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?

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

Well technically you can't at exactly the same time. Depression is a singular state. If you are clinically depressed, you're in a low mood all the time. It's not something that comes and goes with periods of anxiety.

If you have periods of depression and anxiety, it's called mixed state mood disorder or bipolar. Because you're experiencing fluctuating symptoms from both ends of the spectrum. Depending on the frequency and extent of the switch between moods, it can be type 1 or type 2 bipolar. Or subthreshold bipolar which means you experience fewer than 4 mood switches a year. Antidepressants make it worse.

Subthreshold bipolar disorder is as common as diabetes, but not recognised or treated on the NHS. And so our mental health crisis in the UK gets worse and worse.

@Graphista Same! I was a teenager before I realised not everyone 'hears' written text. Why would we think any different after all?
@Nocrispsinthehouse Yes I did, in my late teens. There are upsides and downsides. For example, my recall of written text is almost perfect. Not permanently, but at least for some time, I memorise most of what I read at first reading and was surprised to learn this is not the same for everyone. But my visual perception of where objects are in relation to each other and in relation to myself is often completely wrong, especially if they're moving. I can't drive, and it causes a lot of problems in daily life, like stepping onto escalators.

I am on carers allowance with a very small part time salary on top of that so my pockets are as deep as a 1 inch puddle right now. I am at the mercy of my GP and NHS mental health services!

So it’s about phobias rather than deep seated psychological problems?

I think anxiety and depression are opposite sides of the same coin rather than opposite ends of the same spectrum.

I had mild depression about 4 years ago, and because it was deemed "low mood" i didn't get any ADs. I was referred to Talking therapies who did CBT as distance learning IYSWIM. I tried to engage with it but I found the concept too simplistic and patronising. I was also gripped with growing anxiety (plus there were certain things going on in my life that were not helping with the A&D). I got the end and the facilitator asked how I thought it went and I said exactly my feelings which didn't go down well.

Then I was invited to workshops at the local NHS counselling service. Again, based on CBT. I was told I needed to complete this in order to qualify for counselling. I turned up for the 8 sessions which I did around work shifts. I am a shy person and would hide at the back. Once those finished a facilitator rang and asked how I was. I said, CBT isn't helping (though I admit I didn't try). So then I got 6 weeks of counselling, which helped enormously.

In addition to the NHS help I subscribed to mindfulness apps which calmed my "busy brain" and I did some yoga which helped a bit.

I cannot compare my experience with OPs. At the moment I'm managing but I am all to aware about what can making me slip back. I think CBT is a "one size fits all" cheap approach to mental health which fails the individual experience. We're not homogeneous, we need better MH care, but that's not forthcoming.

And I’ve had both together loads of time. Depression with anxiety is the biggest cause of suicide.

And I’ve taken anti depressants to help it. I don’t think l have ‘sub bipolar at all’

A ‘mixed mood’ disorder has to have one episode of mania. That’s for sub bi polar.

Have you had psychotherapy? CBT won’t help with deep rooted issues and your neurodiversity will be complicating those issues. If you had the money I would see a psychotherapist with an integrative background who has experience working with ADHD.

if finances don’t allow I would try a low dose of antidepressants. Citalopram can be prescribed in low doses - 10mg - and see how you react. They aren’t for everyone but can be life changing if they suit you.

It looks like you’ve put so much energy into trying to ‘fix the problem’ if you do get another go at therapy, try and use it as an opportunity to get to know yourself, not to fix something that is broken. Therapy and real change is very hard. Especially if you’re neurodiverse. Good luck

In terms of “therapy” maybe seeing the right psychotherapist can help. Any old person can call themselves a counsellor these days, I have someone on my FB who is about to complete a certificate in a counselling course because she thinks she’s now an expert in mental health due to her own divorce. Wants to practice as one after a measly level 2 which is totally unethical and somewhat deluded on the expertise that you need to do the job effectively.

A measly certificate.

In practice it takes years and years to become a fully qualified psychotherapist.

My Nan had severe mental illness since she was 15 years old until age 78. At 78 she finally received “proper” psychotherapy and lived her final two years in peace. Prior to this she was diagnosed by different psychiatrists throughout her life as a

• schitzophrenic with associated paranoia/hallucinations/psychosis
• multiple personality disorder
• BPD
• manic depressive

Now of course she couldn’t possibly have all of them but her longevity in NHS services meant she was quite the case study. She had received multiple bouts of ECT and shocks to the head at age 18 and 22. She had spent many, many months even years sometimes sectioned and unable to leave the hospital. Depression….. anxiety…… you name it she had it.

Finally at the age of 78 she gained access to a renowned psychotherapist. It helped immensely. In her final 2 years she lived in peace with zero medication and zero mental health symptoms. Quite incredible.

it was incredibly bizarre to have a “normal” Nan at the end but I am just grateful she found some peace at the end of a very long life institutionalised in mainstream MH services.

Theres always hope…. Never give up!

I could have written your post. Absolutely nothing at all worked for me. Then out of the blue I started a new healthy eating regime (to lose weight not to deal with anxiety) I gave up sugar and caffeine. OMG I cannot explain to you the difference I am like a new person. I have never ever felt like this in my life. Might be worth a shot if it worked for me it may work for you too🤞🏻🤞🏻

Citalopram changed my life

Was also going to say that CBT doesn't generally work in neurodiverse people, it has to be adapted.

CBT addresses cognitive distortions. If your anxiety isn't being caused or worsened by cognitive distortions, CBT won't reduce it. You might have more success with acceptance and commitment therapy.

OP, have you suffered trauma?

Sorry, this is nonsense. Depression is linked to low levels of dopamine and anxiety is an excess of norepinephrine. Completely different systems and it's perfectly possible to have them at the same time.

I had cognitive distortions and could quite clearly see them. CBT did nothing for me.

@BonnesVacances everything you've written on this thread is incorrect! Anxiety is not on the mood spectrum at all. The extremes are depression and mania. And the way the types of bipolar disorder are classified is also not remotely as you say.

@BonnesVacances kindly meant but I'm not sure I agree. If I'm very depressed I'm more likely to be triggered by ocd stuff and experience panic attacks etc the 2 feel comorbid in my experience

@iloveeverykindofcat I'm a singer been in choirs since before I went school! I used to sing everything I read and the tune was not made up by me as such the words "told" me what the tune was. Certain words, letters, phrases and numbers have correct colours according to me too - weirdly not punctuation or mathematical symbols

Ditto reading and memory - I was good at taking exams rubbish at coursework as it was a more abstract concept totally hopeless at anything practical still am, zero spatial awareness

@clpsmum I take a lot of supplements (as you for other reasons as well as Mh) I bumped up my vit d intake when the link between Covid and vit d came to light (I have brittle asthma too) and I did notice this very slightly helped my mood

I also suspect a thyroid issue (lots of history in family) which I cannot get any hcp to take me seriously on.

I've also cut caffeine at times, I have a little sometimes now I initially cut it out for the insomnia but didn't make much difference there. I am a little less anxious if I don't overdo the caffeine

You might have more success with acceptance and commitment therapy.

I had one of the better hcps do this with me briefly but then she retired

Well technically you can't at exactly the same time. Depression is a singular state. If you are clinically depressed, you're in a low mood all the time. It's not something that comes and goes with periods of anxiety

Anxieth and depression go hand in hand. If you are clinically depressed you are in a low mood all the time and anxiety can be part of it and contribute to it.

I have anxiety and depression, managed better than it used to be but I may well need to go back on medication for the depression in the future, who knows

I agree with the acceptance theory, this is what has helped me most, i have had a number of different therapy provisions, some have helped, some certainly havent

I think that learning to accept some of the traits and feelings and live with them is looked down on. I cant tell you how many times I read or have even been told personally 'have you thought about therapy' as if that is going to change everything - you see it on threads on here for example quite a lot

I think it leaves people hanging on to 'therapy' as if its going to be a solution that might not and it also leaves people feeling despondent if theyve had it and it hasnt improved their mood/anxiety

Fair enough. I'll pass on your views to my DD's psychiatrist who terms her anxiety as mania and has explained to me what bipolar spectrum disorder is.

A lot of psychiatrists are out of the dark ages

Anxiety might have a manic element to it and that might be particular to your daughter. Anxiety can feel manic at times but not always

My anxiety is not manic at all, its crippling and paralysing

Biploar spectrum disorder is very complicated so not sure a discussion with another patients psychiatrist is qualification to be telling people on a forum that they do have this or dont have that.

@BonnesVacances

That is just one psychiatrists opinion though isn’t it? Which to be honest is what most of psychiatry is.

People with different opinions and theories and zero evidence of absolutely anything in concrete.

Who is right? Probably none of them.