View Full Version : Taken a turn for the worse
Yesterday I started to be suicidal again. So I'm going to limit what I post on here because I'm in a darker place at the moment.
I have that out-of-control feeling again. I walked out the door on New Years Day without saying anything to anyone and cried in the nearest field I could find and couldn't work out how to end it because I don't have any equipment to do it with.
My friend on the phone was really good even though he was hungover.
My friend that I was actually with was very insensitive and shouted at me, having previously been out of line just before I left. She sent me a message this morning saying how I should apologise etc. I didn't get an ounce of sympathy from her in the several hours that I was crying in her presence. She stayed with me (even though I would have benefited from the space) so I know she was trying to do the right thing, but she was not very nice at the same time (you ruined the party, you're being selfish, etc).
So, a tip: if anyone says they want to kill themselves, shouting at them is not going to make things better. Directing anger and negativity towards them is really dangerous, and shouldn't be done if you want to help them.
I cannot speak to my friend because I feel that it is dangerous that she hurls judgement at me. I am so hurt by her, because I have always stood by her and been there for her. In my darkest hour she made me feel worse. I'm shocked and appalled. She has a brother with mental health issues, and used to self harm herself, so I thought that she might be a bit more mental health literate. I'm so disappointed. It highlights how good my other friend was at dealing with the situation.
I am looking forward to therapy next week. And if I get into a dangerous headspace again, I will at least be near the hospital near my house, so I can walk there. (We went away for New Years Eve.)
I don't know what I need from you guys. I'm just scared that I'm out of control, totally irrational, and upset by the reasonings in my head for why I should end it, as well as being upset to lose yet another friend. I'm upset and afraid. Some of the things I've lost - I've lost them because I have chosen to cut them out, to protect myself from unhealthy relationships. It's hard to live with that.
I'm sorry to hear that. My mum's response to my overdose was to get annoyed and send me on a guilt trip. Just making me feel worse. I'm feeling exactly the same way and very fragile.
I've got a psychologist appointment on Monday and hope I can stay safe till then :(. It sucks, doesn't it.
Glad to hear you have a plan in place if it happens again.
Sunflower2
02-01-15, 22:53
Lior, keep focussed on your appointment next week Count down the hours if you need to! Keep busy, don't let yourself dwell on your thoughts and keep posting on here. You can do this! It's going to be ok. And if you get really bad, follow through with your plan and keep safe. You've been here before and you can get through it again. Sending you a big hug! :hugs:
Sorry you had a crappy night Lior.
Write it all down. That's what I would always do. With a pad and pen you can be your own counsellor. Focus your thoughts, explore how you feel and find a handle on it. It feels good to get it all out. I'm probably solely responsible for about 1% of the Amazon rainforests disappearance due to my hunger for writing pads. It saved my sanity over and over again though. Write until you feel better.
I already wrote stuff down - more as a way of recording what I was thinking, so I could dissect it in my therapy sessions.
I've only got three more booked. One on Tuesday, one two weeks after, one four weeks after that. I don't think it's enough. Maybe she will be able to suggest doing some other kind of therapy. I'm afraid I'll have to register with a GP here and then I need to move in two months again and I don't know where I'll end up so I might need to continue travelling a lot.
I do not think in a normal way when I am depressed and I am starting to think that medication might be an option. I don't want to be in pain any more, and this has gone on for about 5 months.
When I was at uni, it felt like the meaning of life was to be giving and help others. I can't get the same joy or motivation out of that as I used to, because it all seems futile. A part of me doesn't want to believe in that purpose - the part of me that doesn't want to get better, and just end it. I can only believe in it when I am in a good enough mood already. It's not an ideal that helps me survive - it's an ideal that makes my life better when it's already ok.
I am mad and I am scared of myself. I know I can't trust myself. My inner instincts lead me to destroy and sabotage myself and the good things in my life. That's normal for me now. It's heartbreaking that I know that this isn't normal for other people.
I never used to write to record things. I wrote to calm my anxieties down.
I have spent large amounts of my life alone, alone with horrendously large anxieties. When I wrote there would be that anxious me and there would be a personality that calmed me. It would show understanding, it would problem solve, it would reassure, it would show me why it was going to be ok and it would help me understand the why of everything.
I would get it all out, what I was freeking out about, I would calm myself down and try to point me in a direction that gave me an uplift, hope, strength, self esteem etc Then I would have that.
That part of your mind is talked about in lots of places. I think it's actually the frontal lobe, our human side.
Horizon episode on anxiety explained why those with anxious nervous systems succeeded in life despite it and others faired less as well - the ability to mentally manage their anxieties. They observed the blood flow using these parts of the brain in brain scans.
The chimp paradox (book)
Are two examples off the top of my head.
This personality in your head can become everything you need.
Your friend let you down, people often do. Not many are great at being there at bad times. Whereas you know what you need and you can give yourself all the love, understanding and attention in the world. You can search for healthier perspectives on things. You can look inside yourself for what you feel you want.
It's hard to achieve all of this in the hour we get with our therapist lol
Maybe your therapist will offer you more sessions ? I had 12 (cbt) then she asked if I wanted to take up the option of another 12, which I did.
Anyway, each to their own. I just wanted to elaborate on writing and that for me it wasn't about recording. When you write you always seem to be making a journal or blog for looking back on in the future or something. It's a record. It never feels therapeutic.
Do you like yourself Lior ?
I've found things can take the colour out of everything in your life. And at other times the sun appears to be shining like the something that darkens your life is gone.
I think you can subconsciously see yourself in ways that cause this without even realising. Beliefs you hold about yourself based on past experiences.
It can put like a shade on your life that you don't even realise is there.
Helping people is a no brainer, of course it feels good, but when there's clouds above you can't feel it anymore, just like its hard to find enjoyment in anything.
Helping people is still going to be there for you when your world is a bit brighter and lighter. It'll feel good again.
Manage your way through this Lior. These things come and go. It just helps to know why. It's handy to be in control of those clouds that appear overhead. When you are ok with yourself and your world the sun shines.
Of course we are led to believe there can be a neurological element to these things. I don't know you so don't know if that's the case of even if there is a neurological element that gets put right with the right pill. But I do know you appear to have unhappiness in your past and present. Make sure they don't leave you feeling rubbish about who you are and stealing all the light from your day.
Can you remember what triggered your party walk out ?
Was the party ok up until that point ?
Unhappy with how you were feeling maybe ?
Lior, I am sorry you feel so down, but I think you need to work on how you handle confrontation. It seems like you shut down and leave when things get bad instead of sticking up for yourself. You are obviously in a bad place and when your friend yells at you, next time tell him/her how you feel and how her actions have hurt you.
If you keep these things bottled up inside, you wont improve. If you start speaking out when people confront you, I think you will get some more self-esteem?
I don't know you or the things you are going through so I could be wrong. But with all of that said, I really wish you the best and know you can turn this around. Life is worth living. Please stay strong and keep battling!
I also think it is time for you to try medication. From reading your posts, it is obvious that this is chemical in the brain as you seem to go through phases of ups, then crashing down. Medication has helped me. I used to have dark and suicidal thoughts, but since going on medication, my mindset is much brighter and positive. The only way to get rid of a bully is to fight back.
It is time for you to fight back. Nobody can improve your situation but you. I think with meds and therapy you will become a happier person.
Good luck and wish you the best!
Sunflower2
05-01-15, 20:37
How are you doing Lior? :)
I am roundabout back to being normally depressed. Thank goodness! How are you doing Kimberley?
B0yer, I actually did stick up for myself and I do have a lot of self-esteem. I have been fighting back, very hard, against depression. I suspect you might be projecting your specific problems on to me a bit too much. That episode that I went through - I didn't have a choice of what I did. It was madness.
Oosh, you are right. People do often let me down. And I am learning how to give myself everything I need. What I am afraid of is that I also let myself down. I can't trust the inner part of myself that normal people trust, because that leads me to that suicidal mad place sometimes, and I'm not good enough at recognising the patterns or my triggers in advance to protect myself.
I used to write a lot. I haven't been able to write like that for a while. I can't let myself go to that place most of the time - the place that writing will take me. Similarly I try to meditate, and I can't let myself go because it just takes me to a river of tears that I don't want to unleash in front of other people.
I love myself. Liking myself is not the problem. Doesn't mean I'm not in intolerable pain sometimes. There are quite a few things that have led me to this painful place: sex I didn't want from numerous partners, being emotionally punished by my mother for ever saying no to her, a bystander neglectful father, schooling and a society that made me value my career far above wellbeing...
I wrote the story of the night and morning here but I can't publish it, it might be too distressing for some people to read. A conversation about rape triggered things. I started to emotionally withdraw. I drank too much. I walked out the next morning after an argument with my friend, not during the party. I only 'ruined the party' because I was throwing up in the toilet, as far as I understand. It was an overstatement.
Not projecting anything, I was only trying to help.
Good luck with everything and keep fighting. You will turn a corner soon.
So it's Day 3 on Citalopram.
I cancelled a job interview. I don't think I've ever done that before. I am not focused enough, and I don't care a smidgen about getting the job, so it's very unlikely they'd give me the job in my state. I don't want to go. So I am living by my rule now of only doing things I want to do.
I sent them a very nice email with the presentation I'd prepared, apologising and saying that maybe we could work together in another capacity in the future.
It's difficult for me to say no to an opportunity, but I am glad that I did, even though I still feel guilty about flaking out. I wouldn't have enjoyed the job if I got it, and I would have felt that my time was wasted if I didn't get it.
So far in my experience, depression is not like turning corners. It's like climbing up a mountain, and slipping down every so often. Sometimes you remember how to climb up the next time round, and sometimes you have so little energy that you can't find the footholds. I'm still feeling low from what happened at New Year and I am not looking forward to living because it includes this illness, and I only care about fighting it 50% of the time.
Sunflower2
12-01-15, 13:15
How are you getting on with citalopram?
I'm similar to you in the way that I hate saying no and giving in to things, but sometimes it's for the best and I always have to remind myself that my health is a bigger priority than anything else. Keep on fighting with that 50% :)
Yes, I say that too myself too: health is the most important thing.
I suspect myself of wallowing in self pity. How is that defined? Maybe I'm not. Can I just snap out of being depressed if I try? I am haunted by stuff that has happened to me and I care about nothing. Memories of things come back to me. Then I'm trapped in indecision, and I can't move out of bed. I know what I could do - but bed is comfortable, and the other thing involves making effort. Washing my hair is a massive effort at the moment.
Citalopram is making me nauseous. Things are ever so slightly surreal and I feel a bit disconnected, but that could just be the depression, and I'm reading into it as a side effect.
Managed to get to a cafe with a textbook. Barely able to read it. Concerned that I have to be 'together' for a work meeting on Thursday. Really hope I'll be in better spirits by then - simply would not have been able to go if that meeting was today.
I suspect myself of wallowing in self pity. How is that defined? Maybe I'm not. Can I just snap out of being depressed if I try? I am haunted by stuff that has happened to me and I care about nothing. Memories of things come back to me. Then I'm trapped in indecision, and I can't move out of bed. I know what I could do - but bed is comfortable, and the other thing involves making effort. Washing my hair is a massive effort at the moment.
That describes how I am feeling. I should just be able to snap out of it and I am doing this to myself. I've been on the same position on the couch all day sleeping on and off.
I don't think it's as simple as snapping out of it. Before, I used to be an optimistic person, and I could make myself do anything. I've lost that drive, and I've lost a lot of hope.
It's more than being able to discipline myself. It doesn't make sense that I would suddenly lose all ability to discipline myself. It's just got to be madness which is out of my control.
Sunflower2
13-01-15, 08:25
When I'm not depressed I'm really optimistic.. Which makes the depression seem even worse when it hits me. Everything goes from being achieve able and great like an unstoppable feeling, to nothing. So when that changes to depression it's crazy because it makes you feel so hopeless and too weak to even bother trying. Like it's saying what's the point in trying to feel better if you're not strong enough to even try to get better.
I've found that depression lives off of you beating yourself up about feeling bad. The more guilty you feel about being depressed, the more depressed you feel. I know it can seem impossible, but I try to separate the depression from myself. I feel the way I feel and I can't change that. Although Its incredibly hard when your mind is telling you how much of a useless lump you are! Have you heard of mood management? I can't really remember it now exactly, but it's about noting what your mood is, and doing activities to either help bring it up or down. Not big things, like being kind to yourself (don't know how many people have said that to me now!!) if you're feeling low, or doing relaxing things if you're too full of energy. I've also been reading about dbt therapy.. It's for borderline personality disorder but I think it's quite interesting!
I am glad you have tried medication. If you don't do well with this one, there are others out there that can really help. I have quite a few aunts/uncles on prozac and myself on lexapro. I know it is hard at first but give it time as it can take 4-6 weeks to start seeing improvement.
When I was really down, getting out of bed was tough, but work helped me as it distracted me. Could you bury yourself in your work? Or are there things you can do to distract yourself? Have you been exercising regularly?
A good quote that helped me get out of my dark place was "whether you think you can or you can't, you are correct." It helped me stop making excuses for not running or thinking I would get through my dark place.
One day at a time too. Good luck Lior
Thanks Kimberly. I'm similar to that.
I read up on DBT therapy and I feel like I could benefit from that. My family doesn't understand why I get so intensely emotional (even though they do themselves). They get angry, and I cry. I express my emotions in a different way from them. I want to understand how to manage my emotions so I don't suddenly cry... and that probably involves learning what my triggers are, and asking people to not do things that upset me, and know how to change the situation if they persist in doing something that they know upsets me.
I try my best to manage my moods but I don't feel very capable. If I feel tired, I have a coffee, which helps a bit, but with the citalopram I just feel sleepy and dizzy all the time. I know this will pass so I'm just going to wait it out with the citalopram, I know it will take time.
B0yer I have been getting myself to yoga once a week and I try to at least get out of the house and walk a little each day.
I'm too far gone to bury myself in work. That's what I used to do. I don't have the capacity for concentration that I used to have. Can you explain a bit more about your quote? I have a problem where I don't trust myself, because sometimes I go out of control and want to hurt myself... I believe that I will probably end up dying by my own hand, whether that is soon or in decades. Does that mean I am correct? What if I change my mind? Will I be correct then? I don't understand.
Thanks Kimberly. I'm similar to that.
I read up on DBT therapy and I feel like I could benefit from that. My family doesn't understand why I get so intensely emotional (even though they do themselves). They get angry, and I cry. I express my emotions in a different way from them. I want to understand how to manage my emotions so I don't suddenly cry... and that probably involves learning what my triggers are, and asking people to not do things that upset me, and know how to change the situation if they persist in doing something that they know upsets me.
I try my best to manage my moods but I don't feel very capable. If I feel tired, I have a coffee, which helps a bit, but with the citalopram I just feel sleepy and dizzy all the time. I know this will pass so I'm just going to wait it out with the citalopram, I know it will take time.
B0yer I have been getting myself to yoga once a week and I try to at least get out of the house and walk a little each day.
I'm too far gone to bury myself in work. That's what I used to do. I don't have the capacity for concentration that I used to have. Can you explain a bit more about your quote? I have a problem where I don't trust myself, because sometimes I go out of control and want to hurt myself... I believe that I will probably end up dying by my own hand, whether that is soon or in decades. Does that mean I am correct? What if I change my mind? Will I be correct then? I don't understand.
Hi Lior- The quote has more to do with motivation around doing the things you love or achieving goals you never thought possible. It has in no way any relation to self harm.
Basically if you believe that you can achieve the goals you place for yourself, you will work hard enough to achieve them. But if you make excuses to reasons you can't do anything, then you are right and you won't achieve your goals.
Please do not self harm, this is not the answer. If you don't want to die at your own hand, then you won't. Don't allow yourself to let that happen. It is not an option, so don't allow it to be one. I know things are dark right now, but I really think the medication will help. There were times that I had dark thoughts like that and I feared that I would lose control and hurt myself, but that is just the negative thinking patterns we have. Once you combat that with CBT, you will learn that you are a great person.
Again, I don't know you or the extent of the situation you are going through, but things will get better. You are a good person and a hard worker. Please continue with the therapy and after 4-6 weeks, you will have an idea of how the medication will work for you. If you have no luck with the citalopram, maybe try esciptalopram. That is the one I am on. At first I tried Prozac, but it made me too jittery and activated me and I couldn't sleep. Then I switched to lexapro and I am 5x better and much happier. So please continue to work through this. Feel free to PM me if you need someone to speak to.
Thanks b0yer. I know what you mean now. I think in the first instance, there needs to be a positive goal to make that quote work. If you have a negative goal, it's not so useful! I have been in a place before where death seemed to be the best option.
What you say is all from a positive point of view. When I am in this dark place, it's not possible to think like that.
I've been in CBT since September. It's helped a bit, but I can't help feeling that I came back to square one over new year. I've really made an effort with CBT and to structure my days and think about things differently. There seems to be a fog over my mind and I can't think straight.
It's day 5 of citalopram. I think I'm going to get referred to psychotherapy now.
All I am asking of myself is to continue living, to eat, to get dressed and leave the house once a day. I can just about manage this. I've got a bit of work coming up which I was nervous about, but I'm pepping myself up. If I can't do it, well, my health comes first.
Sunflower2
14-01-15, 21:41
Lior I'm the same with emotions. I cry over the smallest things, but funnily enough with the big things, I just shut down and refuse to feel anything. After traumatic experiences, I take months to actually let myself think about what has happened, if that makes sense. As soon as it gets too overwhelming, my emotions are gone. So I'd also probably benefit from emotion regulation!
Even earlier on today, I started thinking about my therapy session tomorrow. I tried to think about what I've been struggling with this week and what it means about me. I couldn't even face thinking about it so I went back to revision. There are deep dark things about ourselves that keep us sucked into this negative pattern of depression and anxiety. I don't know the solution for this other than clearing them out and talking about them! have you been referred for psychotherapy? I'm getting cbt from a clinical psychologist now, but I think it's more than just cbt so perhaps that what I have? Whatever it is, my brain feels drained and pulled apart at the end of sessions!
I wish I had more advice for you, but I'd just be telling you the same things as I try to tell myself that can sometimes be hard to believe.. Keep going, don't give in, push through. But, it does and will get easier. I'm certain of that for both of us!
When I was at my worst lior I did all those things,keep going,keep eating,wash and dress every day and I can tell you from experience it will get easier
Take care and keep strong
The effort you're making is great and keeping to a routine of getting up and dressed will pay off. Good luck with the work but you're right. Your health comes first.
Thanks b0yer. I know what you mean now. I think in the first instance, there needs to be a positive goal to make that quote work. If you have a negative goal, it's not so useful! I have been in a place before where death seemed to be the best option.
What you say is all from a positive point of view. When I am in this dark place, it's not possible to think like that.
I've been in CBT since September. It's helped a bit, but I can't help feeling that I came back to square one over new year. I've really made an effort with CBT and to structure my days and think about things differently. There seems to be a fog over my mind and I can't think straight.
It's day 5 of citalopram. I think I'm going to get referred to psychotherapy now.
All I am asking of myself is to continue living, to eat, to get dressed and leave the house once a day. I can just about manage this. I've got a bit of work coming up which I was nervous about, but I'm pepping myself up. If I can't do it, well, my health comes first.
It's not uncommon to have setbacks. I have them myself occasionally. But don't look at the set back as "oh no, here we go again". Try and look at it through a personal growth perspective. Things may be really bad right now, but you are looking at things that most people shut out. Once you start to come out of this (and you will), you will be so much more mature as a person.
Everyone has set back and everyone has bad days. There are days I feel like crying for no apparent reason. But I take things one day at a time and tomorrow is a new day. A new day that you can tackle and acheive whatever it is you want to acheive.
One thing I noticed to about goal setting is not to be too broad. Don't set a goal that says, "I want to feel better". That will come in time. Try other goals like "I will go to the grocery store today" or "I will go to yoga and find 5 minutes of peace today". Then as you start incorporating those into your schedule, you'll notice that you will start to think less about depression and more about the things you have to do in the day.
Have you talked to any of your friends and caught up about their lives? Maybe grab a beer or a drink with a friend just to catch up?
Just sending everyone on this thread :hugs::hugs::hugs::hugs::hugs::hugs:x
Thanks everyone for your attention and support.
Yesterday I faced my fears and had a work meeting. I managed to get through it without freaking out. I did waffle a bit but in general I think I did ok.
Afterwards I treated myself to lunch and books from a second hand bookshop. Then I started to get worked up about what I had said, what might happen next, etc. I noticed the worries and worked hard to calm down. I focused on just doing things I enjoy.
Today I am also just going to do things I enjoy. I am not going to put pressure on myself to work. I am lucky to just be alive. So I am going to focus on living. I came close to ending my life - so now I am going to focus on the good things about being alive. Any hint of bad stuff and I start to spiral, so I am being extra nice to myself. I realise that this is a bit like an extended holiday but I guess it's worth it, if that's what it takes to get stable.
I am going to go for a wander in the edgy backstreets of Shoreditch and maybe I'll do some writing :)
Good for you lior. you are doing extremely well. I wish you all the best.:hugs:
Sunflower2
16-01-15, 17:33
Yes you are doing so well. You've got a lot of inner strength which tends to pick us up from rock bottom. Don't despair if you hit a blip, I'm starting to accept that recovering is certainly not a sraight journey but eventually we will get to a place where we are stable. Wishing you a peaceful and restful weekend :)
I'm really up and down! I get myself into a positive place where I love myself and look after myself. Then I swing into a place where I try to accept that I am a person that is doing bad things to other people in order to look after myself. This takes me to a bad place.
It goes against everything I have been taught: I am meant to be selfless and normally I am very altruistic. Who am I, if I am putting myself first? Surely I am a selfish person? And being selfish is a very bad thing to be? I've had it drummed into me. If I ever did something wrong as a teenager, I would be called selfish. And then my mum and brother would look out for any slightly selfish action I would do and point it out. I don't want to be selfish.
I'm not sure if there's such thing as good and bad any more. It's about the resources we have at the time. When there's low resources, I am more selfish, and do 'bad' actions. When I am in a good place with good circumstances, I can afford to be altruistic, and do 'good' actions. My strength and resilience is low at the moment so I'm bad at communicating, unproductive and demotivated (which will be read as lazy by some), irritable, and low on patience.
Doesn't help that the new medication is making me sleepy and nauseous almost constantly :(
Had a weird session with my therapist today. I must be hard to help right now. I'm not able to keep to a sleep schedule. She said something like 'what happened on new year's day is taking too much importance, it's just a setback and that's common'. I'm not really thinking about what happened on new year's day. I just feel low. It's as if she was accusing me of dwelling on what happened. I don't think I am. I think it's the citalopram side effects. They make me sleepy and so I would prefer to stay in bed than to do stuff.
I am so ruled by my emotions and I've given up fighting them. When I have a good moment, I grab it as best I can to improve the rest of the day. Sometimes the good moments come late in the day, sometimes they don't come at all. We made a plan for when I'm low and a plan for when my mood is better.
I think she was disappointed in me, and she seemed a bit pissed off about me changing to another borough for therapy, although I don't quite understand why - probably something about the rules and paperwork and tickboxing that I'm not privy to as a patient. I didn't really feel like committing to any further therapy. I don't know where I'm going to live in 5 weeks.
Also she flipping told me to not think about bad stuff til I'm stable. So I've been waiting it out. I've not been thinking about bad stuff. I'm stabley unproductive now. Argh. I'm not thinking logically. I don't feel like the answer is clear to my question 'How do I get more productive?' because I'm ruled by a stubborn unshifting vaguely negative heavy emotion that is there because of my medication, and it makes me want to do nothing. The answer must just be to wait it out, there is nothing I can do about it. Just grab the good moods when I can.
So up and down!
Flashes of inspiration followed by extreme energy crashes where I'm sluggish and slow thinking.
So exhausted of this yoyo-ing :'(
---------- Post added at 14:27 ---------- Previous post was at 14:13 ----------
Not able to relax :( I think I'm going to go home, I can't take this. I'm trying to stay out but I feel so on edge and stressed. I'm trying to chase up my next round of therapy as well as waiting for a work call. I just want to sleep. Can't handle even a tiny thing being difficult or going wrong. Can't handle multitasking either.
superjonboy
23-01-15, 15:04
That how I feel Lior. Feel so weak today which is making me think about what could be wrong.
Spent the day being buzzingly anxious over stuff that didn't even happen! What a waste of time :(
Finding it hard to move. Trapped in indecision. Trying to do many things at once and achieving very little.
I'm so cold. I'm going to go for a walk.
Hi Lior, hang on there hun, there's quite a few of us here that are struggling at the moment, including me. That walk will do you good, my Therapist is always recommending walking and exercise. The weather is going to pick up for a while, we even have some sunny days coming. Just do the stuff that's important or you want to do. You will soon get back that energy and gusto. :hugs:
---------- Post added at 19:39 ---------- Previous post was at 19:32 ----------
And, if you feel tired and lifeless, just rest, chill, sleep. Let it ride it's course. I've just been reading about your Life and I have had a very similar past to you. I am much older than you are and got through it all. I do slip back occasionally with depression, but it is not as bad as Living depression week after week, month after month. If I can be of any help to you, I am here and will be honest and supportive. :hugs:
Sunflower2
23-01-15, 20:57
Hang in their Lior, these illnesses make you feel like such poop. You sound like you're split between positivity and depression. Lots of energy but not getting anywhere. Which makes you feel even worse! It's a good sign though, having more thoughts of wanting to do things. Take it slowly and you'll get there :hugs:
I am having more thoughts of wanting to do things, but then I have days like today where I just can't get properly started. I made breakfast but then actually getting out of the house is too hard. I'm going to go back to sleep for a little bit and then go.
I'm just not interested in pursuing paid work, which is bad for me in the long term.
I can't make myself do stuff I don't enjoy. I managed to break out of that yesterday - I managed to stay out of the house and draw and write instead of coming back home to sleep, which I really would have preferred. And then I managed to come home and send out messages looking for a new place to live (I only have one month left in this house). I was productive yesterday - it was one of my most productive days so far this year. Maybe I'm just burnt out today.
I'm just going to follow what I want to do - and grab the motivation to leave the house when it comes by.
I'm really hoping it's just the medication that's affecting me, and not the blip on New Year. I'm definitely worse this month than last month. Things were beginning to look up. But now I am under-motivated. I'm just over 2 weeks into the medication.
Lay down for a 15 min nap and woke up 4 hours later. I have that knocked-out sleepiness similar to flu :(
I guess it's the med affecting you Lior. I was on Prozac for four years and found it stimulating but later started cipralex. It was obviously one of the more sedating meds as opposed to the stimulating ones and I noticed the difference straight away.
I just walked into a lethargy in those first few weeks and observed and thankfully made the connection that I'd started to feel tired and want to lie down every day. It wasn't what I wanted. It was of no use to me, especially after the stimulation of Prozac. I stopped it within weeks and couldn't get it out of my system quick enough.
So maybe keep a record of certain symptoms and observe if there are new behaviours you are noticing that aren't useful to you. If so, give something else a go rather than continue to vegetate.
Cliched and obvious but I have always found a bit of cardio is followed nearly always by a period where I observe I have found the clarity and focus to get things done off my to do list. Id not done the cardio FOR this. I'd just made the link so many times that I was being productive and had mental clarity and over and over realised I'd done a bit of cardio the day before.
All it takes is 5mins cardio. I'll do it on an exercise bike but anything that gets your heart pumping hard for five mins will do it. It makes sense that your brain will respond positively to being oxygenated and cleaned like that. Your brain will simply function better.
A horizon episode said all it takes is a five minute burst. To many people their fitness doesn't improve with extended cardio and just a brief burst each day is enough to clear fat and other rubbish from the blood stream. Without it your blood stream is stagnant.
You got any free gyms nearby ? In Leeds you can get a Leeds card which enables you to use many council run gyms for free for an hour every day.
Try 5mins cardio one afternoon then try and be productive the following day and see if you have a tad more focus. I know it's not much but it's all I've got. I'm very familiar with how you feel.
A diet higher in protein and lower in carbs can make you more alert too.
And TEA ! Favourite part of my day is my first (few) teas. Probably my most alert part of the day.
Fish oil, high in EPA, I used to suffer really badly from brain fog. I've been on high levels of EPA for months now and am noticing it's extremely rare that I'll experience brain fog at any point. I've started my mum and dad on it and within a month, without any promoting from me, my mum said she was thinking clearer. It reduces inflammation and cleans out things like cytokines that are a marker for anxiety. It's been proven to lower these in the general population by something like 15%. So it's no surprise an increase in mental clarity would be a result of taking it.
If you continue to feel like you're wading through glue every day try something else.
Hi Lior- Just wanted to check in to see how you are doing? I hope all is well.
Thanks for all your help everyone.
I'm up and down. Some good days, some days where I'm fast asleep.
I might try fish oil. But I don't think the sleepiness is a general problem. It's a side effect of the medication that I believe will wear off. I'm in the first month - I need to give it 6 weeks to see if it will help me. It's worth 6 weeks of sleepiness if it means I can stop being depressed after that.
I'm switching to take it in the evenings instead of midday. I'm not sure if it will help, I feel sleepy constantly. Still on 10mg. It will probably take a while for me to work up to 20 or 40mg which is when I might start to get the positive effects. It's a really long process. I'm just letting it happen. It's going to take the time it takes. I'm trusting in the medication to help me.
If I decide to switch to something else... I'll have to start all over again. I'm ending my CBT course and getting assessed for therapy in another borough - with all this change I don't want to change my medication as well right now. I can barely cope with changing therapy and moving house as it is.
I do yoga. I don't feel like it gives me energy. Its gives me the space to be present in my body rather than just my mind.
I've learnt what I can from CBT. I practice what I've learnt. I try really hard.
I'm scared that I only have one CBT session left in 3 or 4 weeks' time... and I don't know when I'll get assessed in the new borough. When my appointments have been 2 weeks apart rather than just 1 week, I have noticed particular dips in mood.
My CBT therapist recommended IPT - interpersonal relationship therapy - to help with my family relationship problems. She thinks I've done enough CBT and it's time to move on to looking at the family issues. CBT has helped me manage my mood but it hasn't helped me recover. I have deeper issues which I need to address. I need to look at my family and how my upbringing has affected my beliefs, habits and personality, so that I can see myself for what I really am, and change parts of myself.
Ach exhausted!
I'm feeling really good today, better than in ages! I have had moments of real optimism and I feel interested and motivated just a tiny bit - it's a glimmer of my old self! It's so wonderful.
I've still felt sleepy but it's been so great to have good feelings just for a little while. It gives me hope that it's possible that they'll come back more permanently and I could enjoy life again.
It's made me remember how AMAZING being happy feels. Being depressed is a truly awful state - I've been unable to feel positive well-being. I've felt moments of joy and pleasure - but I can easily cry afterwards; the feeling passes so quickly. I've been unable to feel motivated or interested in doing things that will benefit me, that I used to enjoy. I've been like this for so long now that I forgot what it feels like to be interested in doing stuff. Until today - I had ideas about fun things to do! And I used to be like this all the time.
I don't think it's possible for someone who hasn't been depressed to imagine what it feels like to not be motivated to do fun things that will improve life. It doesn't make any rational or emotional sense in the world of non-depressed people.
Also I don't think it's possible that many people will understand indecision paralysis - when you think about a few options of things to do, and then can't do any of them because you can't decide which one to do. I just stay in bed and play on a phone game instead - puts off the decision about where to go when I leave the house. And that means I might not leave the house at all, all day. I try to plan things in advance, but if a plan falls through, I take hours to decide what to do instead. This is my main experience of anxiety at the moment.
Anyway, today is a good day! I feel good even if I'm not being 'productive'. I'm just going to enjoy it.
Sunflower2
02-02-15, 17:54
Really glad to hear this Lior! The meds are kicking in now do you think?
I completely understand the indecision paralysis. I am the WORST decision maker ever so know how frustrating it is. At my worst I'd go with the decision and regret it for the rest of the day thinking it was the wrong one. So I couldn't even win!
At that sounds annoying! When I make a decision, usually I'm ok with it and stop thinking about it after that. Sometimes I want to run away from the situation but I don't blame that on my earlier decision.
Honestly, I think it's because I got stoned last night. I'm still feeling the after effects. I know it's not a long term solution. I don't want to make it a habit so I don't feel at risk of that. Also I did freak out quite a bit, which makes it very clear how disturbed I am by some past experiences. The good of the whole experience outweighs the bad. I wanted to get high for so long - the last time was over a year ago. I knew it would be a good thing for me to do and I was right.
I feel so much more hopeful and calm that things will fall into place - and I think that calmness will help things fall into place. I see a glimmer of my old self, so I know now this limbo will eventually end - I'm not permanently stuck like this.
Back to normal anxiety and depression today! Couldn't leave the house because I couldn't decide what to do. My mum emailed me saying she'd had an operation but didn't say what so I've been worried about what she might have had. I've just emailed her to find out. I really don't want her to die. I'm not ready to hear that she has cancer or something.
I've got an assessment next week and I'm really hoping they will be able to help me. I hope the waiting list won't be too long to start seeing someone.
I'm tied up in knots worrying about stuff.
Good news is that work stuff is very slowly ticking on, and I will have somewhere to live for the next year. And I'm still managing to see friends a lot, so social stuff, work stuff and home stuff is incrementally getting better.
Woke up at 4am and couldn't get back to sleep. Think it must be because I've started taking citalopram in the evenings instead.
Ach I hate this buzzing anxiety, stopping me from working. Find it so difficult to get started on anything I need to do. Even when I have a plan, it just seems too hard to do so I can't start and I end up doing something unnecessary.
The last couple of days I've been really cut up about some of the times I haven't stood up to people. I've allowed myself to be sexually coerced very many times and it's just hit me that I'm still at risk of giving in to people I don't want to do it with.
I'd rather say yes to people and make myself uncomfortable, than disappoint anyone. I'd rather hurt myself than hurt someone else.
I easily fall into the trap of feeling like I owe people sex. If it's expected, then I feel like I have to follow through or they'll be disappointed and I cannot disappoint people.
I do anything for romantic attention. If I'm repeatedly pestered for sex, I feel like it's the only way to keep the person's attention. And often, it is the only way. And I know that means they're not worth it. But I haven't been able to see that.
My first two partners set out certain sexual expectations of me which I got stuck in. I still haven't manage to shake out of how they taught me to be - compliant, or they would not love me any more. This has affected all of the relationships I've had since. I believe I have to be compliant to their every wish or they won't love me.
I can't even recognise when I'm just being passively compliant in order to please the other person. This really concerns me. I don't think I would have had sex with that guy the other day if I wasn't stoned. I wasn't that interested. Which means that I am still putting myself into situations where I can be taken advantage of.
Also I don't think I'm in a consistent enough mental state to make good decisions. I'm highly impulsive. This is scary. Something could happen again. It's still a current situation.
I am frightened of my own decisions and beliefs. I'm quite overwhelmed. I really want to dissect and understand this with a therapist. The CBT therapist didn't want to go into past relationships - it was all about current mood management. I need to understand why I am the way I am, and how to say no. I really hope at the assessment next week, they will set me up with a therapist that can help me with this.
What if they don't?
As you Lior, I fully understand where you are coming from here.
It's taken me a long time to be happy with myself and learn to say NO!! when needed.
I have learned that respect comes more in abundance if you do say NO!
I was living in a feeling of Insecurity, wanting to be loved, proving something to myself, scared of being alone, scared of losing; all that sort of stuff.
Lior, you know I am here, if you need to talk, but it is something that you can in time change and be more in control. :hugs:
I thought I was secure. I just wanted wonderful close romantic relationships with love - fairytale style perfection.
One of my close friends got raped a couple of weeks ago and told me today. It's quite distressing.
I think I might tune out of all these thoughts for the moment. It's a bit too much. I need support to get through this. I've been having more frequent invasive thoughts.
Started on 20mg citalopram today. Was on 10mg for 30 days. Wish me luck with a new potential bout of side effects!
Sunflower2
10-02-15, 07:27
Good luck!
good luck,going up a dose is not as bad as starting them
superjonboy
10-02-15, 12:27
Lior - 20mg of Citalopram massively helped me back when I was on it.
First day or 2 I might have noticed a bit of headache e.t.c after increasing but it was nothing like when I first started on them. It could also have just been the anxiety from increasing the dosage.
Thanks for the hope guys. Haven't experienced any negative side effects of the dose increase so far.
Just went for an assessment for more therapy - or so I thought. I don't know what it was an assessment for any more. They asked about my childhood and my family and I told them a lot of stuff. I have tonsillitis as well so it was not a pleasant experience. I cried.
And then at the end of the session, they said that they don't refer or fix me up with anything. They might give me a list of counselling services to call. But they thought that psychotherapy would be best for me. They can't fix me up with that though.
I already know that I have depression. And I kind of already knew that psychotherapy was going to be best for me. But they can't refer me to any service that offers that. So what was the point in me going?
They said they would talk about me tomorrow in a meeting and then let me know what they've decided. But since they only deal with schizophrenic patients, I know they won't offer me anything. They are training some people in DIT but they said that (if they decided to put me on that course) I could start that in 4 months when they have finished their training.
So I don't know what I should have got out of this. Affirmation that I'm not schizophrenic? Affirmation that I do need psychotherapy? I wasn't looking for affirmation, I was looking to be hooked up with further treatment.
They basically said that I could have looked up further treatment without their help. I'm not clear on how they are meant to help me then? What was the point of all that? Why did I go to them, if not to be referred on to psychotherapy? They don't offer it on the NHS.
I think I'm going to have to start psychotherapy. Even if it means paying for it. I need to have that support. I've started on this journey anyway. I need help doing it.
The doctors agreed that I need psychotherapy, so why can't the NHS provide for it? If it's recognised as a necessary treatment to help me become a productive member of society again?
Hi Lior
try rething.org I got counselling from self refering on their website within two weeks.it was quality support as well,I also had private therpay but found it not vey good for the money if I am honest.I also had psychotherapy on the NHS I had to wait a while but it was very high quality treatment with a person that really cared.The private counsellors i had wouldnt give any input and I just spent an hour telling them stuff with no interaction,waste of money
See if there is a rethink in your area it might help
The borough that I'm in doesn't offer psychotherapy. So even if I wait, I won't get the help I apparently need from the NHS. Maybe I should move house?!
I'm going to have to pay for it myself. I don't think counselling is what I need - I need to understand how the mind works, how relationships work, why I am the way I am, how to stop being a stressed out perfectionist who gives people whatever they ask for regardless of how it might hurt me.
I'm still really angry about yesterday - I have murderous hateful thoughts towards the doctor and everything. He was patronising. I feel a fool for hoping for help from them - I was hoping that they would lead me on to my next step in this journey, and they told me to find help myself... so I just don't understand what the point was of me going in at all? What are they gaining from it? What was I meant to gain from it?
They told me that I have self harm issues, that I have a troubled background, that I have been sexually assaulted - I don't think of my life like that. They told me that my problems are bad. And then, they told me they can't help. They only help people that are comatose and have already tried to kill themselves.
Why recognise that I have problems, and then not do anything about it?
I feel worse than before. I wish I knew upfront what the point of that assessment was. I wish I knew that they wouldn't be able to refer me. Then I might not have bothered going through it. I didn't know they were going to ask about my childhood and my birth etc and reframe my whole life as worse than I perceive it.
They've basically told me that my life is shit, and I should bugger off and sort it out myself. I thought I was helping myself by asking for help from them. I was relying on them helping me to find the next step.
I did come away with a list of things to look up - but I'm confused because I had to ask for that to be written down. Clearly they don't write it down for most people. How are they helping people? I don't understand the whole service.
I need to question my feelings because I did come away with this list of things to look up. They are not referring me. But they did recommend Mind and a couple of other places. So I do have my next step there. I just have to make the phone calls instead of them. It's not within the NHS system. I guess that's what they meant when they said 'services in the community'.
Surely I could have got these recommendations without telling them my life story though... that assessment was quite an ordeal.
Why does the NHS not provide psychotherapy in my borough when it is what the doctor recommends for me?
MyNameIsTerry
13-02-15, 08:04
Hi Lior,
I hate that they have done that to you. It just sounds like a box ticking exercise for the NHS to say "well we did the assessment and advised what the patient can do...the rest as you know is due to insufficient funds in the pot".
If someone does that in any situation, the result is an angry customer who's time has been wasted when they could be told upfront "no cash, no treatment". Thats why I think the NHS do things like this just to avoid blame later if something happens.
Have you had CBT yet? CBT is psychotherapy, but I think people tend to believe psychotherapy to be the old definition of the service that takes ages to access - known as Level 4 on the NICE stepped care model. However, even if you access Level 4, the psychotherapist still has to assess what is the best form of therapy which may be CBT so I think people are often out of date with their knowledge of these areas as the NICE stepped care model seems to have come in between my 2 breakdowns in my city which puts it at no more than 8 years ago.
Types of therapy offered can be seen on here:
http://www.nhs.uk/conditions/psychotherapy/Pages/Introduction.aspx
Its only about money when the service is not available.
In the areas where it is, like mine, I was told the minimum waiting time is 12 months (so, some could lose their jobs just being on the waiting list!) although Kimberley on here has had it a lot earlier. This is all due to lack of trained psychotherapists and lack of money to employ more.
In the areas where you can't get it, it just means your local care trust has not funded it. The government are behind it being available but the problem people often realise with the NHS is that its not reall National, but Local with an overarching governance. Local trusts are responsible for what we get and you may have seen some cases in the media where patients can't access X cancer drug because they are in the wrong region or a certain type of surgery.
There was a case a few miles from where I live. A family man in his forties with depression who had been on antidepressants for 6 months and got no better. His wife became very concerned when he told her he wished it would just end somehow (I know I've been there many times when it gets too much) and dragged him back to his GP with her present. He was referred to the local mental health team for assessment and he told his wife he finally felt he was getting somewhere. He was assessed, all the usual rating scales that IAPT use. He had to wait 5 months just for the initial assessment. 10 days later, he ended his life. The coroner ruled that not enough was done to prevent this by the local mental health service. They stated he marked himself as a 3 on the assessment for potential to harm so represented low risk. His wife stated she believes that the let down of having to wait to then be told to go somewhere else and join another queue when he had finally asked for help could be the only reason as his mood plumetted due to that meeting despite feeling like he was getting somewhere when visiting his GP.
So, this is for Level 2 or Level 3 services. In my area there is a 30 day referral policy for Level 2 which I think is really good to at least get some help, even if you need something more intensive as sitting around with nothing is worse and makes it harder to treat later.
What is the irony here? He lived across a CCG border to me and these newer boards do commission mental health services too. If he lived closer to me, his wait would have been 30 days, not 5 months.
He was also told he had to self refer himself to a wellbeing service which is completely incorrect as whilst you can self refer to the one mentioned, they very clearly state on their website that so can your doctor or any other healthcare practitioner. So, he waited 5 months to be told to go elsewhere to a wellbeing service that he could have registered with 5 months ago!
Will anything change? Probably not. Its all about money sadly and its the physical illnesses that get it.
So, if you can afford it then maybe its an option. But as MrAndy says, there are places like Rethink and MIND that will provide free therapy, most likely CBT.
I find it incredible that they recommended you go to a charity to get help when we pay our taxes for the NHS to help us! I hope that those who say this have some conscience and feel bad about it because its wrong.
I had issues in accessing help. I was referred by my GP to my local service who offer Level 2 & 3 services from NHS grants and it took 90 days to access a 30 day appointment service. 3 referrals after 3 appointments with my GP asking for help and I was never told why this went wrong but I assume my GP caused it as they have been inefficient many times whereas the service I went to were spot on for everything in terms of contact. I was told I needed Level 3 High Intensity (CBT) but couldn't access it because you had to go through Level 2 Guided Self Help first. I took any help and just started Level 2 but I found it ludicrous that even the assessing wellbeing practitioner said my issues were too complex for her Level 2!
So, I finish Level 2 and think I'm finally getting somewhere to be told I had to wait 3 months for Level 3 CBT because I only go in the queue once I'm finished with Level 2! AT this point I was pretty annoyed because I could have started my CBT within 6 weeks if they had put me in the queue when they first assessed me and agreed I needed it. So, I complained to my GP and said I would pay to bridge the gap if needed (and ironically I could find some therapists from this exact service also having slots open for private therapy!) so he referred me to the Level 4 people instead and said its worth a try. The other team had already mentioned that they had been created to cut down on Level 4 as its usually at least 12 months. Level 4 rang me and said I needed Level 3, not them, so I explained it all and this very helpful lady called the head of the Level 3 service to discuss the mess who stated there was no option to speed it up because they didn't have any resources...and then the next day I get a message off the local office for the Level 3 guys who have suddenly got a slot open!
I stated I didn't want to be bumped up a queue just because I complained as thats unfair on others but I should have accessed this all earlier given someone cost me an unneccessary 60 days at the start so at the worst I should have been only 30 days away from Level 3 anyway.
This sort of incompetance and bureaucracy would annoy anyone let alone someone so anxious they had trouble sitting and doing things!
When will the NHS actually learn that all this is detrimental to us?
I hope the above story doesn't upset you. If it does, please tell me and I will edit it out but I wanted to show you how stupid it all is and how that sometimes goes too far. If going through this makes you feel similiar, please contact someone and rant on here so we can support you.[COLOR="blue"]
---------- Post added at 08:04 ---------- Previous post was at 07:22 ----------
They are training some people in DIT but they said that (if they decided to put me on that course) I could start that in 4 months when they have finished their training.
According to this website:
http://www.d-i-t.org/about.php
This is a Level 3 High Intensity treatment so its not actually in that traditional Level 4 where psychotherapy would sit.
This is the CBT level.
So, I guess you could determine whether this brief version of Dynamic Interpersonal Therapy is more suited to you than CBT. CBT doesn't delve into any past relationships
DIT is not NICE recommended as its new so its going to be assessed from being used, I guess.
The question though needs to be is DIT right for you? Recommending it on the basis of it being available because nothing else is, is quite strange. Perhaps if it could help, it might be worth taking what you can get from it?
Perhaps a question is - do you have a pattern created from childhood that has a connection to how you behave now?
Thanks Terry, it's very reassuring that you think how they treated me was wrong. I know it's because of a lack of funding but I'm still pissed off anyway. They said they would contact me yesterday and they didn't. I've got tonsillitis so I'm going to try hard to not get stressed right now so that I can recover more quickly.
Your story sounds typical. I was reading up on accessing services on the Mind website and there is a vibe that it's hard to access services. I've only ever heard you talk about Level 2 and 3 and 4 - do you have a diagram of that anywhere?
At the assessment they said I need a psychodynamic therapy which I think is like what I had privately before - and what they won't offer me. They said clearly that Wandsworth don't offer it. They don't even have IAPT in Wandsworth apparently - it's CMHT or something.
Yeah I do find it ridiculous that they're telling me to go to a charity.
DIT might be right for me because I might have patterns from childhood. They said that I had a difficult childhood (I said it was more my teenage years). I told them that I had been ill as a child and they thought that was significant - apparently that means that parents might overprotect the child. The doctor said he had theories about why I might be depressed now. It's frustrating to me that they said these things and I don't understand the depth of what they said. They have answers - but they didn't give them to me.
I've had 13 CBT sessions, got my last one next week. It's helped to a certain extent.
I don't think there's any point in me doing more CBT. I did a spate of research yesterday and I couldn't find any free psychodynamic therapy - only free counselling, which will not be able to help with the depth and complexity of what's been going on (ingrained patterns from childhood, relationships with family, aspects of my personality like perfectionism and people pleasing, sexual consent). I did find low-cost therapy websites - quite a few of them actually - so I'm going to see if I can call them up. Maybe when my tonsils are better and I don't sound like a frog.
I can also look up the self harm group - maybe they'd let me join them as support in the interim. I don't think of myself as a self harmer. I think about it but I don't do it.
---------- Post added at 15:30 ---------- Previous post was at 12:54 ----------
So I called them up. They're not recommending anything to me, except for the self harm group, which is actually a personality disorder group for which there is a 6 week waiting list.
They recommend that I take a break from therapy to assimilate what I've learnt. I am scared because I've felt worse in between CBT sessions when there has been 2 or 3 week gaps. I'm hoping that the citalopram will make a significant difference - I don't have much else to rely on.
I had a little moan at the lady on the phone who was sympathetic about the funding etc. She said that she would pass on my suggestion about setting expectations for the assessment in the letter rather than at the beginning of the assessment. I said that I could have acted differently if I'd have known that they would just tell me to go to Mind - I would have got on waiting lists for Mind earlier, and not waited to be told that. She said that they were a signposting service primarily. It seems a bit extreme to find out all my deep seated problems and signpost me somewhere else.
She said that if I did feel worse, go back to the GP, they might refer me back to them and then if I have another assessment they may be able to help.
I'm really afraid to go without therapy. I get into darker places without it. How do I do this? What can I do to keep a sense of perspective? I've been reliant on my therapist for pointing out unhelpful thinking. Withdrawing into myself and writing as I do doesn't give me perspective - it reveals darker parts of me, and I don't know what's healthy or unhealthy.
MyNameIsTerry
14-02-15, 07:03
You are right to be annoyed. Not calling people back is a annoyance no matter where it comes from but you would expect that mental health cases would be considered a massive no-no in those stakes when we are talking about people often in destressed states. It just makes them look even more uncaring and that we are trivial to them. At the end of the day therapists may be busy but they have admin staff and receptionists who are perfectly capable of doing that just let you know there will be a later contact. Its simple customer service, respect and decency!
This leads me to how we have to chase all these people around. They have told you there is no IAPT service in Wandsworth so this is either a) they don't want to send you there for some reason or b) they are incompetant and unaware of the services in their own area because....there is an IAPT service there and they have a website http://fis.wandsworth.gov.uk/kb5/wandsworth/fsd/service.page?id=lBXguXR3o4c
It says on there that you can self refer or refer through a GP and they offer CBT & DIT and couples counselling. They also have 2 treatments which are Level 2 in the guided self help category.
So, I'm thinking you could contact them and see if they cover you and how you can access DIT that way.
Your CMHT (Community Mental Health Trust) seem a pretty pointless bunch. They seem to be underfunded hence only taking the most severe cases and the obvious prioritisation of things like schizophrenia. However, looking at what Rethink state, they should be doing a lot more as seen here http://www.rethink.org/diagnosis-treatment/treatment-and-support/cmhts
The NICE Stepped Care Model is something that IAPT services follow but its there as guidance across the board for mental health conditions as see here http://www.nice.org.uk/guidance/cmg41/chapter/3-a-stepped-care-approach-to-commissioning-high-quality-integrated-care-for-people-with-common but the problem can be that some areas, as seen in posts on this website, show a more old fashioned approach that things like this are trying to do away with.
There are individual NICE guidance docs per condition but here is the depression one http://www.nice.org.uk/guidance/cg90 and you will see the stepped care repeated in here in the Guidance section. If you want the anxiety ones, let me know and I will post them for you.
IAPT's remit can be seen here http://www.iapt.nhs.uk/commissioning/models-of-care/
Thats basically Level 2 & 3. Level 1 being your primary healthcare provider (GP) and Level 4 being the very complex or severe issues, referred to years ago as psychotherapy but really the multidisciplined people who manage patients more intensively as opposed to Level 2 & 3 where it seems the GP has more responsibility as medication is out of bounds for these levels.
Do you need to attend a PD group? Is it relevant to your case at all? If you don't have a PD, I don't understand why they are recommending it so have they diagnosed a PD as I don't think its been mentioned above?
I agree with you. They don't need to know everything to make a suggestion of therapy, they can do an initial assessment where they determine what is best and then delve into the real detail from there. It sounds like you were treated as though you were going to be helped by them for them to then decide at the end that you were not severe enough. They should have a slimmed down process for that and they would have an idea of the issue from the GP referral. They can easily publish a criteria which they can then check you against to decide which side of the fence you are on, just like in any other process. They are just messing people around!
If you go back to your GP and get another referral you hit the same process. If you still aren't severe enough for their criteria, ther same result is likely. I don't think thats great advice, more to cover themselves because unless you worsen to the harm stage, I'll bet money on the fact they will see you as non urgent again.
Looking at what I assume is their website http://www.swlstg-tr.nhs.uk/advice-support/conditions_treatments_and_therapies/ they seem really big on plastering the charities on the pages where you would be looking for advice or help on services offered. They are pretty vague in what they offer and anxiety doesn't even get a mention. They are part of a part depression initiative called 'Co-Creating Health' which they don't seem to have discussed with you but reading about it here http://www.health.org.uk/areas-of-work/programmes/co-creating-health/Background/ it looks no more than Level 2 services just over a longer period.
Worrying about leaving therapy is normal. I remember feeling like this, but I adjusted. Keeping a sense of perspective might mean using this place. No ones an expert, but it can be easier as an outsider to point something out.
Be careful if going the private route. It will open up other forms of therapy that are not NICE recommended, although that doesn't mean they aren't workable. Anxiety UK have a decent section about some of the less well known forms (includes main forms as shown on the earlier MIND link) here https://anxietyuk.org.uk/get-help/get-help-3/talking-therapies
There is also no protection in the UK in this sector as it remains unregulated. This means you or I could purchase an online only course and do 100 hours for a diploma (that is really more a certificate), pay for public liability insurance, set up a company name and then take clients without ever seening anyone or having any ongoing supervision. Certain titles are protected and covered by existing regulation but most are not and its advised to use a reputable register to ensure you get someone suitable qualified & monitored as can be seen advised on MIND's website here (my therapist also gave me advice on this for the future) http://www.mind.org.uk/information-support/drugs-and-treatments/talking-treatments/accessing-treatment/#.VN7xkeasWSo
Honestly, there are many self regulation associations out there but many are also pretty dodgy eg some are actually training companies so you pass and can pay to register and use their professional notations. However, people who go this route can't join the reputable ones like BACP as they won't accept their qualifications as valid as they don't include things like minimum hours of live supervised client work.
Remember as well that many therapists thesedays are offering skype services so it lets you fish farther afield.
Have you thought of Mindfulness? MBCT is NICE recommended for recurrent depression. I don't know whether it would get into the issues you want to explore, probably not, but Mindfulness is really good for changign how we think and brain scanning studies are showing how it makes changes.
Who did your CBT? This should have been IAPT.
There is so much crap in these areas and I think there should be a service that just lets us make contact to find out who can get help from no matter where we are. A central team that have registers off all the local services, charities, etc. Right now, Google is that method!
When I used to go to a local charity there would be people in all sorts of states and being messed around like this. Those of us in a better place took it upon ourselves to help with advice along with the session coordinators who were always helpful & knowledgeable of local services. I can rememver people saying there GP's didn't offer anything but either time off work for long periods or medication...GP's need to be governed in a stricter manner in my opinion as they are getting away with poor standards. There is no excuse to be unaware of NICE guidelines or their own local services.
Wow Terry, thanks very much for all that research you did for me :)
The NICE guidelines make for an interesting read. No mention of long term psychodynamic therapy... I understand what you mean about the steps now.
I was wrong about a couple of things - I must have misunderstood what they said, I was pretty ill with tonsillitis. They'd written down for me to call them rather than them calling me, and I guess I thought they'd implied there is no IAPTs rather than them directly saying it?
Anyway, the STD clinic told me about somewhere I can get cheap psychotherapy which I will check out. Also going back to my old psychotherapist who did help me a lot is an option, but I need to talk to my grandma about helping me pay for her. I don't have a job at the moment - no income. Hopefully I will be starting a job soon but I'm scared I won't be able to stand the challenge - getting stressed leads to getting suicidal, and I'm still not quite on top of eating properly and sleeping properly, let alone pioneering innovation in government (which is the new job).
Leaving CBT wasn't as hard as I thought it would be because I don't love the therapist. I am afraid of not having her as my importance filter though. I can't prioritise effectively in life - I want to do everything.
Still waiting for the letter from the assessment... they did give me stuff to chase up. I just wish that it could be made easy for me - I have to keep chasing and consider many multiple options, and I struggle with decision making and trusting my judgement. I hope that in 10 years, psychotherapy will be available in an easy way - maybe using your centralised idea, a Google for therapy and treatments. Wouldn't it be nice to have a centralised system that can refer you based on needs and area, and can recommend you other well-being stuff like local exercise classes.
Speaking of which - I'm off to yoga now!
In other news - moved house this week, found out my friend has an STD, found out I have a different harmless STD, still got tonsillitis, got loads of social stuff planned over the next few days, mind is frequently racing with anxiety (mainly about moving house), stopped writing so much about bad things that have happened to me this week. Got 100 things to do but trying to take the pressure off - I do have time to get stuff done.
I called my old psychotherapist and I have an appointment booked for Tuesday.
I'm not sure how I'm going to pay for it... I will work something out. I'm going to have to start using my savings... I don't want to dip into them but I guess that it will be worth spending money on my health rather than saving it for property. I've worked hard to save up a deposit for a flat but it's worth nothing if I end up killing myself. I have to keep reminding myself of that - I have worked hard to make sure that I save rather than spend that money, so it's difficult to allow myself to start spending it.
Tomorrow I will get a new mattress so maybe I'll be able to have a good night's sleep from tomorrow night onwards. Maybe that will make me feel more grounded.
I feel much better having moved to this new place, knowing that I can stay here for as long as I want. There is no time limit here, as there was in my last place. Even at my parents', there was a sense that I should move out asap. I don't have to move away from here until I want to. That notion makes me feel calmer - there is one part of my life that is settled, and I know what's happening. No matter how long it takes to save to buy property, I can stay here and rent. It's just about affordable for a London rent. I am going to make this room as lovely as I can make it.
Good for you, lior. You deserve to look forward to better times and making your new surroundings beautiful is just part of the process. As is spending money on a trusted therapist. You don't need any justification for doing that-it is a huge investment for your future wellbeing.
Thanks pulisa for that positive comment. It helped affirm my decisions. Today I finished covering boxes in pretty paper and spent time arranging my stuff to look nice. I felt a bit obsessive but the books do look really nice now.
I've got my new mattress. I booked an eye test and a doctor's appointment and a massage. I washed my hair and I'm going to do my nails. I'm even cooking dinner from scratch! That's very unusual for me :)
I'm making sure to look after myself.
I'm also working through a book called The Artist's Way, which guides creative unblocking. It comes off as a bit religious but the exercises are really good. It's a way to evaluate things, and to work out what you could do differently. Through that, this week I promised myself to get a massage, get a new hair product and be mindful of making difference to culture through small positive actions that I can take.
I feel hopeful. I do still get waves of sadness and exhaustion and energyless - I am definitely still depressed. I still don't care about a lot of things but I definitely have noticed an improvement.
This has given you an uplift Lior, I am so pleased for you. :)
I went for an eye test and the doctor said I have more than 20:20 vision - some adults never get to see as well as I do. So that's great news!
I went for my second treatment for warts. They've pretty much gone but the virus will stay in my body for up to 3 years. There is no effect on fertility or lifespan, it's just an aesthetic STI. But I have to tell anyone that I have sex with that I have it, because I may spread it to them, even with a condom. Apparently 70-80% of adults have had it at some point, sometimes without symptoms, so it's very common and you're lucky if you don't get it.
It's probably the least bad STI to get, but I still feel tainted. I have to have that conversation before I have sex with a new lover. It makes me not want to have sex because I don't want to spread it. I don't think it would be right of me to spread it. Even if they consent to sex with that risk... is it ok to spread it? The doctor said that most people do consent to sex with that risk because it's harmless. I still feel disgusted and tainted though. I feel like a bad person because I have this. It's a reflection that I have had lovers. I don't judge myself harshly for sleeping with people but I know that other people might do.
I went for my first psychotherapy appointment with my old therapist yesterday. I'm still processing it.
In between the STD treatment and the eye test, I went to a park and I wanted to scream, but the pond and ducks and people around were tranquil and I didn't want to disturb the peace. I wanted to scream but nothing came out. Eventually I tried to not care about other people, and I screamed. I thought I would not be able to stop once I'd started but then I started crying instead. I started bending over so I walked to a bench to sit down so that I wouldn't get mud on my knees. I bent over and sobbed for half an hour. I thought about how I am not going to ever have a comforting mother, and I realised that my tears were grief for the ideal comforting mother that I will never have. I long to be comforted. That's why I want to be in the arms of someone at night. I am not being held. Soothing kind comforting words don't come from my mother and if she hasn't learnt to do that by now, she never will. It shocks me whenever people hug me when I cry, or even show any sympathy.
These thoughts are familiar to me - they are not new. But now that I am going to psychotherapy I think I may start progress. The therapist is not going to charge a fee for now. Hopefully I will start working and start to be able to pay her. She said something about low cost counselling but I really don't want that, I want her. We're booking things week by week because she's only working three days and she's busy. I am afraid she wants to retire soon. But even a few weeks with her will help me. I know it.
I forgot to take my pill last night but it's closer now to the next dose so that's ok. I feel so exhausted from all this thinking and emotion.
MyNameIsTerry
26-02-15, 10:45
Hi Lior,
I hope you are feeling a bit better now?
What do you think triggering this as you seemed to be feeling a lot better, more positive & determined in the last few days? Was it the STI issue that was the trigger or had things been building up again and it just pulled the trigger?
I know I've had days where I've been in tears like that. I've been holding it inside while shopping and like you, walking in the park and just feeling like I'm hopeless. It passes, I find I have mood swings but the beauty of them being swings is that they also swing back to better ones like you had recently and started doing more.
I get what you mean about the STI, its not something that is very easy to approach and some people could be put off but as long as you are honest then you are doing the right thing. I think I would be questioning not having sex until it had passed to but its whether you can live like that.
You aren't tainted and you certainly aren't a bad person! If you were a bad person, would you be on here talking to people and helping them as you do? No chance. You help people on here because you are a good person. Its very obvious from how you describe your emotions that you are not a bad person because you care, a bad person wouldn't give a toss about others.
Some people judge other people for having sexual partners, and they judge women more than men...way of the world and sexual equality will probably never make it to those levels and there are situations on the other side of the coin where men are judged more harshly than women. The thing is, people who judge based on those reasons don't matter. Whats wrong with having sex with people? Everyone does it and its been very common for beyong 50 years now (anyone who has an old fashioned mindset should consider the amount of babies that the world wars produced outside marriage and then drop the double standard when talking about later generations!)
What do you find helps you when you are struggling? Can you implement these things when you feel those dips coming on? Could they cut them off? I know I can do this but it doesn't always work but as you recovery you get mor skilled at it and you respond better to these measures.
No problem about the researching by the way, if I find mental health services or other agencies messing people around, I try to find them information they can hit them over the head with! Besides, by searching for other people to post replies I have learnt a lot in the past year so it helps me to.
I hope you feel better soon.
I had a wave of good stuff - I got my psychotherapy appointment booked and I finished moving house.
But the psychotherapy appointment itself was hard. And the meeting at the STD clinic wasn't great.
It was my second visit to the clinic - the first time, the nurse was very aware of depression and health anxiety and she said that with warts, they tell people that they don't need to tell sexual partners because they probably already have it, but you can tell them if you want. She said there's no point playing detective because it could have been anyone and they might not even know they have the virus because they might not have symptoms.
And the second time I went to the clinic, the doctor said I must tell all future partners so as to give them the decision about whether they want to take the risk. And I agree - morally that makes sense. But it makes me not want to have sex at all. It's not a sexy conversation to have, and I don't want to pass it on, and I feel tainted by having it, even if it's not harmful. God knows how people with HIV must feel - that must feel like being really tainted. Thank goodness I only have something harmless.
So my anxiety kicked off again after that conversation with the doctor, and anyway I'm concerned about sexual stuff. I know I've got a lot to work through about sex. And stuff in my psychotherapy session covered stuff about coming to terms with not being mothered, which is new for me. I'm not going to get support from my family over this. I'm not ever going to get comforted by my mum about anything, because she doesn't have the capacity to do that. She will never be able to help emotionally support me through any of my issues, sex and consent just being one of them.
So I was upset because those issues are at the front of my mind. I'm glad I had that cry, it was a long time coming. I'd wanted to scream for ages so it was good to try to let it out.
Today has been better. When I eventually was able to wake up and get out of bed, I did some writing in a cafe, and I met a nice man in the cafe and we kissed! And then there was a work party and I got a free burrito and had some nice conversations. It was a good social day, with a smattering of work.
I feel fine now - a little anxious about this encounter with the man - it was quite spontaneous and I don't know if I can let it lead anywhere, it's not fair to drag a new person into the tempestuous soap opera of my life.
Most of the time I think I'm a good person. I am far too much in my own head and self absorbed at the moment though. I talk too much about myself and I'm bored of it. Yet I am also bored of talking about other people sometimes. Everything is the same, everyone is the same, humans are boring. I know that's the citalopram making me disconnected. I hope it will pass. I want to stop feeling the distress of depression enough to be able to stop thinking about myself and start thinking about Big Issues and what to do about them.
MyNameIsTerry
27-02-15, 07:43
I think you will have a lot in common with Rennie's thread there lior. It seems you both are going to have to accept it somehow to enable you to move on with your life. You will find people that will show you the love you need (and deserve!), its just a question of finding the right person and perhaps it will help with a lot of this? You would still have to move on in terms of your mother, but our partners tend to be in our lives more on a day to day basis so as to occupy our needs in many families.
Its the problem when its someone else because you get confronted with the same questions as you do over your own issues a) learn to change it b) do nothing and let it continue or b) accept it and learn to move on. When its someone else, it can so often be b). When its not your partner, its harder because other family members and friends occupy slightly less focus in your life and so are less likely to feel the need to change. So, it can end up forcing your hand by limiting your choices.
I'm glad things have been better for you. Sounds like you had a nice day.
I guess it depends how you feel your current problems would infringe on a relationship, whether it could make you feel worse in some way or whether any later break up would affect you more. If you think it won't affect you, maybe its worth taking it slow and having some fun and deciding before things start to get serious?
I've had my share of being bored with life, the world and other people. I've struggled with the "everythings the same" issue in my head since I've been off work...too much time to fill in, it can be a bit of a curse really. I've been on Duloxetine for a few years now and I've been having swings of anxiety & depression. I've discussed them on various threads before. They started as 1 week good to 3 weeks bad but as I improved it went down to 2 weeks each, then 10 days bad, then 7 days, then 4 days, then 3 days and then it hit 2 days but I started to experienced them more frequently. These have been killing me for years and when they come I can sometimes stop them, unlike a couple of years ago, and when they go I will wake up and feel different. There is usually no trigger at all and I've been concerned about being able to cope like this with things like work because I find myself sinking into the negative thought patterns each time. Well, I implimented high strength Omega 3 after reading about some studies in depression and after a few weeks of slighty higher anxiety in my bad cycles (but less of a dip in mood) I have found I no longer experience hardly any mood swings. I still get the anxiety build up but I don't sink so there is less negative thinking. I started with a decent dose of vitamin C too. I stopped at Xmas as I was slobbing about for a couple of weeks and within 4 weeks I had become much more anxious and the low moods came back. I wasn't going out walking either which probably added to it. So, I started back on the Omega 3 & vitamin C. Guess what? In a matter of days I was feeling different and now over a month on, the swings are gone again.
So, its clear to me that Omega 3 and maybe the vitamin C play a part in my health. I'm more positive, more wanting to do things, etc.
Maybe its worth a look? The Duloxetine didn't do this for me.
If you do, there are online reports and it was 1000mg of either EPA or DHA (can't remember which without looking).
Do you think you get as a build up of emotion and then it results in this need for release? I think I get this sometimes and when it goes things feel better. I know in the past sometimes a cry seemed to flush it out.
That nurse seems to have a moral compass issue! Whilst the state you said are 70-80%, you said that is based on a lifetime so it seems more likely that there is a higher % of people right now haven't got it so why not prevent it spreading if you are in the medical community? I think I would go with the doctor there! Its your choice completely though, but I agree with you on the moral perspective although its a hard thing to do. I know what you mean about HIV too. I've never known anyone with it, to my knowledge, but I can't imagine how isolating it must be. I bet a lot of them end up with depression like a lot of us.
End on a positive I think. Lior, you always come across to me as a strong intelligent woman but someone who has some demons that are causing havok in your current life. You tackle complicated work issues and get some great offers. So, if you can resolve this other stuff, it makes sense you will thrive because you are strong on the other issues.
I'm struggling a bit today. I came up with lots of things to do today but I just crashed. I felt overwhelmed so I couldn't do any of it. And then little things got in my way like the washing didn't dry properly, and someone hadn't emptied the hoover filter. Simple things like that make me want to give up on doing anything.
I couldn't do it so I got back into bed and tried to distract myself with a phone game. I was worrying so badly. Then I let myself just rest and sleep and forgave myself for not doing anything. That felt better. I reminded myself that I have had some productive days recently so it's ok to not go at normal speed - you are suffering from depression, it's to be expected that you have some bad days. I let myself rest and then when I felt more up to it, I got up and started doing stuff. I got a couple of things done. What bothers me is that I need things to be in a certain order - like I can't wash my hair before I've hoovered, because there might be dust in my hair. And I can't wash the dishes before I eat lunch, because then I'll have to do more dishes and it's not time efficient. Then if I don't feel like doing the first thing, I can't do the second thing, and I'm trapped and not able to do anything at all.
I do take vitamin c. You've recommended Omega 3 before - I hesitate because it's expensive and I'm not earning at the moment.
I don't want to pass any virus on even if it is harmless. That stops me from being able to 'just have fun' with a new person though, because if we want to take it into the bedroom we have to have a talk and that stops it from being fun. I'm intense as it is.
End on a positive I think. Lior, you always come across to me as a strong intelligent woman but someone who has some demons that are causing havok in your current life. You tackle complicated work issues and get some great offers. So, if you can resolve this other stuff, it makes sense you will thrive because you are strong on the other issues.
Thanks for the encouragement. It's nice to hear that from you because I hear it from my friends... so coming from you, I know that people don't just say that because they love me, I genuinely am perceived as strong and intelligent. I don't feel strong and I don't feel all that intelligent. I feel depressed!
I am going to keep trying, keep going. I am going to be gentle on myself and keep encouraging myself. The citalopram might start working properly soon. I'm not my most amazing nice version of myself right now, but by nurturing myself I will get back to a state where I can put others first without it seriously affecting me negatively. I hate being this way. I want to be able to please others without ending up energyless and more depressed.
MyNameIsTerry
01-03-15, 08:14
Do you think that sometimes you plan too much stuff in and the effect it has is to overwhelm you? This was one of my big downfalls at work, its called "All or nothing thinking", one of the Cognitive Distortions.
Maybe spreading things out and doing just 2 things a day, but always doing them would help get things done and keep the momentum or build up maybe. That way you are less likely to look at the whole list and find yourself becoming overwhelmed by it all?
Its really good to hear that your friends say that. You have your moments, your spirals, but on the other side you are ploughing through and successful.
Its a real pain with the STI, its not like you can cover the area due to the skin-to-skin issue otherwise you could perhaps work around it. I'm wondering whether you can channel this, use it as a vehicle in your therapy, because I recall you mentioning that you were worried about the fact you feel you give into potential sexual partners too easily to please them. Now you have a physical boundary to get beyond so could you try to use that as your reason to be more assertive over this issue somehow? (Sorry, if I've got any of that wrong, I'm not judging or anything, just wondering if it could be turned into a positive)
I'm not working so cost is a big deal for me, I look for bargains everywhere and spend much longer looking through different companies websites for products thesedays. I had the same concerns with Omega 3, but many of them are rubbish in terms of EPA & DHA and the majority is the fish oil itself, and in the end I found that one of the best, bizarrely, was Tesco's own brand cod liver oil liquid. This was a good find because its on £3 for a months supply and they have a long running offer for 3 for the price of 2 that has been going on for years, I think they run it pretty much permantely.
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