Biting the bullet: CBT

[NoPoet]

Can anyone tell me how long CBT takes to start having an effect?

[ash1807]

Hi PP

I have done two lots of CBT:

The 1st was via NHS some years ago, where I had weekly group sessions. To be quite honest, these never took off for me, as a couple of hours of 'altered thinking' once a week was not sufficient to override my default thought patterns.

My 2nd and far more useful was a couple of years ago where I attended a private day hospital. I was fortunate to have a company medical insurance. I spent almost a month with the same group, constantly given various sessions on CBT. Being away from the usual 'real' issues that come iwth having a job/family,and also being part of a group who all had the same need to feel better helped me immensely. Apart from pure CBT, I was also offered counseliing, meditation, relaxation sessions which should have formed a package to turn to.

I came out feeling a lot happier and also more aware that all my problems lie within and controllable. Sadly, in the euphoria of a new 'me', I slowly started slipping back to the default behaviour.

Today, I am not in the best of places,but I have a much better awareness of what is wrong with me. I still am on medication, which in itself brings different issues to my mental/emotional welfare. You are probably in a better place, since you are med-free for now.

I do follow your 'blog' on Citalopram. You seem to have sussed a lot of your issues out, you are in a good place to take that 'one more heave' to move into a more normal living.


Take care
Ash

[NoPoet]

Ash, thanks for the honest reply.

In your reply, I noticed something straight away. Do you have any kind of support network? I.e. helpful and considerate friends and/or family, the Samaritans, Anxiety UK, a sympathetic doctor etc? Or do you simply deal with your problems on your own? It is very easy to "relapse" or fall back into bad habits when you feel you're alone in life; during a spell of anxiety I am a totally different person when I'm with friends or my girlfriend than I am when I'm alone. Also, in a closed environment like your second CBT course, it is very easy to start feeling on top of the world. The trouble is, we need to operate in the real world, and being insulated from the world only gives us a brief respite. A core component of CBT is exposure therapy and this seems to have been lacking.

I am actually considering going back on the meds. Blowing my trumpet about coming off cit (again) was a conceit and I should have been better prepared. However I am actually starting to see a possible return to meds as a simple choice rather than a scary admission that I'll never get better. Citalopram has a proven record of relieving some of my anxiety symptoms and I now know my issues with cit were simply related to health anxiety, although that doesn't make the health anxiety any easier to bear at present.

I've changed my CBT to this Saturday instead of Monday. At present I am waking quite early (around 7ish) and not being able to get back to sleep, making me stressed and less resilient; my anxiety goes through the roof when I'm alone at home; I am suffering from tension headaches; I am finding it hard to believe that I can get past this, despite having done it before (albeit with meds and therapy over a period of time).

I am quite keen to know how much of a difference CBT can actually make, cos at the minute I can't see the wood for the trees.

[Mirabelle]

Hi Poet
In my experience you get out of CBT what you put in. It takes time and repetition but you will get there. As for the meds? So what if you go back to the Cit? Do you feel that you will have wimped out if you go back to the meds?
If so then maybe you need to think about how you are viewing you illness. Would you say a Diabetic wimps out by taking insulin?
It is what it is, my friend. Do what you need to do to get by.
All the strength you have gained will stand you in good stead, believe me.
I was ill with anxiety 20 years ago and recovered completely with CBT alone. Once I had got thru that I was never afraid of anything again, it puts things into perspective and it also made me more understanding and less judgemental.
I am now ill again with anxiety and using meds and CBT. It's not easy but I know I will recover and be invincible once more. I wish the same for you.
xx

[NoPoet]

Hi Mirabelle, thanks for the reassurance. One aspect of the illness we identified is my reliance on other people and outside factors to feel better, hence my partial desire to get back on the cit. I am feeling anxious to varying degrees pretty much all the time these days and it is wearing me out. I guess I see cit as a way to get rid of the anx but I am prepared to try CBT alone for now. I just don't know at this stage, I want to get better and am prepared to work hard but I hate feeling like this and I don't know how long the CBT will take to start working. I know that with support and guidance I can overcome the worst of the anx, I just wish I could believe that day was coming!

[Mirabelle]

Poet
By taking the Cit you are merely facilitating your recovery, we both know that meds alone will not do the job. If only they could! The CBT is a process and as such takes time. You need to be able to practice what you have learned and also for the thought habits you have developed to be changed. This will take time, try not to be impatient. We all want the horrid feelings to go away, and they will, but by focusing on them you give them power over you. Remember Claire Weeks says 'let time pass '
I know you are a dynamic man who prefers action to inaction and that is good but also remember that you are looking for a lifetime change and not a sticking plaster.
Look to the process and not the outcome, you are in the process now, the outcome is in the future. Now is all there is.
xx

[ash1807]

Hi Poet

I think you hit the nail right on it's head, about the lack of any support system after the CBT.

One of the big issues I have, you may even resonate with me here, is when I do feel well, I am quite happy to fall back in to the life I am most comfortable with. Upon finishing my CBT, there were weekly aftercare meetings, which I did attend for a few weeks, but then found it unneccessary. Big mistake.

One of my 'feed the anxiety' behaviour is that I tend fight it alone, to the point that no one at work are even aware of my current condition. I do need support, but having lived with a anxious person for a long time, my family tend to be sympathy-fatigued now. What we need is a person we can relate to. This can be difficult for us blokes at best of times. Talk to me about the pro and cons of a Beemer being the best drift machine, I will quickly become your best mate.

As for using a med as a support system whilst working on your self, I applaud you. You are well read and certainly have a very strong belief in yourself. As Mirabelle rightly says, that recovery is an inside job, no quick fixes, but a long hard but ultimately satisfying journey. If this requires someone to hold your hand, be it be therapy, meds or whatever, hold it tightly.

btw, your post contents seem to suggest that you may not need to start CBT from scratch. You have a brilliant understanding on thoughts, behaviours, emotions....

On a different note, I too am looking for a local CBT therapist. I have nothing to loose, My short love affair with Mirtazipine is finally over and I am speking to my consultant on a review of my medication. I have had some pretty good times whilst I was with Cit. I have had many meds over the years, but Cit was probably the best tolerated for me. Sadly, like all meds, they ultimetely poop out on you

[NoPoet]

Hi, am back at work using my phone so short reply!

Regarding the meds, I realise I have a big problem with them, a health anxiety-related knot that must be unbundled. I phoned Anxiety UK for some reassurance and advice regarding CBT and general health anx. Once again it was a fantastic call which considerably cheered me up. I'm not even bothered about being at work today!

Ash, it sounds like you respond well to therapy. It's a crying shame that you slipped back a bit but it's entirely understandable. Loads of us stall our own recovery by quitting therapy, self-help etc when we start getting better; who wants to carry on using coping techniques when they're feeling good? It just reminds us of times we felt bad, which makes us think we're gonna relapse. (This is what I am hoping CBT will help to resolve.) You are very far from a lost cause mate. Get in touch with Anxiety UK.

Mirabelle, I will reply more fully when I get a chance, but thank you!

[NoPoet]

Quick update to the above post. I've got my first support group meeting tomorrow at 10am-12pm, then it's straight to work from there. It's gonna be tiring, especially as I am waking up early most mornings, but if it helps, I don't care about being tired! Today has been the most anxiety and tension free day since I last had CBT. I totally relate to Ash's post about slipping back into anxious habits and I hope to learn how to stop that from happening. It's mostly the lack of tension which has made the difference today; it's been the tension that has been the worst part.

Mirabelle, I discussed something similar to what you said with Anxiety UK this morning. I am always leaping ahead in my thoughts, usually to unhappy conclusions, and if I can stop doing that... Well, it'll be a better life, that's for sure!

[potato11]

Hi Psychopoet

have you tried out the online cbt4panic program recommended here on NMP?

it helped me more than I can put in to words

http://www.nomorepanic.co.uk/showthread.php?t=91696

it's simple to understand, even funny with the illustrations, and you get sent a mini booklet to help you when your out and about incase you have a panic attack. Absolutely brill.