beating myself up

[tricia56]

hi firstly sorry for posting again on here but i haven't really got no one to talk to about how i feel or really understands ,as you all know from my previouse posts ive struggled with GAD and HA for a long time now and had the cbt and to afraid to take meds, but i do try to help myself but every day i still wake up anxiouse and its there constantly no matter wat i do. i don't go out very much exept go to local shops or my gp or walk round to see my daughter who lives near by,but yesterday morning my daughter foned me to see if i wanted to go and watch my little grandson play as he has joined a the core of drums band and they were playing at a big park, strait away i got so scared and didnt want to go because i knew i had to use public transport but in the end i went even tho i was so scared and anxiouse but all the time i was there i was a mess inside i couldn't enjoy watching my grandson or walking round the park and just kept feeling i want to go home but i couldn't walk home it was to far, i managed to stay there for 3hrs but in the end my other daughter turned up and i asked her to drop me home,i know i should of been proud of myself that at least i done it but i didn't all i have done is beat myself up and feel quilty like letting my family down like why couldn't i have stayed there no matter how i felt and why didn't the anxiety go down while i was there as i thought that the anxiety is supposed to go down the longer you stay in a situation or place you are in but it didn't go down at all and now all im doing is questioning why does this happen and beat myself up and question myself that maybe its not anxiety its some thing else wrong with me, sorry for such a long post but i just thought maybe some one on here can maybe give me some advice and help me understand anxiety much better.

[Autumn4]

Well done for going & staying for 3 hours !!!! Try to control your breathing when you are out. Practice 8 - 12 breathing - in for 8 & out for 12 or basically breathe out for longer than the in breath. Try this even when you are at home. I have just the same issues as you & I know how difficult it is. The anxiety carried on because you were thinking about the need to get away & felt trapped. You were also hyperventilating I would imagine. You need to try to really focus on something that is going on i.e. at the park. Really look & listen to say the drums & pick out as many details as you can. Every time your mind goes back to your body sensations just try to refocus again. It takes practice but it does help. :)

[MyNameIsTerry]

I think the issue of your anxiety level not dropping is like how in GAD you can conquer something one day and get up the next feeling just the same about it. This, for me, is where exposure therapies alone don't work and I think GAD is one where this can often be the case because a lot of the time we don't even feel there has been a trigger.

I can remember my CBT therapist asking what triggers my anxiety and I replied 'waking up'.

I reckon this is where Davit's take on CBT comes in a lot over the cognitive side. However, I also believe we can improve ourselves from a behavioural side so that we become more confident which will reduce anxiety levels anyway.

Panic will always subside over a duration because the body can only generate so much adrenaline before it shuts down release of more as part of its normal functioning. Anxiety can then be kept quite high until the adrenaline is metabolized into something else the body needs, passes in your urine or you burn it up with exercise or deep breathing. Until then, it will be coursing and you feel very aggitated.

So, if you can't get to that 50% reduction via exposure, you can look at other strategies first e.g. change how you think in CBT so that you reduce the impact to your anxiety before entering a situation. Or another option is driving down overall anxiety levels with things like relaxation, but this can take some time to have a marked effect.

I would welcome seeing Davit on this thread as I think he has experience in this area that could be useful.

Exposure therapy can be conducted in several forms too. The most successful is ERP where you use a hierarchy to work from lesser exposures up to the one you fear the most and then even further to ensure you have conquered it (I think therapists don't always do this but its the recommendation). Other exposures are more in your face and these are the ones that can be a problem as they don't work for everyone.

[tricia56]

thk you autum for getting back to me I do post a lot on here and do struggle because being axiouse everyday all day for the past 9yrs it takes it toll on me and I don't know why or what im doing that is keeping it going even tho I I have read all all about anxiety and have a good insight of it and what I should do and I do try but for some reason I never get a break from it and I feel that im the only as I don't know of any one else who does suffer with it constantly everday all day

---------- Post added at 11:08 ---------- Previous post was at 10:30 ----------

thk you terry I reguard your advice very highly you have a very good insight and understanding of GAD, as you know i had cbt 4 times and each one only lasted 6 to 8 sessions and I most of the time I never got homework or charts to fill in and take back for the therapist to look at exept a thought challaging chart which I filled in and when I took it back the the next week the therapist didn't even look at it so I wasnt told if I was doing it right or not, most of the time it was just talking about what I done that week,the last cbt I had was just working on the behaviour side which I started to do and I did start to feel better as the weeks went by but then out the blue after about 6 sessions the therapist told me that he felt that he could no longer carry on with the therapy because he said that even tho ive come along way and have got to the top of the mountain and that because I don't take meds I wont be able to get over the moutainand that if I start taking them after 12 wks of being on them then he would concider starting again even tho from the start he knew how frieghtend I was by taking meds and didn't want to take them , I rember walking out the room crying because I thought wat am I going to do now no one is going to help me now because I wont take meds that's when I started to go down hill again and went back to how I was mabe I should ive just kept on doing what I was doing when I was doing the therapy but I just lost all heart in it if that make sence and I cant afford to pay for cbt myself and I don't know were else I can get cbt again for free

[theharvestmouse]

Your posts would be easier to read if you used full stops.

[blue moon]

Crikes I had better remember full stops......

[MyNameIsTerry]

......

Now you are in credit :D

---------- Post added at 07:05 ---------- Previous post was at 06:21 ----------




[/COLOR]thk you terry I reguard your advice very highly you have a very good insight and understanding of GAD, as you know i had cbt 4 times and each one only lasted 6 to 8 sessions and I most of the time I never got homework or charts to fill in and take back for the therapist to look at exept a thought challaging chart which I filled in and when I took it back the the next week the therapist didn't even look at it so I wasnt told if I was doing it right or not, most of the time it was just talking about what I done that week,the last cbt I had was just working on the behaviour side which I started to do and I did start to feel better as the weeks went by but then out the blue after about 6 sessions the therapist told me that he felt that he could no longer carry on with the therapy because he said that even tho ive come along way and have got to the top of the mountain and that because I don't take meds I wont be able to get over the moutainand that if I start taking them after 12 wks of being on them then he would concider starting again even tho from the start he knew how frieghtend I was by taking meds and didn't want to take them , I rember walking out the room crying because I thought wat am I going to do now no one is going to help me now because I wont take meds that's when I started to go down hill again and went back to how I was mabe I should ive just kept on doing what I was doing when I was doing the therapy but I just lost all heart in it if that make sence and I cant afford to pay for cbt myself and I don't know were else I can get cbt again for free

Thanks Tricia, I really appreciate that.

First off Tricia, don't worry about posting a lot on here...its what this place is for. I know some people get annoyed by it but this is Nic's website and as long as she is ok with it, everyone has to be too.

I think you have been treated harshly by these "so-called" therapists. Its obvious that your local trust doesn't invest in mental health as 6-8 is only just longer than Guided Self Help. There is no way proper CBT can be delivered in such a short time frame and even the NHS agree in their literature on top of what NICE say.

The therapist who said you are doing well but can't recover without meds is incorrect. If you are making progress, its a good sign that meds are less likely required. Its when therapy is going nowhere that meds should be considered. Given you were on session 6 in a region that works to 6-8 sessions, I wouldn't be surprised if this was an unscrupulous therapist trying to reduce his list to stick to that standard. Its not like its the first time someone on here has suffered due to a poor therapist.

MIND & Rethink offer therapy so perhaps contacting them might reveal if they can do anything? AnxietyUK also offer reduced cost therapy if you join them (only about £30 a year for membership).

I don't think the decisions to not allow you to have CBT without meds is a good or informed decision because your CBT has been far under the standard in length and we have this therapist sending mixed signals. Your GP needs to consider that.

If you are in England you can now decide who will conduct your therapy. (they decide the treatment though). This might mean you can get to a different provider?

CBT is known for its use of homework. For a therapist not to use it isn't inline with what CBT is supposed to do. Given this and the short sessions, it seems more like Guided Self Help to me.

Do you know whether you have had Level 2 or Level 3 or both? Your GP should know that or be able to find out. If you have only had Level 2, then that would explain this and you can be referred to Level 3 which is what your GP should do or the IAPT service you were referred to.

[Davit]

I would deal with the agoraphobia first and the GAD should fall into place once the reason to worry disappears.
Exposure will do you no good if you do it with negative thoughts. Hard not to though with Agoraphobia.

[tricia56]

thk you terry, im not sure what level I was on but I will ask my gp , and just thought id let you know that davit bless him has private messaged me and is willing to help me so just want thk you u both for your kindness and support. ps I hope ive put the right full stops in.