NanaNina re. CBT

[kizzie]

(sorry to put your name in the title wasnt sure how else to grab your attention)

Anyway - in another thread you kindly asked me if ive tried CBT - and youve also mentioned it elsewhere a few times. I didnt want to take attention away from the OP in the other thread so thought I would start a new one. Hope thats ok.

Anyway - I have had CBT - a few years ago - but the practitioner wasnt very good and only looked at it from a very basic point of view. Ie. Its raining. No its not - tell yourself its sunny .

Im since done a huge amount of reading about it (inc the mood book you have suggested on another thread) and am keen to do more. The thing for me is that when Im well, Im very well. Busy senior job, happy family, very contented.

But when Im hit with one of the blips out of the blue (and they are completely out of the blue)and I then get hit very hard with severe negative thoughts. Life pointless etc etc.and everything feels very black. It just makes no sense to me.

But anyway - from your experience of doing CBT - do you think it might help to deal with that. (Even though my 'normal' thoughts are ok and it feels like a very chemical thing...)

Thanks Nana Nina x

[choklitmountain]

It's only as good as the therapist - some life coaches are often better than basic CBT trained psycho babblers. You need someone who can challenge your thoughts, but in a positive way, and leave you feeling better than when you started. That's a good sign, and it puts you back in control of your thoughts and not going back down the same spiral .

[NanaNina]

Hi Kizzie - no problem about using my name. I know exactly what you mean about CBT making some kind of sense when you are feeling ok. I also understand what you mean about the blips out of the blue and I am still getting them 5 months after being discharged from hospital. It IS soooo much harder to try to use CBT at such times, but my CPN (who has helped me enormously) tells me that it's when the blips come, that is the time that you need to challenge your negative thoughts and try to have more balanced thoughts, so as not to scare ourselves, and try to do simple tasks to get through the day and not isolate ourselves.

I am not saying I am always successful, if I wake up feeling flat and empty etc in the way only people who suffer from this horrid illness can understand, I have to force myself out of bed and shower etc. I am lucky in a way as I'm retired and my partner is very supportive, so I cry (literally) on his shoulder and say things like "I can't take any more of this - I just want to go to bed and not wake up - some people must be brave and can cope but it I can't - I'm so ashamed - I'm useless etc etc etc.

Then I write down an unhelpful way of coping with the blip (as above with I'll never get better ever etc) and write how it makes me feel (useless, hopeless etc) and cannot think of any activity I can do to get through the day or distract myself,and I can see that I am in a viscous circle.

Then I write down a more helpful way of coping e.g. "this is a blip, it's a normal part of recovery, I've had them before and they've gone away and this one will too. How I deal with it is the most important thing. One day I will be fully recovered" Then this makes me feel a litle more hopeful and I force myself to do simple tasks, go for a walk, see a close friend or do something other than doing what I want to do, which is to go and lie on the bed!

SO I'm really not saying CBT is a cure all - far from it, but my CPN (in whom I have a great deal of confidence) tells me that it's how I deal with the blips that is the important thing and I think I've proved that she is right. I woke up with a blip out of the blue last week and my sister was due to come for lunch. I picked the phone up to cancel and then thought NO - this is avoidance and I have read that is the worse thing we can do and is the thing likely to lead to relapse (which scares the life out of me) so I carried on and told my sister I wasn't feeling good but I'd do my best and I managed and felt good that I had done it, rather than gone back under the duvet.

Are you recovering from a severe episode Kizzie - can't really remember your history. I keep a daily record and score every day as - really bad, not good, reasonably good, good or very good and from time to time I calculate the scores, and am usually surprised at how many moe good days I have had than bad. Also knowing that these blips are a normal part of recovery helps me too.

SO - not sure if that helps - and I too think the blips are a chemical thing because I can rarely attribute them to anything. To date I have had four blips, carying in length from 5 days to 15 days (I was really really scared then that it was relapse) but my CPN said no, that wasn't the case and that it would end like the others had, and of course it did. So in a way getting over blips does help to know that they DO go away.

Best wishes and hoping for a lot of blip free days for us both and all the other sufferers.

[kizzie]

Thank you so much for taking the time to write all that Nan nina- so helpful and all makes sense. I really really appreciate it - and sure it will help others too who read it. Take Care.

Thanks too chocklit - i think you are right that the cbt is only as good as the person who delivers it.

x

[natsyloo]

Hi Kizzie and NanaNina, hope you don't mind me joining the thread. I've just started CBT for PND and I too am really interested in itas I've only had a very basic understanding of it in the past but have started to research more.

It's so cruel the way our minds work when we're anxious and depressed in that you crave the very opposite of what is actually good for you. I'm making a concerted effort to socialise when I feel like crawling under the duvet and usually it does lift my mood.

I've just completed the first phase of treatment, which involves identifying the areas you most need to tackle so you can drill down to the area that most affects your mood - be it situation/practial issues, altered thinking, altered emotions, physical symptoms and behaviours. The thinking behind it is that if you alter your behaviour (ie stop 'avoidance' tactics, do things that give you self esteem etc and you also tackle negative automatic thoughts (NATs) then your mood/emotions and physical symptoms will automically improve.

Obviously this is only my own albeit basic grasp as a CBT debutant but I understand the mechanic of it and have since realised how my negative thought spirals are contributing to a sustained low mood.

The hardest thing is applying it when you're in a distressed/emotional place, but the idea is that the more you practice, you will retrain the pathways in your mind so altering the negative thought cycle.

I'm looking forward to learning more and hoping it aids recovery. Sorry for rambling!

[NanaNina]

No you're not rambling natsyloo - you obviously have a very clear idea of CBT which has helped my understanding as you put it so well. You're so right that the hardest thing is applying it when you are flat/distressed but this is just the time you need to put it into practice isn't it.

I have proved this by going out for a walk/visiting a friend or something like that when I have been feeling really flat.

I think the idea is that once you have really practised it, you can use it at times in your life when it is needed. Not a cure all as I said before but certainly helpful for the "here and now"

In Jan I am starting to see a CAT (cognitive analytic therapist) which is a combination of the cognitive/thinking parts of us in the "here and now" but also looking beneath the surface to see in an analytical way to explore any issues from my past life that migth be contributing to the fact that I have suffered 2 major episodes of depression. Am having to pay for it, but if there is anything I can learn to prevent this horrid illness again, it will be money well spent.

Best Wishes

[natsyloo]

Thanks NanaNina - I would say practice makes perfect but that's an area I really need to tackle. Lowering those expectations of perfection!

Good luck with your CAT - sounds really interesting as I know there are big debates in the world of psychotherapy re: CBT simply being a sticking plaster. I'd rather have a plaster than an open wound though!!

Best wishes and take care.

[kizzie]

Will be really interested to hear how that goes Nana nina.

Natsyloo - good luck with your cbt - hope you see some benefits really quickly x