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?

Its quite a young science in the big scheme of things and everything about it is theory based on studies but not physical medical evidence some of the time as brain chemistry is difficult to test out sometimes.

Won’t help if your autistic
in fact it makes it worse
Samantha craft ,autism in women checklist
worth a look ,if only to rule it out

@Graphista Sounds very similar to mine. My very not-deserved straight As in the sciences are because I just read the textbooks and reproduced them in the exams, changing some of the words so it didn't look like I was cheating. The problem was that then some teachers wanted me to pursue science at a higher level and I didn't know how to explain that it didn't really work that way 😂. Useful in school but much less so in adult life.

@BonnesVacances you can. Anxiety is not a mood disorder. It really isn't.

Bipolar type 1 is diagnosed when a person has ONE episode of full-blown mania. That's it. Despite the name bipolar disorder, you don't need to have even one episode of depression to be diagnosed with type 1.

Type 2 involves ONE episode of major depression and ONE episode of hypomania lasting at least 4 days.

The reason I've written the numbers in capitals is because the frequency doesn't matter when giving out the diagnosis, which isn't what you've said. Just the presence and extent of the extremes in mood. Less than 4 episodes in a year is not sub-clinical at all, though 4 or more episodes in a year would be called rapid-cycling bipolar disorder. There is a less severe manifestation that has a different name: cyclothymia.

Should say bipolar disorder type 1 may be diagnosed, not is. There are differential diagnoses.

@bellac11

Brain chemistry theory has also been debunked. Many people working in mainstream mental health services give less credence now to the medical model, even psychiatrists themselves.

The DSM is so unscientific it’s laughable. A bunch of old white men sitting around a table putting human behaviour into neat little diagnostic boxes.

My Nan had severe psychosis which is apparently due to abnormal dopamine levels. Except her psychosis was not due to dopamine levels it was due to sexual abuse in childhood, which then no doubt (maybe) altered her brain chemistry. And that’s a huge maybe.

A lot of mental illness is caused by trauma which is experienced consciously or unconsciously. It can be a very unpopular opinion on mumsnet though but it is one that is shared amongst many respectable people working in the field (psychiatrists too, of which I’ve met many humble ones in my time not just ones with god complexes).

True. But ours speaks about this at international psychiatry conferences and there are countless papers that back up what he says, so I'm happy with that. When I have in the past clarified what I posted earlier as my basic understanding of what he has diagnosed and why, he says that my knowledge on that is now better than most UK psychiatrists.

Fwiw he says it's a thyroid deficiency which has been proved in DD's case by genetic testing. Her thyroid gland functions fine but the hormone doesn't get transported or processed by the brain due to a genetic mutation in DIO1 and DIO2, so she's neurologically thyroid deficient. Again, countless papers on this.

A lot of psychiatrists are out of the dark ages

Yea what they think/believe is heavily dependent on their age/when and where they trained

Useful in school but much less so in adult life.

Omg yes

@JollyWilloughby head injury is another possible factor of which I have had 2 yet again is dismissed when I try and raise the possibility even though there's research coming through that shows it could have significant impact

Totally agree with you about trauma, we work in a trauma informed methodology but I think that theres quite a lot of evidence about how the brain develops around the experience and therefore the altered neurology for those who have suffered trauma or shock, to a lesser or greater degree.

Im not scientific enough to say whether thats what I mean by brain chemistry but I think that many of us, me included have compromised organic origins to our brain functioning. Thats what mine feels like when Ive been ill anyway

I think at the moment and for some years Ive more or less had disthymia (not sure of spelling) rather than clinical depression.

Papers or not, he sounds like he has a god complex informing you your knowledge is now better than most UK psychiatrists (many, many psychiatrists have papers).

Proclaiming you cannot experience depression and anxiety simultaneously is a bold claim he’s made there. I am sure his research will also be debunked at some point along with all the others it’s inevitable.

@bellac11

Yes I know what you mean. Me personally I take a balanced approach to MH. I’m not really that radical. I do not put all my eggs into the one biomedical basket though that’s for sure. It’s incredibly outdated to do so. I am glad mainstream services are slowly moving away from the medical model and focussing on trauma informed services.

I had loads of therapy for anxiety and phobias including CBT and hypnotherapy, oh and not forgetting exposure therapy which was torture. Then one day I was seeing another therapist and she mentioned the possibility of me being on the autistic spectrum (both my DC’s are diagnosed), she explained how many therapies don’t work for people on the spectrum as it’s harder for them to let go of the thoughts they are having because the way our brains are wired. She told me that I had to learn to live with the anxiety and to stop looking for a cure. I have no excepted the way I am (often a anxious mess) and I now have strategies to handle my anxiety, I use mindfulness techniques, mainly distractions, I keep busy, exercise or get stuck into a hobby, basically when I’m anxious I keep very busy or I take myself away to somewhere to clear my mind. Anxiety is a big part of me but I try not to let it ruin anything or stop me from doing things, learning to deal with it has helped my phobias too, they are still there but I no longer spend hours thinking about them.

@Graphista

I don’t know much about brain injuries but I do remember one service user who had to wear a helmet due to a severe motorbike crash whereby his skull was quite literally caved in and he most certainly did have MH problems after.

I suffer with Anxiety.

I did CBT. Didn’t help in the slightest.
I think because my brain just doesn’t work that way. Because my brain and anxiety overrule any attempt at deploying coping mechanisms. Plus it’s like my brain knows what I’m trying to do and just goes “Nope. That’s not going to work and you know it”.

I’m now on anxiety tablets (not anti depressants, but beta blockers). They don’t take away the anxiety, but boy do they help calm down the physical symptoms of it.
So I still get anxious/stressed, but my central nervous system doesn’t have a meltdown and I don’t have the palpitations, sweating etc

I’ve heard CBT has helped many people, but like you, I’m not one of those people!

Nothing that I can recall other than losing my 4 year old niece 10 years ago which was very obviously very traumatic and probably propelled my issues to where they are today but I had the problems from the age of around 5/6.

I can tick most of the boxes for inattentive ADHD with definitely overlaps of some autist traits.

I’m sorry, but l have had mixed anxiety and depression all my life. I’ve seen about 8 psychiatrists. I am not bipolar. I think one of the 8 would have picked it up.

l see a mental health nurse every month. He’s never said l have bipolar either.

Mixed anxiety and depression is a normal thing.

And l think all those psychiatrists had published papers. I know the current one does.

This is me (and my brain!) to a T. I have pondered the idea of beta blockers. One of my sticking points when it comes to my anxiety is not just the thoughts, in some way I could cope with that but the physical symptoms which come with them, that alone greatly exacerbates my health anxiety so I then get caught in that vicious cycle then my IBS/digestive issues kick in which I freely admit to being absolutely obsessed with and have put myself through a myriad of very unpleasant diagnostic procedures because I am convinced I have some awful condition then comes more anxiety and more unpleasant physical issues and on and in it goes. A good start would be to break that cycle.

I definitely without doubt suffer from both extreme anxiety and depression. Without doubt.

OP, I feel the same. I've had three quite lengthy runs of CBT with ERP on the NHS (minimum number of sessions 18, I think) and seen no improvement.

The more you've written, the more I relate; I have a lot of similar issues to you, but I was recently diagnosed with autism at the age of 41. I finally asked for a referral after years of it being mentioned to me, and after reading a lot of posts here I'm wondering about ADHD now as well. I was kind of hoping that the local mental health team would come up with something new for me in light of the autism, but they're referring me to a specialised national service for OCD, which still only offers CBT, just in an inpatient ward. I've been accepted there before but declined the place. Even though I'm not sure CBT will work even in this setting, at the same time I'm afraid that the autism diagnosis and something else mental health-related (alleged psychosis that has been a known issue for years but has only just been given its own diagnosis) will mean they'll refuse me this time and I'll be left with nothing at all. Things I've read make me unsure if CBT can be effective in autistic people, but I believe it's the only therapy NICE recommend for OCD so I don't think they'll offer me anything else. I'm also in no position to go private.

@JollyWilloughby your posts are really interesting, especially regarding your nan and how psychotherapy changed her life even after so long. I didn't realise that trauma as a likely cause of a lot of mental health issues was unpopular on Mumsnet, though I do see the chemical imbalance thing mentioned a lot here when there is little or no good evidence for it. I have to admit that generally speaking I do like things organised into neat little boxes and my current list of diagnoses does make sense to me (even though I don't think I'm delusional, I can see why others might!). Although the fact that previous psychiatrists didn't think I had any specific named psychotic disorder, and the one I saw most recently does, even though those "symptoms" have been consistent for ages, does make me wonder about the validity of any of it.

OP, I hear you on the CBT not working. It’s particularly bad the mass market way where you are just given a leaflet walkthrough. I really resisted further CBT attempts but actually this time I have a therapist who clicks with me and has got me to a point where I can actually engage with negative thoughts and manage them a bit. He is using other techniques as well and explains it in a very scientific way that really helps me. I should say there’s a recognisable trait of ADHD and dyslexia in the family and DD is awaiting an autism diagnosis. So some of it is about finding the right therapist, for me, and some of it is about recognising that if my cousins and my children are all ND then I probably am too.

The anti-depressants (fluoxetine for me) really help, they are the only way I am at all functional at the moment. But can I also recommend progressive muscle relaxation? It helps me bring the base anxiety level down so I can do the CBT work.

Thinking of all of you going through this 😘

Completely relate

And like you the thought of having any kind of anti depressant medication terrifies me. My GP however absolutely will not go down that route unless he feels it absolutely necessary (they don’t seem to like giving out strong pills at my Dr’s). And I really don’t want to go down that route myself unless I feel it’s my only option.

I guess I want to try and find other ways to manage it before going for the strong stuff!

It’s soooo hard when your brain overrules everything. No matter how hard you try to block out the thoughts and re-train it, it’s like it’s always there, being super cynical and patronising 😁

I figured if I could at least have more control over the physical symptoms of my anxiety, it may stop me from feeling so wiped out and rundown all the time. And the beta blockers have worked really well in that department (I’m on Atenolol but there’s also Propranolol). And because the physical symptoms are more under control, it actually helps to calm my mind a bit more. Because the physical symptoms were only making the mental side worse!

Worth considering the BB’s if you don’t want to go on anti depressants x

flourella your reply has given me hope, I’ve been so scared to broach the subject of possible autism or adhd at the age of 49 thinking my gp will basically dismiss me, even though I’ve struggled since early childhood. Did you have to wait long once referred? I haven’t had much luck with tackling my OCD thoughts and behaviours via CBT but maybe it’s better in a hospital setting? Are you going to try it?

I’m really intrigued about the association with ADHD / Autism and anxiety though. My partner constantly tells me I’m OCD and I can recognise that I may have some behaviours that would look like I am!

Can anyone point me to some more info on this please?