Therapy on the NHS for Anxiety - help!

[Jellybeanz]

Hi all,

Mainly a lurker on here, so this is my first post. :S I’ve only really forced myself to post anything at all because my situation is getting pretty desperate. As of the moment, I’m not diagnosed with anything - I’ve never talked to anyone about my anxiety. I like to keep it covered and hidden away for my eyes only – if I can manage. The only aspect of my anxiety I’ve sought help with is the hyperhidrosis (tried iontophoresis, botox - was very near to having THAT operation) but I now know that it’s just another gift off good old Aunt Anxiety. I gave up treatment on it after that realisation.

The very idea of seeking out help for my anxiety terrifies me. The thought that someone else will know about it – discuss it with others, analyse it, criticise it. I know I really need help, but I don’t feel I can trust anyone. Though, the need for help is getting more and more urgent. I’ve had a bit of a drinking problem for the last few years. Mainly to help make situations less daunting, and while it was initially quite helpful, I’m now drinking a dangerous amount of alcohol every day and I think my body and bank account are starting to protest. I’m desperate to stop, but facing any potential difficult or new situation just makes me reach for the bottle again.

That said; I want to know if I was to go to my GP and ask for help… well, first off I’d like to know a non-awkward way of telling him about it – I doubt there is one! More importantly, I want to know about confidentiality. I’ve completed a few job applications recently, and there’s always a medical history check to complete. By confessing all to my GP – will potential employers then have access to this information? I’m a 21 year-old graduate hunting for a job, I highly suspect ‘social anxiety’ and ‘alcoholism’ will look good on a medical record. And I have this awful mental image of an interview turned even more terrifying with questions about ‘my mental health.’

If you have any experience NHS treatment of social anxiety disorder I’d love to hear from you. I feel like I’m about to enter the Twilight Zone.

Thanks for listening! And er, nice to meet you all. :)

[Jsp]

Firstly, don't be scared about speaking to your doctor about this. Anxiety is a real problem, especially when alcoholism is involved, and they will understand your problem, and try and give you all the treatment available. To be honest, they won't even say much, just ask you how you feel in certain situations which induce your anxiety, and what symptoms you get. They face patients like this often as psychological disorders such as anxiety and depression are extremely common, so do not feel embarrassed for admitting up to this and your symptoms.

They will most probably refer your towards counselling first, before giving you any medication (these are also highly addictive, so they try to steer people away from these.). Only problem is that there is a huge waiting list for counselling such as CBT, has taken me about two months to wait for it! I haven't started my counselling yet, but from what I know they normally give you CBT (Cognitive Behavioural Therapy). This refers to a type of counselling which aims to change the way you think and react, especially in situations that induce your anxiety. Your counsellor will ask you what makes you anxious, and why it does, and will challenge your viewpoint, eventually changing your own views, abolishing your anxiety.

If you have extreme physiological reactions like I did, such as raised blood pressure, increased heart rate etc. then your may doctor prescribe you with a beta-blocker, such as Propranolol and Alpranolol. These work directly on your central nervous system by clinging onto the heart, slowing it down, which will inevitably lead to yourself calming down. Although these do tend to make you feel drowsy, and could even make you faint. Other than that, they are relatively safe. Another type of treatment is the use of benzodiazepans, such as Valium. These work directly on the brain (to be specific, within the neurotransmitters) and will enhance your mood and chill you out, but they are HIGHLY addictive and are normally avoided, unless only needed for short term management (e.g if you think you're about to die and your heart rate is like 130), just to temporarily calm you down and enable you to rest.

From this they will also help your alcoholism, which may be rooted within your anxiety problems. From experience, doctors and nurses from the NHS seem extremely helpful and kind towards those suffering from anxiety or other psychological disorders, and will understand what you are going through completely. Do not be scared, they are there to help and will not judge you.

And as any medical service, all the information is completely confidential. It is against the rules for your doctor or hospital to give information on your health to other outside sources.

I'm not even sure if I've answered your question, so feel free to inbox me if you have any more queries. Or just want to chat :)

[Sootica]

Hi there, the best thing is to see your gp and maybe say that you've come to ask for some advice as for a while now you've been experiencing severe anxiety and have been self medicating with alcohol. Explain that the anxiety has thus far prevented you from stepping forward, but that you want to get back to healthy and this isn't happening so could they help you, ideally with some kind of talking therapy.
Go to a gp you feel is intelligent and will listen to you, don't try to underplay how unwell you have been and how you are struggling, as funding is in short supply and you really have to force yourself to get up and blow that whistle (like kate winslet in titanic) or you're at risk of being left at sea!
They will likely offer you medication first in the form of SSRI's, Trycyclics or SNRI's - if you are extremely stressed, they may offer you a short course of a fast acting Benzodiazepine drug such as diazepam, lorazepam, librium etc. These are short courses (1-3 weeks) as are highly addictive.
With the OTHER drugs mentioned above, they are not classified as addictive, but you can get withdrawal symptoms so is always best to taper off slow and consult doc before you make any changes, they work by building up in your system so and can take a few weeks to effect any change. It may be trial and error as to which drugs suit you best. Obviously, try not to drink with them at all - this is where you must be honest with your doc about the likelihood of you staying straight while on medication - as the two do not mix well and your poor old liver will suffer for it.
The reason I mention the medications first is because they are cheaper than therapy so this is most likely what you will be offered first, you should certainly ask for therapy and make a point of saying this is what you would like or you may be fobbed off with a packet of SSRI's. Not to say that meds don't work, they can help a lot, but usually better in conjunction with talking therapies. Depending on where you live and what the budget is like there, you maybe referred for counselling, CBT or psychotherapy (the latter is expensive and they are not keen to refer people for this unless they are obviously headcases like me - I jumped up and down and yelled help and went to A & E and asked to be put into a shelter and there was nowhere to send me, I was out of my mind over half the time, but the waiting list was a year for psychotherapy and they felt admitting me to a psychiatric ward would worsen matters - so I got lorazepam and got addicted in the waiting time - was only drug that helped at the time after trying many others on prescription over several years - it was the lesser of evils in that it kept me alive while I waited for therapy :) After therapy and a meds change switched from Mirtazapine (what is sometimes termed a novel/tetracyclic antidepressant)to clomipramine one of the older tricyclics I had at first resisted - it was a bit of an overnight transformation, heaven knows why but it clicked in with my body chemistry real good and everything became easier to cope with. I am still hooked on benzos and slowly trying to reduce, I still have dark days, but it was absolutely worth all the effort and making a fool of myself in front of many people my throwing (completely genuine) hissy fits just to get some treatment.
Please don't worry what people think, most of the time they are thinking about themselves and we all just blunder along in our own heads. There is a lot to be said for reading and writing also -CBT 'for dummies' workbook is a good book, Dorothy Rowe is an excellent author, I also find if you persist with breathing exercises like they teach you in yoga books, this can be very calming. Exercise 40 mins 3 times a week - get your heart rate up - unless there is a medical reason not to of course - this can be bopping to music in your bedroom, a run in the park, swimming, cycling, housework, whatever but it really is good for your brain. Eat a well balanced diet, doctors are not always too good on this front, but it really does create a good foundation for your mental health to blossom. Alcohol deprives your body of some vitamins as do some antidepressants, so look into this and make sure you are getting good nutrition throughout treatment.
Lastly, you've taken the first big step in reaching out - if you are really really scared of going to your GP maybe practice talking about it by calling the Samaritons or saneline first. There's nothing to be ashamed of or embarrassed about, the only people who should be embarrassed are those who are behind the times and fail to recognise we all have mental health and the brain is a part of the body that can get ill and out of balance just like any other organ.
About the careers thing, if the job requires a CRB check, I am not sure what the protocol is on medical records, but I would think it would only come up if it was pertinent to the position you were applying for. Other than CRB checks, no employers are allowed access to your medical files and it is unreasonable for them to ask you to do so. If it asks you on an application for to declare medicines and illnesses that's tough, I might lie, depends on situation - I would rather not as it just perpetuates the stigmatism attached to mental health issues, but on the other hand, it exists and the job market is extremely competitive at present. Good luck, take care and remember you can't get perspective when you're brain is out of sync, so please do reach out for some help xx

[Steve Wilson]

Hypnotherapy is good for treating anxiety..:)

[Jellybeanz]

Hey again,

Thanks for your helpful responses! They actually gave me the courage and motivation to go and see my GP about my anxiety. I was quite lucky, as instead of seeing my usual, eccentric doctor I got to see someone else who was very sympathetic and urged me to try CBT. So I’m on the waiting list for that now… have been for about 3 weeks – hope I get some form of contact soon. She also put me on propranolol, which as you said, Jsp, is helping with the physical symptoms… though my mind’s still up to its usual tricks. Not sure if I should go back and ask for something help with that?

In the meantime, I’m trying to cut back on the drink and attempting some form of exercise every now and again. I’d love to do running or cycling, but get really self-conscious just walking down a road… so it might be something to work up to eventually.

In regards to the job hunt, I recently had a big change in career paths and oddly enough am starting an NHS course this September. Though unfortunately, I do have the daunting prospect of the occupational health check to deal with in the next few months. And one of the questions did ask if I had any mental health problems… I wrote anxiety and didn’t really elaborate. Probably not the right thing to do, but I suppose the appointment will give me opportunity to explain.

Anyway, thanks again for your replies. Think I might post around here more often. :)