"Sinking" feeling?

So I was talking to my therapist today. We were talking about the CBT module I'm completing for health anxiety, but I put this here because this particular feeling I'm talking about doesn't just concern health anxiety but rather all things I'm anxious about in general.

Anyway, we were doing a practice thought challenge, where I basically say what I'm afraid of and we work through evidence supporting it, evidence against it, and then come to a conclusion.

I mentioned to her that the hardest part with doing these types of exercises is that no matter how "logical" the solution I come up with is, it doesn't always make me feel better, if that makes sense. So I can straight up say "no, I am not going to wake up tomorrow and start losing clumps of my hair" and generally believe it, but then this awful, negative, sinking feeling swoops in and makes me feel really low and it honestly makes me anxious about it all over again. It's like it doesn't matter what I think, I can't shake the pain of it.

It's actually a similar feeling to one I get where I am happy or excited about something, then remember something specific that has been upsetting me, the sinking feeling comes in, and all my happiness is gone. Sometimes there isn't even a specific worry, it's just gone.

I was trying to sort of explain it, but was having a hard time coming up with the exact words to describe it. That's kind of a common problem for me - I've internalized my anxiety/depression for so long it's hard to translate it for others, if even that makes sense.

My therapist said it was an understandable feeling, but did seem a little confused as to what I was trying to describe - no doubt I wasn't doing a very good job.

Does anyone else get this or something similar?

I can understand what you are going through how do you explain feelings and anxieties and put them into words, I struggle on forums like this to explain my GAD and depression, why it sometimes improves and why I get worse again.
When I attended CBT therapy like yourself the counsellor would get a bit impatient that I could not always explain my thought processes and my anger issues. I felt CBT was not as effective as made out but between medication and CBT they seem to be the two main treatments for Generalized anxiety disorder and other mental issues.
CBT did put a name and explanation to various symptoms from my anxiety such as 'avoidance' , 'catastrophizing' etc. but changing these habits seemed to be hard for me to grasp or badly explained by therapist.
After some of my therapy sessions I could come out feeling drained and negative and I would wonder why am I doing this to myself and I hoped it would all fit together later on. I found these treatments worked for a short time and I maybe fell into bad habits again . Who knows :)

Take Care

Some people can have those "epiphanies" where something clicks and they turn a corner. However, many of don't and this means repetition.

The thing is, Poppy, it takes time for you subconscious to be trained to become this way and so it takes time to train it again. This is why CBT can be frustrating, and I felt this way about it, because the therapist explains how to combat thoughts and it seems so basic and also so easy. The reality is far from this, it takes a lot of effort, yet I can't remember my therapist saying that once. From doing my own reading about the mind and therapy I worked this out for myself and from what others said in such texts.

Your current frustration is natural. I remember it. Just challenging a thought made no difference to the way I felt. But why would it? We don't have the power to change our thinking at such deep levels in such a short space of time. It would be dangerous if we could.

So, challenging means doing it over & over again until things change.

Intrusive thoughts are a good model for explaining this. They will still keep coming, warts & all, for some time but by sticking to challenging or accepting them you will see a change at some point where they may become less frequent and less intense. You may see parts of the structure collapse e.g. certain symptoms may no longer come with them. And you may even find yourself amused or laughing at them like I did. At this point they really drop off.

CBT with thoughts is teaching you that you have a point in the process where you can choose to insert a positive or neutral response. This means the area of the brain looking for the response is starved of it because it is only looking for negative - because negative is the correct response. Don't validate it, starve it. This will show the subconscious the intrusive thoughts are not required and they get mothballed. New associations are made in the brain between the scenarios/events triggering them that are based on positive or neutral.

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Originally Posted by rcs

I can understand what you are going through how do you explain feelings and anxieties and put them into words, I struggle on forums like this to explain my GAD and depression, why it sometimes improves and why I get worse again.
When I attended CBT therapy like yourself the counsellor would get a bit impatient that I could not always explain my thought processes and my anger issues. I felt CBT was not as effective as made out but between medication and CBT they seem to be the two main treatments for Generalized anxiety disorder and other mental issues.
CBT did put a name and explanation to various symptoms from my anxiety such as 'avoidance' , 'catastrophizing' etc. but changing these habits seemed to be hard for me to grasp or badly explained by therapist.
After some of my therapy sessions I could come out feeling drained and negative and I would wonder why am I doing this to myself and I hoped it would all fit together later on. I found these treatments worked for a short time and I maybe fell into bad habits again . Who knows :)

Take Care

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Something I believe is that the NHS state CBT is X% effective but it is based on the CBT studies, not in vivo collection of their services. I've never researched this but I would be interested to see the IAPT's success rates.

Effectiveness in studies won't map to real world because the psychologists in them are probably "gold standard", not an IAPT therapist who could have had 18 months training.

I wonder if this is why we are seeing so many threads about poor therapy on here and why CBT doesn't seem to be helping many people. It could be the old issue that people get better and move on though so it's hard to say but in the threads I often see, the therapist is clearly quite poor. There is a guy posting on the OCD board (perry) who's therapist has him doing the same exposure exercises even though he has conquered his fear of them! :doh:

Look at the meds situation. Are the success rates "in studies" matching real world experience? Has anyone ever bothered to check? It's not in the drugs companies interests to bother, they have their premarketing trials and have the licences.

I know my CBT wasn't very useful, and after speaking to people on here (and doing my own reading) I don't believe I had more than a longer period of guided self help, which would sit on the lower level in the IAPT pathway that I had before it. However, I did find that I started to see progress from Mindfulness that my therapist introduced me too and after therapy ended I starting wanting to tackle the goals I couldn't even start in therapy. I've seen a few people on here say a second CBT course helped them and I wonder if it's like me I that respect.

Interestingly, the body of psychologists even criticised IAPT for offering watered down therapy. IAPT is short therapy. Some people on here even say their CBT therapists have told them all they do is exposure work now. So, I find myself questioning whether this service was designed to plug a whole for the NHS rather than give the patient what they needed.

I have had what I call "depression attacks" as opposed to panic attacks. A sudden feeling overwhelming depression/sadness/horror

I think you've described it perfectly. Anybody who experiences that will know exactly what you mean. It's what I'm left with on a daily basis because I have so many memories and associations etc

I think it's a traumatic thing losing your mood or feeling anxiety return. You can monitor for and dread it. It's hard to unfeel this stuff. I spend my days turning my attention away from many things, shushing and challenging stuff.

My mood can be on a knife edge depending on how something can make me feel about or see myself.

I can usually unearth what has affected me and just not have anything to do with it and move on swiftly into a place that makes me feel better or I can take what came automatically and can say no, what a load of rubbish and see it in a way I like more and come out on top.

I think you have to be in touch with what's really bothering you about these things that affect you, notice what images or movie played out in your head.
The words might have been "I won't wake up to clumps of hair" but the image might have been you with hair missing or some other vision of you seeing yourself in a way that really steals your confidence and self esteem.

Imagine it like a system that plays out the same way each time automatically resulting in the lurching feeling and loss of mood.
There might be self esteem sapping images, dread of the feeling returning, resignation. All so quick you miss most of it.

With me I'll feel a point at the start where I'll feel susceptible. A thought at the periphery of my mind, a suggestion forming, a memory starting to form. Break it up. Throw loads of spanners in there. For me it's just a shush. I won't let it form. I won't entertain the idea, see the image, feel the memory. Instead I'll put my mind onto those subjects that feed my confidence, self esteem, interest and enjoyment.

See it. See images of poppy you like. See past successes or hopes for the future. See what and who you enjoy. See your interests and anything else that makes you feel like you. With repetition you can make those things automatic. You can become used to seeing the poppy etc that makes you feel good and feeling yourself plummet at the drop of a hat becomes a memory.

Don't just accept the feeling though. It's obviously happening as a reaction to something, even if you're not entirely aware of what that is. Even if the something is just the fear of it happening. Record what you see, think and feel when it happens. If you don't notice anything maybe you just fear the feeling and feel at its mercy. I'd put money on it being some kind of little mechanism though that once understood can be broken up.