaviours can be rationalised.
I found these CBT sessions to be very useful in pinpointing some of my behaviours. The tough one is to be able to practically & consistently apply these on a day to day basis. The overwhelming and overridoing notion is to fall back to what I am used to. I have found this to be the biggest hurdle out there in the real world.
You also acknowledged that dedicating some time to relax is quite satisfying. I often found that spending time with my own thoughts a terrifying ordeal. I got lucky as I did make an effort to attend some buddhist meditation classes. It is far easier to relax in a guided environment. Today, I do spend some time meditating in stillness, but more often with some guided commentary. Again, the benefit of this can only be realised through regular practice.
Poet, I have a really good realaxtion guides, ping me if you need to send them to you
The need to work towards getting better has to override everything else. This is missing in me. I have met people with far greater issues get better, since they have put everything on hold while they work on themselves. One even gave his well paid job up. I applaud these guys
I have been looking at CBT4panic, anyone with positive experiences ?
Hi, another quick reply, didn't have time to get online before work. Sorry if I once again miss some replies, i'll make up for this tomorrow, I do read everyone's replies. Ash - the CBT4PANIC is apparently very successful but is more aimed at overcoming panic attacks. Try www.livinglifetothefull.com or google No Panic as they offer online CBT. Also everyone is strongly recommended to speak to Anxiety UK as they provide a terrific helpline and cheap therapy (all kinds).
I have got more to say than I have time to respond so I will just say it's been a time of shocks and revelations, and I am still off the cit. CBT tomorrow.
cathycrumble
30-12-11, 15:18
Hi poet glad to hear the CBT is going well I am waiting for mine to start.
Also thanks for telling us about Anxiety UK just phoned them and was very positive.
I took a 10mg of cit 2 days ago and OMG I was ill so I am not taking anymore I havnt been too bad but I thought the cit may help give me some calm. I was on them last year and I suffered the SE and they did help me infact I felt so good, I came off cold turkey and went back to being ill again.:mad:
I know anti depressents are just not for me so I have to do other coping stratagies. IE Claire Weeks and hopfully CBT and putting the positive thoughts into practice. not easy but it can be done.
Cathy xx
Hi Cathy, thank God, after me talking about Anxiety UK for months someone has finally rung them!!
I'd rather pay for therapy and get it now, not in 2 months when the anxiety has taken root. My employers are actually accommodating me so I can finish early to attend that self help group in January. Also a situation I was finding very distressing has been resolved and that has reduced my general tension level.
I guess an anxious person is more afraid of themselves than anything else. After all, our upsetting thoughts and feelings originate within us - they don't come from the outside world. This seems like the central philosophy behind CBT. We learn to cope with ourselves, then there is very little the real world can do to stop us!
cathycrumble
30-12-11, 20:17
Do you know that has just clicked with me lol what you have said "After all, our upsetting thoughts and feelings originate within us - they don't come from the outside world." We put the fear in these thoughts. That's something i must learn to realize.
Cathy xx
Right, epic reply-to-everyone time.
Mirabelle:
If I get a chance I will PM you but I literally don't have enough hours in my day at the moment. I think you could help me quite a bit. Thank you for your continued support and reassurance.
Theharvestmouse:
I have read from a few (not many) NMP members who have relapsed after CBT. In most cases this took months or years to happen. They didn't state exactly what caused it. They were very positive about the CBT and all of them went back for more. While therapy is extremely useful, it isn't a guarantee that life won't get us down from time to time; we have to accept that we will always be more vulnerable to anxiety and depression than most people, but we learn coping skills to help us with this. Everyone has something they are vulnerable to!
The "final" session of CBT does not have to be the end. If you're getting it through the NHS, consider going through Anxiety UK and paying for your therapy. Anxiety UK's therapists are considerably better than other counsellors I've seen due to all of them having extensive experience with anxiety, depression, OCD etc. They have heard your story a million times before and come across as a helpful, confident lot who do not doubt that recovery is possible. You can extend your therapy as required. I think that you should ask your therapist to reassure you about the relapse prevention aspect. They will only be able to teach you this new skill once you are making general improvements in other areas. You cannot be taught to avoid a relapse until you are strong enough to be classed as recovering or recovered.
Ash:
I said to my therapist today that it's been 3 years and I am still constantly finding things out. If I was doomed to be like this for the rest of my life, I wouldn't be discovering so many important new things, I'd simply be sitting stagnant. I would recommend a self-help group to anyone, it can really help to relieve some of the tension and can be very eye-opening!
I am also at the stage where being alone with my thoughts is frightening and upsetting. But this is all a distortion of what's really going on. I realised I am not afraid of me, I am afraid of the negative thoughts, and since I don't have a fully effective coping strategy yet, I am basically at their mercy. I would imagine this applies to nearly everyone reading this. If we had effective means of coping with them, why would we fear them? We wouldn't, at least not to the point where the fear became distracting.
Think about what it would mean if we were relaxed and happy in our own minds. We weren't constantly brooding over problems, we weren't afraid to think certain things, we didn't have an unpleasant bundle of tension clenching in our brains.
I have been there, I was like that just 4 weeks ago, and I can tell you it never occurred to me to be afraid of myself. That's the reason I came off citalopram and decided to end my counselling. I had been like that for months. I was happily sitting on my computer writing stories, I was spending time with my new girlfriend (another benefit of months spent anxiety free), I was doing well at work.
When we stop fearing ourselves, we learn to live with ourselves.
I guess that is what recovery really means.
Cathycrumble:
If citalopram helped you in the past, why is it not for you? 2 days is nowhere near enough for it to help you. I do believe, though, that 2 days is enough for it to make you feel like crud - but that's the thing about medication, only a few of us seem unaffected by side effects. If we were in good emotional health we could probably deal with it. SSRIs and all the rest simply provoke our anxiety and make us even more aware of our bodies and our thoughts, which at our stage is a really bad thing! But with a support network like Anxiety UK and a therapist, and your self-help stuff like Claire Weekes, you stand an excellent chance of riding out the rough first weeks.
My therapist today said that if your anxiety is bad, persistent and occurs every day, there is nothing wrong with speaking to your doctor about medication. She said, and this is the common view at NMP, that medication is more of a sticking plaster than a cure. It will never cure your problems. It simply takes the edge off your anxiety/depression/OCD so that you can learn skills to cope, then recover, and ultimately prevent a relapse once you wean yourself off the meds.
So if more of us could view medication purely as a useful tool with many advantages and some early drawbacks, and look to ourselves to provide the cure, we stand a fairly awesome chance of getting better.
Hi Poet
I'm happy to talk whenever. Happy new year.
xx
For anyone who is wondering whether CBT has been effective, I have learned tons of important things after only 3 sessions. I'd recommend CBT, but it can be a lot of work and at first it can be quite daunting as you realise things you never consciously acknowledged.
theharvestmouse
07-01-12, 19:55
Thanks for the reply Poet, only just saw it now. I will consider looking at carrying on with CBT, I think it might be useful. My therapist on the NHS has been great and I have learnt a lot with her.
She's done her bit now and its up to me to stop hiding and go out there and try to get my life going again. The only part of my life which is ok at the moment is work, while I am grateful for that, the other areas in my life that are lacking are the most important.
Right now I'm fearing going back on there again doing things and meeting people, my therapist said she thinks its my fear of rejection, and she's right. Its that and the fear that I will realise that I have not made a recovery and that could set me back a lot.
Bit like in the game snakes&ladders, you get to the end and a few spaces from the end was that huge snake which took you back to the beginning.
theharvestmouse
14-01-12, 21:00
So I have finished my NHS CBT sessions, I was fortunate to have a great therapist who I really connected with, that made all the difference. I was sad to say goodbye to her in the last session, but she's done so much to help me and now its up to me to go out there and do it!
Just jumping in on this, i did the CBT4panic last year and it worked for me, after 5 years i am finally able to take my little girl to school on my own i was agoraphobic, probably won't work for everyone but it did for me, i haven't relapsed even though i am going through a real tough time at the moment, if anything i have grown stronger through it.
Wish you lots of luck PP, stick with it.
di xxx
theharvestmouse
17-01-12, 08:50
Quick update, last night was my first real test on how the CBT has had any affect on me.
I went to an Art life drawing class for the first time. I coped a lot better than I thought I would, I was much more like my normal self, yes I am still taking Citalopram but the whole evening was a major step forward for me. When I came home I felt so pleased that I had done it and am now planning to do more things.
theharvestmouse
18-01-12, 19:08
2 days on from my best day in ages and I feel like I have lost that good feeling I had on Monday night. I had a real positive feeling after doing the art class but today has been bad for some reason. The anxiety has been here, I managed to get through the day but just feeling a bit down and some of the bad thoughts came back.
I have been trying to stop them and just be positive but its so damn hard sometimes. It feels like its not me sometimes, its like a switch inside my head that I have no control over. And now that my CBT has finished I can't talk to my therapist about it. I have just been trying to think what she would say to me.
Who knows how I'll be tomorrow, want to get back to how I was on MOnday night.
theharvestmouse
20-01-12, 22:48
So 2 days on from my bad day and I've managed to get the positive feelings back just through thinking about what I am doing next week. Got my art class on Monday and then I'm going to a yoga class on Tuesday, never tried it but looking forward to giving it ago.
Ive just started CBT myself last week and very sceptical about it now one session didnt do anything and Ive got some homework to do , but one of my issues is I suffer very bad from apathy as well as my deep depression and anxiety issues
At one point I felt tears rolling down my cheek , not that she had said anything that had upset me , it was a thought that entered my head ... not a good one but I felt good that I had reacted to it , kinda of made me feel hey you still got emotions so perhaps something in it
I feel at times if I could just cry a while I would feel so much better , the tears I shed despite being so few were the only ones that ever came in the last year , Im so depressed at times I just cant for some reason its as if something wrong with me, pyschologist believes I have lost the art of basic coping skills.
3 years of working 18 hours a day and 7 days a week had basically broke me , I was working like a machine work work work ....
anyway like you Im sure not going to be easy but as Ive said to everyone I will give anything a go to try get my life back and I wish you well
theharvestmouse
23-01-12, 22:40
Well tonight I'm feeling quite down and the old feelings came flooding back and its very scary how quickly I can go from feeling pretty good and positive to very bad and thinking suicidal thoughts again.
That is what really worries me, I was ok this afternoon and then I went to my art class and whatever chemicals were in my brain last week were just not the same tonight.
I wonder if its to do with adrenalin, last week with it being the first class and me just going in not knowing what to expect of how I would feel, I had the adrenalin pumping.
Just not feeling the buzz I felt last week after I had got home, I feel things will just be like the old days and I will do this course and at the end I'll be the same anxious person.
Hope I feel better tomorrow
theharvestmouse
31-01-12, 13:38
Was much better last night, a lot less anxious, feel good that I'm doing things and not letting the anxiety stop me. I know this is going to be tough but I will just keep going.
theharvestmouse
05-02-12, 18:55
This weekend I have had feelings of positive anticipation about the coming week, I have quite a busy week lined up, trying more new things. I've realised that even in the 3 weeks since my CBT ended my attitude towards things is changing. Whereas before I would have a feeling of complete dread about going to something new that would just make me panic I now feel more excited and just nervous (like normal nerves).
sickandtired
05-02-12, 19:00
oh im so glad the cbt is working for you.....i have my first session on the 14th feb
im still so mixed up with my emotions,one minute feel positive and hopeful......the next just numb and in shock i suppose
even though i feel alot calmer than a month ago,i still worry that something will happen and trigger the whole panic thing off again......
Hi Harvestmouse, it can be surprising how you can seem to have a massive backward step, but you need to keep reminding yourself this is a combination of bad memories and bad thought habits. Blips might occur more and/or seem more severe as the therapy kicks up bad feelings, so remind yourself often that thid is a normal and necessary effect of treatment.
If talking or thinking about something makes you feel worse, let your therapist know, as this means you've probably found something important.
theharvestmouse
15-02-12, 11:11
Hi PsychoPoet,
I've finished my CBT and so not have therapy and more so this is something I have to cope with by trying to use the things I have learned. I've learned to block out certain thoughts because I know how damaging they can be, that said its a constant battle and not easy.
SickandTIred, I hope your first CBT went well!?
HarvestMouse, sorry, I missed the part where you said therapy had finished. What did your therapist teach you with regard to relapse prevention? It must be pretty scary facing the world on your own through new eyes, but when you're recovering as well as you are, scary is just another part of the job :)
I try to keep in mind that anxiety and excitement are exactly the same physical sensations seen from different viewpoints. It certainly helps (at times) and allows me to regain some sense of control.
I have had 7 sessions now which have mostly been theory. We are still looking for a "way in" for exposure therapy to tackle my deepest fears. Every time I spend half an hour in my room listening to my worst fears looped back at me, it does have some minor effect at first but I feel kind of divorced from the scenarios I am trying to imagine. It's like, I recall how scared I was when I thought I was having suicidal thoughts, but when I try things like [NOTE: Some people may find this triggering] "I am scared of depression which I believe will lead to suicide, which leads to death", I can't seem to recall how scared and confused I was, or the shocking effect it had on me physically (release of adrenaline, going into a massive blip). It's like I am watching a film starring someone else.
On the other hand, this does make me feel better in some weird way, and my therapist reckons that's my subconscious working on the exposure therapy. She says therapy doesn't have to have some big dramatic effect, it can be little changes that we don't notice at first.
SickandTired: If your therapist is halfway decent you may find yourself making considerable progress after only a few sessions. Try to comply with the therapist. Tell them if something is painful. Don't be shy - I walked into the room on my first session and burst into tears straight away!
I am going through the exact same fears as you at the moment. I tried exposure response therapy this morning but felt so much worse. I have posted a thread in OCD section about it.
I am terrified of becoming suicidal as I have had intrusive thoughts about self harm that have scared me senseless. So now my fear is that having anxiety will cause me to be depressed and will want to die.
So when I tried ERT this morning I was alone in the house and allowed myself to think depressing thoughts whilst looking at my dressing gown cord. I had to leave the house. I felt so much worse after it. I don't know how to tackle this one and I so badly want to because I want to enjoy my life again.
theharvestmouse
17-02-12, 15:36
Overall I am doing well PsychoPoet, my therapist basically said that I should come to terms with a setback happening, but just to try to carry on and not let it affect me. Also to carry on with my thought diary and relaxation exercises. She more or less said that there will be setbacks and I have to almost accept them but not let them hold me back.
As it happends, the last few days I have felt anxious, I don't know why its come back now because I have been doing well. But it has and I have to deal with it, I know that it can go as quickly as it comes.
Its when it comes back that I start thinking the suicidal thoughts again, sometimes I think weird stuff like if I kill myself it will be almost to spite the anxiety. Its also like I want to say "ok world you are a piece of sh*t and I don't understand this life and never really have so I'm done with it, you win".
But I have other days when I think that I could never do it because I do have a lot to live for, I have to keep telling myself that I am not far off having the life I want.
Hi people, here is some info from a post I made in the mirtazapine forum which may prove helpful:
Exposure therapy for anxiety
Assuming your anxiety is not caused by a phobia eg agoraphobia or arachnophobia, where therapy would directly expose you to the object or situation you fear, exposure therapy involves you recording a "core fear" - something which is very triggering to your anxiety (but NOT your depression, if any).
So if you are afraid of your physical symptoms, someone might find "I am terribly afraid of my headaches, they mean I am seriously ill" would actually help to reduce their fear of the headaches over a period of time.
Exposure therapy typically requires 10-12 hours to be fully effective and it takes place over several weeks. My therapist recommends no more than three one-hour (at most) sessions. A session ends when your anxiety level returns to what it was before your session, or your anxiety drops to lower than that level. This can take quite a while but doesn't always.
Sessions should not be terminated while your anxiety is increased as this is how anxiety takes hold of people - they flinch away from it and never learn that anxiety dies down after it reaches a certain point. You can change which thought you expose yourself to if you don't experience any increase in anxiety. So if the headache thing doesn't make any increase at all, it is not a "core fear", it is merely a symptom of a core fear. You could try "I am seriously ill and I am going to die" for example, since health anxiety is simply an expression of the fear of death.
Exposure therapy for depression
NOTE: This information is for people whose depression is related to or caused by anxiety.
Exposure therapy should never be used to tackle depression or depressive thoughts unless a carefully managed plan has been agreed with your therapist. There is a very real risk that depressive symptoms can increase if you directly expose yourself to feelings of depression or thoughts that will trigger your depression. For example, if "I am worthless" is a "core fear" which is the reason behind your depression or depressive feelings, you cannot simply sit there listening to it repeated over and over.
So while you CAN expose yourself to feelings of anxiety, you CAN'T expose yourself to feelings of depression.
Instead of exposing yourself to depression, you should try to identify what CAUSES you to feel depressed, and then challenge that - you don't simply feel depressed for the sake of it, there is something working behind the scenes.
So if you feel depressed because you think you are worthless, you could instead try to listen to POSITIVE looped thoughts: "I am loved by my friends and family because I am a good and worthy person." You boost your own morale and start to strengthen your sense of self-worth by challenging the "core belief" which causes you to feel depressed.
Alternatively, if you know (and your therapist agrees) that your depression is directly caused by anxiety, you can target the anxiety using exposure therapy, and as the anxiety gradually starts to lift, the depression should start to clear up as well, since they are connected.
This means that whether your main problem is anxiety or depression, you could clear up a large number of symptoms in one go provided you have a very well thought out treatment plan. This is why exposure therapy should be aimed at destroying negative "core beliefs" or preferably changing them into something positive, rather than dealing with every single negative thought that arises. It is also why people have so many blips and relapses; if you don't kill the core fear, then no matter what else you do, it's only a matter of time before it comes back to bite you on the arse.
Thanks for the info.
I think this is we're I went wrong today then. I was focusing in the depressive thoughts whilst alone in the house. It made me feel a lot more anxious. Because I fear that u will become majorly depressed, lose the will to live I am not sure how I would tackle this with exposure.
When I only had the thoughts of stabbing etc exposure worked realy well for me as I just held a knife an tried to convince myself to do it. It cause anxiety but that faded quite quickly an those thoughts never bothered me again.
I realy don't know how to tackle this worry.
theharvestmouse
18-02-12, 12:17
Its a very complex issue, especially where the suicidal thoughts are concerned, I don't think there is any set pattern and maybe that is what makes it the unkown and all the more scary.
FOr instance there are people who kill themselves without ever really thinking about it before, and then something happening and within hours they go and do it. THen there can be someone who has been suicidal for months or years but for some reason they just never go through with it. I suppose there could be a fine line between a vague thought of suicide and just doing it, that's what scares me. What if I one day just cross that line without really controlling the feelings myself.
Yes this scares me also. It's a thought that makes me feel sick at the moment. I can't stop thinking about it and it scares me. I know I don't want to die I just want to get better. The thought that I would do that to my family sickens me.
Scared11 - what I have learned is that my fear of "going mad" through anxiety or depression and killing myself is not the same as being suicidal. There are some very complex issues going off that all interact with one another. The idea behind CBT is to ignore the symptoms and instead go for the core issues, since the core issues are what generate the symptoms.
So in your case, you would NOT be classed as suicidal. "Suicidal ideation" could best be described as imagining doing it with the intention of actually going through with it, or considering actually doing it without making an attempt - the point being you either want to do it, or are trying to make your mind up about doing it.
"Suicidal thoughts" doesn't mean that much on its own. People think that if they think of suicide, it means they are suicidal, or doomed to one day become suicidal. This is completely wrong and is not based on any kind of logic. It is an irrational fear. If you read an article about the police and imagine yourself as a criminal being pursued by the law, that doesn't make you a criminal, nor does it mean you are now fated to somehow become a criminal, nor are you suddenly being hunted by the police. So why would imagining an attempt at suicide be any different? It isn't, and this is the key to overcoming your fear of such thoughts.
Death is one thing common to all humans and it is an in-built fear we all share. If we didn't fear death, we would put our lives in danger on a regular basis and our species would not survive. However, some people suffer from a fear of death that is more intense than "normal" (normal meaning it is a fear which occasionally occurs but does not cause prolonged or undue suffering). A fear of suicide has the fear of death hiding behind it. What you probably haven't considered is how your fear that you will somehow suddenly becomes suicidal implies that you will somehow lose control of yourself. So a hidden trigger for your thoughts/fears about suicide is likely to be that you fear losing control over yourself.
You might never have thought that consciously because you're so busy suffering the fear and guilt about your thoughts of suicide. So you don't notice the hidden issues which are pulling all your strings. You then concentrate on reading about depression, reading about suicide, become hypervigilant to all mention of the subject, and you feel like you're going crazy - you believe your fears about suicide are becoming a self-fulfilling prophecy. It doesn't come true, of course, because you are not suicidal, you merely fear that you might be one day. You fear (without realising it) that you will lose control, yet you never lose control.
On the other hand, fear of suicide may simply be an expression of your fear of death. It's likely that you are experiencing symptoms of health anxiety by worrying about your mental health suddenly deteriorating to the point where you die. The fact that you fear you'll commit suicide is probably irrelevant. Your fears are of your mental health, of death (health anxiety is an expression of your fear of death), and behind it all you fear losing control.
Do you find yourself holding onto your thoughts and emotions very tightly? Are you scared your thoughts and feelings will run away with you - like if you get mad with someone who is pissing you off, you'll end up shouting and screaming and crying and being violent, then you'll suddenly become suicidal?
If so, you should strongly consider a treatment plan which will help you regain confidence about your ability to control your own destiny. You won't fear suicide anywhere NEAR as much if you know in your heart and soul that you are not suicidal and never will be. Also, since the fear of death (which is linked to health anxiety) seems to be a major point for you, you should consider discussing this with your therapist. As Dr Claire Weekes continually stresses, "Acceptance is the key" - you will never entirely lose your fear of death because it is hard-coded into you to keep you alive! You are not SUPPOSED to completely lose that fear!
God and nature and evolution determined that the best way for us to stay alive is to be conscious that we aren't immortal so we take logical and rational steps to protect ourselves. You've taken some mis-steps and you've come out of sync with your nature. That's where CBT comes in.
EDIT: Can you see how complex this whole thing becomes? The longer you have been a victim of anxiety/depression, the tougher it becomes to un-learn your bad thinking habits and replace them with new ones. The key is to gradually, through discussion, analysis and attempts at exposure therapy, find out your core fears (of which there probably won't be that many) and then attempt to address them directly, one at a time.
As for exposure therapy for depression, as you can see from this epic post you're going about it the wrong way. Instead of trying to summon up feelings of depression and overcoming them through brute force, challenge the negative core beliefs which cause the depression. "I am terrified of losing control" could be a place to start and you can work from there.
Thank you very much for taking the time to reply to my post. I have had a quick read but will read it again properly later on.
It's such a relief to hear from someone who has experience and knowledge with this particular worry. I keep telling myself that's alls this is, just a worry, a horrible 'what if?' thought. And a confusing one at that. When u feel down and these thoughts worry you, it's easy to think, 'am I actually suicidal now?'
I even called the samaritans today looking for them to feel me I was not suicidal. They didn't, they just listened to my worries. I explained about my OCD and my fears of what may be but I am sure I just made the poor guy confused as to what to say.
I know deep down that this is just linked to my fear of death, I have had health anxiety forever. And I am obsessing over it (my OCD).
Your completely right when u say I probably cling on to my emotions. I do this all the time. If I am feeling down I search for why an look for something to cheer me up as soon as possible. And if I feel happy and positive I always question why and it's not long before the negativity starts again.
I have never taken medication as I am very worried of the suicidal thoughts side effects. I am considering taking them though. I had CBT for this last year which finished in April but feel I need to go back. I feel scared my this as I feel it's too soon as I should have been better for longer. But u suppose if I need to see a therapist for the rest of my life then so be it. I know life can be better than this.
Thank you for reminding me of everything I already know, we all just need reminding sometimes.
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