CBT again?

Hey everyone, hoping someone could give me a hand with something.

I've had anxiety a long time, about 8 years. Started out as health anxiety and eventually became GAD. I had it under control a long time, around 6 years but recently relapsed towards the end of last year.

During that time, I saw a counsellor at the start of treatment and did CBT during a rough patch 3 years ago when my parents split in order to deal with depression. It helped quite a bit and I was feeling better after around 8 sessions.

After a colossal argument with my old workplace last year that ended up in court, I ended my job and was signed off work with clinical depression. Sadly in December last year, my Health Anxiety kicked off and i'm more anxious than i've ever been with panic attacks almost daily.

I've started pregabalin and have been on mirtazapine for about a year. The pregabalin is ok but i've felt like the mirtazapine have done nothing for me. I have great anxiety over medication and feel extremely anxious taking multiple meds.

I briefly had a CPN and she was horrible to me, blaming everything on my lifestyle and saying that I actively seeked attention. I informed my GP and he immediately withdrew me and referred me to a psychiatrist instead. This episode actually worsened the anxiety.

I am now seeing the psychiatrist and have discussed everything with her at length, including all the problems that led me to this point. I'm due to see her in a weeks time (it was meant to be the end of next month but I asked if she would see me sooner because i'm that bad) and I still feel like total trash. The physical symptoms are almost unbearable and are triggering panic almost every day. I feel like the meds are masking some of it, but it's not gonna be enough to get me through this rough patch i'm in.

I did discuss CBT with my psychiatrist and mentioned that i've never had it for anxiety, only for depression and asked if it might be an idea to do it again. She was reluctant though and said that she didn't feel digging up things i've already tried would be a good idea. At this point though, the medication isn't enough and i've no idea what to do next. It's been so long since I did it that I honestly don't remember any of the techniques I did, my mind is mush.

I suppose what i'm asking is, even if i've already done CBT would I be able to do it again exclusively for the anxiety if I asked for it or am I completely missing the psychiatrist's point? Are there any other types of therapy that would be good for me to try that I might be able to bring up at my next appointment?

I'm tired of feeling awful every day, I just want to get better and live a normal live.

Thanks for reading!

Oh it sounds super frustrating for you.

I don't know anything about psychiatrists. They're the ones that prescribe meds right?

I've done CBT, psychotherapy, and counselling in my time. The idea is that you're meant to leave a period of 3 months between periods where you're in therapy in order to put into practice what you've learnt. You shouldn't be doing more than one kind of therapy at once.

There are books you can read that describe CBT techniques - and there must be a lot online as well. I don't think you need to be in therapy in order to refresh your memory with CBT techniques.

If you don't understand what your psychiatrist meant, maybe it's worth talking to her again. Maybe try to explain what you hope to gain from CBT, and maybe she can suggest a better alternative that will better match what you want to gain?

I find talking therapy helps me a lot, weekly, in addition to meds and a lot of work in self care - I have put into practice a lot of what I learnt from CBT from my sessions 2 years ago, and it has made a difference to me.

Thanks for the quick reply Lior.

Yeah psychiatrists are the ones that can prescribe meds, had to see her to get the pregabalin.

I'm terrible at putting into practice techniques from books. I read through some of Claire Weekes stuff and it was genuinely interesting and I recognized a lot of myself in there, but putting the techniques into practice felt impossible, like I couldn't concentrate. I guess I also feel like my situation is vastly different to what it was 3 years ago. But perhaps a different type might be the answer.

Yeah I see her next Friday, it can't come soon enough. I suppose it's not even really about CBT in general, it's more that i'd like to do something to supplement the medication since i've got a bad feeling that the minute I stop taking them or reduce the dose, the problem will come back because i've not really been dealing with it, just covering it up.

Thanks for your response, it's given me something to think about for sure!

Yeah, common practice is to take meds and do therapy as well - your gut instinct is right. Meds don't sort out the root of the problem.

I've learnt a lot about myself thru CBT and psychotherapy. My therapist is amazing, I'm so lucky to have her.

Maybe if you don't find the techniques practicable, maybe they're not the right ones for you right now. Maybe you could try other techniques.

I'm not a Claire Weeks fan. I really like the Psychology Today website, and also Everyday Feminism which deals with some of the abuse and prejudice I've experienced.