Why hasn’t CBT/therapy etc helped me?

[Nocrispsinthehouse]

I have had anxiety since I was a small child and combined anxiety/depression throughout my adult life (now 49, and it’s the worst it’s ever been).
I have always felt that my anxiety is really deep set and ridged (I don’t know how else to describe it). I had many issues as a child. Major panic, anxiety, OCD’s, existential fears, phobias etc. These issues were never addressed by my parents and it was all put down as my ‘thing’, my personality trait, just me being me.
Over the years I have tried so many things to help. I have had endless counselling sessions, lots of CBT sessions, hypnotherapy, have seen a Psychologist, had EMDR, mindfulness etc............nothing has helped long term no matter how much effort and time I give it.
Whenever I read about anxiety and depression there are so many who will say CBT and therapy etc helped them out of this dark hole.
But they have little impact on me. Why haven’t they helped me? I have given it my all with these things but it’s as though I am more anxiety than actual me and I will never be able to take over the reins.
Has anyone else with mental health issues struggled like this?

Did anything help you?

The type of ADs that are thought to increase the risks of dementia are not commonly prescribed, and wouldn't be given to you for anxiety. You'd be prescribed SSRIs, which have no link to dementia.

My mum never took any TCA’s only Citalopram, Fluoxetine, Sertraline and Trazadone. It may be mainly TCA’s which pose a risk but it still concerns me.

OP can you change GP? Because you don't seem to have much faith in yours. In any case, anti depressants helped me. The SSRIs didn't numb me, just helped me dig myself out. I actually felt like I could hear myself think for the first time in a long time. I was on them for a few years. And I would definitely pursue a diagnosis. If your GP didn't take you seriously - although with all that evidence I don't see why he wouldn't - then see another GP. But there's no point in assuming they won't help you until you try.

It might concern you but there's no medical or scientific basis for it.

There's often a genetic component to mental health issues too, and those are also biological. Seriously, pills are your best bet here.

I took a TCA for years as l struggled with SSRI’s. Dementia is last of my concerns. It was either take a TCA or not be here.

MolliciousIntent I definitely haven’t ruled SSRI’s out of the picture, in fact my friend is 5 weeks into taking Sertraline and really is back to her old self but I am just absolutely bloody terrified to take them, I know that’s overwhelming anxiety talking right now but that’s honestly how I feel. I am my own worst enemy I know 🙄
Dimenw I just in the process of changing surgeries atm, so hopefully I can book an appointment once I am fully registered with them. My current surgery are no longer seeing patients face to face, only emergencies or if it actually involves the need to examine someone, they obviously feel telephone consults work for them but that doesn’t work for me. I felt that I couldn’t get my point across via the phone. Thankfully the other surgery which my dc, husband and parents attend have been seeing patients face to face all year.

I was going to say exactly this. It took me 4 years, various sessions a week, with an excellent therapist but psychoanalysis finally freed me of depression by tackling the root cause and trauma.

Good therapy is not cheap and I had to make sacrifices, like I won't get on the property ladder for many years, but being free from depression was definitely worth it!

I've had CBT at various times over the years. It provides help identify issues and offers coping strategies. However, the person has to put them into practice and that's so hard when down. I've found it a real struggle and at times Im better than others. Then I end up going back and often its only to be reminded really of things I've done before.

CBT has helped me accept and change some things which made a significant difference to my well being but major changes arent always possible.

So, I know exactly where you are coming from. i didnt give it up as I didn't get on with medication and that was only dumbing life for me not answering my problems too. The other good thing about CBT is it isn't invasive or chemical, so for me I see it as no harm done.

But its not a miracle cure, you are right. It's hard, difficult and sometimes feels impossible

CBT /mindfulness don't get rid of anxiety or depression they are about learning to cope with it. If you can reach a point where you no longer fear them or try to fight them then they are no longer in control and then they start to ease.

I've had tonnes of therapy, counselling etc and paid out thousands for private such as hynotherapy and NLP and nothing has helped in any meaningful way. I am now on the waiting list for a full autism assessment having passed the initial assessment. It all makes sense to me now and I hope I don't have to wait for too long. I've also been on and off anti-depressants for more than 30 years.

I also have ocd cbt has never worked for me it actually made it worse and I had it for MONTHS! I worked really hard, I did all the exercises etc (as much as I was capable of - I'd reach a point where I'd plateau, the person delivering would push me to do more and then I'd spiral right back down! - anyone else same?)

Cbt is cheap and easy to "deliver" is why it's pushed. There's sod all decent research being done into alternative better options

If you go on Mh forums you'll find there's a lot of us that cbt didn't work for - we're then labelled "unwilling to engage" 🙄

Infuriating!

Pps comments re asd are interesting as more than one hcp has suggested I may have Asperger's but I've never been referred for any kind of test or diagnosis, perhaps I should pursue this? Though I'd have no idea how or if it would even be useful at my age (49 same as you op)

I'm currently on mirtazipine max dose which helps a little but isn't a cure. I've just moved house, need to register with a new gp which I have been putting off because I am terrified they're gonna mess with the meds side of things and even taking a dose late really messes me up!

Been on loads of different anti depressants. The only one that really worked for me I'm now basically allergic to! So that's a real bummer! Some had no effect at all some made me more ill than ever - and yes I was pushed to "presevere" but even the hcps eventually had to concede it wasn't right to keep me on those ones.

Can't take ssri as adverse reaction issue

CBT is it isn't invasive or chemical, so for me I see it as no harm done.

The wrong therapy for a patient can be harmful though - this is why I think it's horrific that ANYONE can call themselves a "counsellor"

Hormones also definitely affect me. A previous cpn noticed this and had me keep a diary. Right enough in the week before my period anxiety was through the roof. Week of depression through the floor! I also have endo and im currently on noriday for that and the Mh aspect which that cpn helped me argue for. Unfortunately she later became a nightmare for other reasons

Much more research is needed into mental illness generally and the various conditions specifically.

I haven't worked in years, I have no life to speak of, I fee useless and a burden most of the time. I hate it.

If I had received good quality care following the 1st breakdown perhaps I wouldn't be where I am now, I'm fairly sure that's true. That I would be a happier, healthier (mental illness impacts physical health too, esp as self care tends to go out the window when we're really bad) , more fulfilled and productive member of society. I'd have been a better mum too. So many regrets.

I get so angry when hcps treat me as if I like being like this - who would?!

So yes op I hear you, I know what it can be like.

My heart goes out to you and everyone else struggling with this

It's been useful at my age @Graphista, I'm 37, recently diagnosed. Also told my autism is a 'classic Aspergers profile'. I have ADHD too. Got to this age without when realising. I had no clue, just always felt 'different' and not quite right. I only clicked when my child was diagnosed age three, I attended a load of courses to learn about autism to help her, and then slowly I realised everything they were teaching me about was very, very familiar....dug a bit deeper, learned about ADHD and ding ding ding ding - alarm bells there too.

People (not you, generally) have a distorted view of what autism and ADHD are and really don't understand without doing research into how the conditions can present in adult women. The amount of people who are totally disbelieving when I say I have ADHD. 'But... you're not hyperactive!', 'But... you're so normal!', 'But.. you've got a family, small children, a nice home, a nice husband!' Yep. I am normal and ADHD doesn't mean your the stereotypical hyperactive ten year old boy. I'm not hyperactive physically, but my brain totally is!

It's been useful for me because I understand myself now. The ADHD is medicated and it's been life changing (am only nine weeks - I think- in). Even though the autism can't be medicated, realising that you're not a useless adult, that your brain in fact works differently to most other people's is a revelation. It's been wonderful to realise that to live happily you have to meet your needs, not the needs that society thinks you should have as an NT person.

It also explains an awful lot of things from my past, that I've been able to process now and put to bed.

If you really think that you're neurodivergent then personally I would encourage anyone to find out no matter your age.

HimalayanSnowcock I really hope you haven’t got too much of a wait. Did you go through the NHS for your initial assessment?
Graphista I did the same with all of my CBT sessions, had (still have) a folder full of material and would bloody work on it hard, it’s very hurtful to be told that I haven’t engaged in the concept (I too have been told this on previous threads), I worked on my sessions with blood, sweat and tears, desperate for something to help me.
I believe that therapies like CBT may definitely help when people are in the early stages of anxiety/depression but mine is so deep set and present from early childhood (which is when it SHOULD have been addressed).
Definitely peruse the possibility of a ASD. Have you looked at the Psychiatry-U.K.com site, lots of info on there including the ‘right to chose’ scheme which you can print off and give to your GP.
I feel for you, I only work 8 hours per week and even that’s a struggle as I have awful IBS as well. And you are not a burden lovely, you deserve a good life as much as the next person. We don’t ask for poor mental health, more needs to be done in this country to allow us to access help especially for long term sufferers. The 6 weeks the NHS offer is just not enough, for a start it takes several weeks just to feel comfortable with your therapist and that doesn’t give long for the therapy to set in and before you know it, the sessions are over! I would love long term therapy, maybe that’s the answer but at £50+ for therapists and £300+ for psychiatric help that’s way out of my reach.
I so wish I had received help when I was a child and first presented with issues and struggling rather than being teased about my ‘strange’ idiosyncrasies like my parents would do, even now my dad will say I’m wasting time seeing therapists as ‘You’ve always been this way, you’re not going to change now are you’? !!!

The brain chemistry theory was debunked years ago, although it's still widely quoted;

www.psychiatrictimes.com/view/debunking-two-chemical-imbalance-myths-again

I had the same as a child. Worried about everything, from small relevant everyday things to ridiculous things (like what I'd do if I was an actor and I was too scared to kiss on camera! ), very shy, couldn't talk in front of anyone. I was just 'being silly' according to my mum, but looking back now it was so worse than just shyness. The worrying got less in my teens but the anxiety never has. I've also suffered bouts of depression.

Antidepressants have been the only thing that helped me. I found one that suited three years ago and stopped them about two months ago. I was worried about stopping them but I think I finally feel better and as they took away the anxiety I finally could do all the things I've been scared about for nearly 40 years of my life, like making friends, talking loud enough to be heard, making conversations with strangers. Antidepressants have changed my life and even with the side effects I'd go back on them if needed.

"I so wish I had received help when I was a child and first presented with issues and struggling rather than being teased about my ‘strange’ idiosyncrasies like my parents would do, even now my dad will say I’m wasting time seeing therapists as ‘You’ve always been this way, you’re not going to change now are you’? !!!"

Imagine your mind is like a ship, with a crew and a captain. The captain is your conscious, rational mind; the crew is your subconscious which is in charge of everything that you are not consciously in control of - your automatic thoughts and actions, your feelings and emotions, your memories and your imagination.

When you were a child your ship didn't have a captain as children aren't capable of analytical, independent thoughts until around age 9/10. What your mind was doing however was soaking up information about you, the people closest to you and the wider world, at a ferocious rate. Some of this information was incorrect, some was correct then but isn't now and some was interpreted incorrectly by your crew but ALL of it was believed to be true and filed away as such.

Now your captain is fighting with a crew that truly believes this false/out dated or harmful information is as true now as it ever was. A simple example;

If your first, and all childhood, experience of spiders was of fear and horror because your mother was terrified of them then that was the appropriate respond and that will be hard wired. As a adult you know that the majority of spiders are completely harmless but there's a crew member who will shout "holy shit, there's a spider!" and set off a fear response - raised heartbeat, sweating, etc.

The good news is that you can reprogram your subconscious to get rid of childhood myths and preconceptions. The aim of your crew is to keep you happy and safe at all times and once they know the current strategy isn't working they are happy to change.

@Escarpahell I LOVE this analogy. Going to share it with OH now, it’s fab.

I could have written this ! Until it just all came to a head and I accepted that whatever the cause no amount of therapy was working and I started AD. Life changer!

I’ve never been able to reprogrammed my myths though. I’m 58. When will it happen for me? I’m not sure everyone can do this.

I can't say I've every experienced depression OP but I have high anxiety with obsessive compulsive tendencies. The cure is medication specifically tailored to these problems. They don't stem from any particular trauma. There's no repressed issue to uncover. All the worksheets and self-help and therapy in the world made little to no difference. Its definitely 'in the brain'. I'm also neurodivergent, have synaesthesia and object blindness. Medication gives me a better quality of life. That's all there is to it. I don't care about stigma, but there is also dementia in my family. However I'm quite sanguine about that as I've already decided that if I get diagnosed I'll put a firm time limit on how long I'm sticking around - I'm not sad or morbid about this, its purely pragmatic, having seen the end stages of dementia up close.

iloveeverykindofcat Did you get your diagnosis through a psychiatrist? I am going to pursue this as I truly believe several of my family members may be neurodivergent especially my grandad, my mum, myself, dd and ds. DS has dyslexia and also has synaesthesia.

Unfortunately there is no cure, some people can only hope to manage their symptoms and their recovery journey can be lifelong. There’s always hope things will improve.

Anxiety and depression are at opposite ends of the mood spectrum. So you can't treat them both at the same time with the same treatment. They're different conditions and both are so misunderstood, especially by psychologists.

Have you tried a private psychiatrist OP? How deep are your pockets?

@mymindisamuckingfuddle

Thank you for your patient reply

I would never profess to understand but I have a relative currently undergoing assessment (a child) and I recognise similar traits/issues and my mum has said she thinks we are very similar

I'm not hyperactive physically, but my brain totally is!

I can absolutely relate to this

I honestly wouldn't know where to start to get help though I have little faith in gps at this point

@Nocrispsinthehouse thank you your reply moved me also

I too have been like this - whatever this is - all my life

for a start it takes several weeks just to feel comfortable with your therapist

Omg yes!

Another thing I hate is every new therapist, dr, cpn makes me tell them of my childhood trauma (which they believe is causative) which I hate doing - why can't they just read the notes? Why isn't there a basic summary attached to my "file" they can read before I meet them?

I also can't afford to go private - cos I'm too ill to work!

@Escarpahell yea aren't they now thinking the brain chemistry imbalances are symptoms rather than cause? In the case of ocd it's neurophysiological too believed to be cos we're missing a part of our brain?

The good news is that you can reprogram your subconscious to get rid of childhood myths and preconceptions.

How?

I have had consultant psychiatrists tell me I understand the condition and my own illness far better than they ever could (I'm in the position of also being a former hcp so I can to a certain level read and understand the research - what little there is)

One recently qualified psychiatrist I corrected on something and he doubted me, went away and checked it and came back to me and apologised!

@iloveeverykindofcat also synaesthesia here until I was almost 10 I thought everyone had that/it was normal

@BonnesVacances I've had psychiatrists try and tell me I CANNOT have anxiety AND depression at the same time

The first step is understanding and then changing. A true example; I know a woman who had a needle phobia which she managed by avoiding injections wherever possible; this worked until she was diagnosed with an illness that would require multiple blood tests, etc.

With help she traced the fear back to the BCG jabs at school (you're of an age to remember them!) and the overwhelming terror of a group of impressionable 11/12 year olds with no control over, and no understanding of, the process.

That was when one of her crew stepped up and said "right, we're all shit scared so from now on I'll be in charge of keeping us well away from needles".

Once she realised this and was able to tell her subconscious that needles were now essential to her survival, the phobia disappeared.