Archive for April, 2012

The feet of a tightrope walker.

The feet of a tightrope walker. (Photo credit: Wikipedia)

About 10 weeks ago I started Cognitive Behavioural Therapy with some trepidation (how far were they going to push me?), with some relief (I had been waiting for a long time), but mainly with an expectation that this had to work because I knew I couldn’t continue down the ever narrowing path that I had got myself on.  Now that it’s over, has it worked?

Certainly, I am no longer avoiding things: I do the food shopping, I drive to and from work, I have had my haircut at a hairdressers, I have even driven on the motorway (something I haven’t done for 10 years).  I experience less panic attacks, and the ones I do experience are shorter and less intense.  From outside it has definitely worked.  In the first two sessions the therapist had me hyperventilating to prove that it wouldn’t hurt me, that I was bringing on the worst of the symptoms myself.  Then we started doing things I didn’t do – she took me to Tesco and on the train.  I had homework every week:  I had to welcome panic attacks without any safety behaviours (see if they were as bad as I thought), I had to not avoid things, I had to record everything down in diaries.  I responded very quickly and I have got my life back.

Yet the underlying anxiety I have hasn’t gone:   I still have knots in my stomach that tell me I have something to fear, or feelings of guilt over… I don’t know.  I still feel tired from the daily effort of coping with anxiety.  I still cannot have a panic attack without some safety behaviours; even though I fight it, there is something in me that doesn’t believe 100% that my panic attacks won’t send me mad or hurt me.  I still have to actively avoid avoiding things rather than just go about my daily life.

From the point of view of my therapist I am a complete success as I am in charge of my anxiety now.  “You were never trying to get rid of the anxiety symptoms, just look at them differently,” was how she reassured me at our last session.  However, from my point of view I feel I am stood on a tightrope and it wouldn’t take much to lose my balance and find myself falling back into avoidance behaviours and round the clock anxiety.  At the moment it takes a lot of energy and guts to keep walking along the tightrope because there is part of me that wants to jump off – in some ways it would be easier.

Despite this, I am going to try my hardest to stay on the tightrope and continue to walk along it albeit slowly because what CBT has done, I believe, is kick-start a recovery.  It has not been a miracle cure I so wanted it to be, but it has given me enough knowledge of my condition to shrink it slightly.  It is now up to me to continue to shrink it further because actually I would like to get rid of the symptoms of anxiety.  Will I always be susceptible to anxiety? Probably.  Will I always have to work this hard at it?  Hopefully not.  Has it worked?  It’s too soon to say.  Would I recommend CBT to others?  Definitely.

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Ireland (Photo credit: Trent Strohm)

Recently I took a trip to Ireland with my family to visit some of my husband’s relatives, and throughout our stay there were numerous enquiries about people’s general health, ongoing health issues and recent operations.  Yet how my battle with anxiety was going was never mentioned.  Not because they weren’t interested or didn’t care, but because they didn’t know.  There was plenty of opportunity to bring it up, and in fact no reason that they didn’t know already  – irish people love to know everything they can about everyone – I’m sure they have asked after me during several phone conversations.  Yet I nor anyone else refered to it, even though every night I filled out a panic diary as part of the CBT I’m having, and had to battle daily with some sort of anxiety.  It wasn’t until I was on the ferry back that I wondered why? Why am I ashamed? Why is it such a taboo?When someone has a physical condition, people naturally sympathise, even if they haven’t had that condition, everyone has been in pain or felt sick.  But, the same could be said for anxiety; everyone has felt nervous at some point.  So why do I think that people won’t understand?  Maybe that’s the problem: because everyone has felt anxiety at some point, they think they do know how it feels and it’s not that bad.  Also, for most people, there is generally a reason for it which makes it more manageable – again, it’s not that bad.  So I’d have to explain why this is different, worse, debilitating, to people who didn’t really get it. Would they even believe me? For the most part I can hide how I am feeling inside or I can make a reasonable excuse to leave so people don’t see me at my worst.   Would them knowing make the anxiety worse?  If they knew,would feel I was under constant surveillance for signs of anxiety?  Would I simply regret telling them?Of course the answer to these last questions is no.  In other areas of my life, such as work, I have needed to be very open and generally it has helped.  They may not have understood but then they don’t need to offer some support.  Actually, I have found that more people than I thought do really understand as by opening up they have confided that they also suffer from panic attacks and anxiety and I have felt able to support them.  I have one friend who is have CBT the same time as me; a fact I would never know if I hadn’t confided in how I was feeling.  It is said that anxiety of one kind or another will affect one in three people at some point in their life, so by opening up and sharing stories with the people we know we can raise awareness of this taboo subject and help each other in the process.

Next time I go to Ireland I’m just going to mention it – see what happens.

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I noticed that someone in the government is suggesting that there needs to be a ‘mental health secretary’ in order to raise the profile of mental health up to the same level as physical health.  The reason being that mental health affects a lot of people yet the services are not nearly as accessible as if, say, you had broken your leg.   This got me thinking about my own experience of mental health services.

I was only six when our family had our first need for mental health services.  From a six-year old’s perspective we woke up one day to find my dad had literally gone mad overnight and by the end of that first day it was clear that we needed help fast.  Not knowing  where to go, the out of hours doctor was called.  He promptly turned up and then promptly left – stopping briefly on the step outside to write a hasty prescription then retreating – clearly out of his depth.  I don’t know exactly what happened over the next few days except we looked after him; often eating dinner while my dad was naked, talking balmy or being an animal.  We also slept downstairs with the ironing board in front of the door so that he couldn’t leave the house with no clothes on – eventually he was sectioned.  For the next six years, my dad was in and out of hospital while they tried to diagnose and control his condition.  He was assigned key workers that my mum could contact when needed and mostly, I would say that, the service was good: as they got to know my dad better, my mum had proactive people that she could get in touch with quickly.  To date, he still has regular meetings with a psychiatrist and with an added diagnosis of Parkinson’s disease, the different professional areas are keen to coordinate.

Perhaps because my own experience of mental health has not been as dramatic or, perhaps serious, my experience hasn’t been as positive.  When I first had serious anxiety, I was at university but went to my doctor at home as it was the holidays, they prescribed me with beta blockers which I though made my chest tight.  Now, if you have suffered from anxiety, you will know that one of the symptoms anxiety is a tight chest – I don’t have asthma and so there is no reason why they should do this, but instead of investigating further, I was taken off them and told to go to the doctor at uni.  By this time, getting to the doctor was almost impossible and when I got there sobbing, I was told off by the doctor because I hadn’t come sooner.  However, they still simply prescribed me antidepressants and sent me on my way.  Over the next eight or nine years I was on and off of various antidepressants even though depression was not the problem.  One doctor I had bearly spoke to meet when I would make my monthly appointments to get the antidepressents.  He never asked any questions and it was only when I moved doctors that she informed me I had been on them for over two years.  I was refered to the mental health team when I moved, but because I was holding down a job, I was simply not a priority.  It is only now after having a child, so is potentially a social services case, and taking time off work (it could also be a change in borough – my forth), that someone has taken me seriously and I feel like I’m actually being helped.

This is where, I feel, the mental health services are going wrong – not taking moderate cases seriously enough.  Because the problem is, eventually those moderate cases become serious chronic cases unless they are addressed.  I don’t know what the answer is – perhaps more education for GP’s, more awareness in society so less stigma, more money put into therapies that really do help rather than just medication or spmething else.  What I do know is that, if a mental health secretary can get people help sooner, then I’m all for it!

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