Aibu to need help figuring out what type of therapy I actually need?

[Thisendsnow]

I need help!

I don't actually know what's wrong with me...
I think I have a mixture of depression and social anxiety coupled with low self esteem. Not sure which came first, if one causes the other or what. I have felt this way for years (5+) and it is getting worse.

I have completely isolated myself, so no friends so to speak and my partner has recently left too so I am taking this opportunity to actually work on myself and get better.
I have seen on lots of threads 'have you tried therapy?' etc for people with similar issues, but I just don't have a clue what type I would need. Can you help me figure it out?
In the past I had 10 free sessions with NHS and it was a general 'chit chat', the woman didn't really ask me anything or guide the session, she just left me to ramble on and we never actually did anything more than a moan with a friend. She did tell me a number of times 'girls would kill to look like you', 'there are people who would be overjoyed with what you have' which actually made me feel a million times worse.

I don't necessarily feel down, but I never actually feel happy if that makes sense.
I find myself saying 'I hate my life' constantly throughout the day
Lost job to covid but have zero inclination to find another one due to the anxiety of being looked at (currently living off savings)
I am insanely jealous and compare myself to everyone else

I have a temper (never used to) and low tolerance for anything
I don't find pleasure in things I used to anymore

Help! I don't want to feel this way forever so any suggestions would be much appreciated. I have some savings behind me so can pay private but couldn't afford to get it wrong and need a do over

The person you saw sounds awful.

To be honest I was a lot younger and in a bit of a daze at the time. She was a self referral thing, I have no idea what her actual title/role was. She never asked a single question in 10 weeks so I just kind of gossiped at her a bit and filled the awkward silences.
I really need it to work this time, I wasted my 20s being miserable

I would take care and research their qualifications. A large part of why you’re seeking help is that you’re seeking support to unpack the underlying causes of your depression, anxiety and low self esteem. They are symptoms rather than causes in themselves. If that’s the case, then it might be useful to seek out a counselling or clinical psychologist. They hold degrees in psychology and doctorates in their chosen fields, in addition to hours and hours of experience even just in completion. They are registered by HPC, so you can trust you are getting a psychologist with the skills and qualifications they claim, and they abide by a professional code of conduct. Anyone can call themselves a counsellor so make sure anyone you’re interested in is professionally qualified.

Hi OP, the NICE guidelines (which analyse all the evidence for therapies for different difficulties) suggest that CBT (cognitive behavioural therapy) is the most effective therapy for issues related to depression and anxiety. So it’s worth asking your gp for a referral to your local talking therapies/IAPT service or in many cases you can self refer if you google your local nhs talking therapies service... if going private, you can find a cbt therapist on babcp.org. Of course , with any therapy, the fit between the therapist and client is crucial, so it’s important that you click with the therapist and feel they understand you. Good luck!

Ps I also agree with Wiredforsound that a clinical or counselling psych could be helpful (they all have training in CBT and several other types of therapy) and whoever you get, you can check they are properly qualified and accredited by searching online.

Hi,

I have been down the counselling route and psychiatrist route and it was only when I found a good Psychotherapist specialising in EMDR & CBT that I made headway.
You need to rule out health issues - thyroid etc. Go to your GP and get tests, make sure you have good sleep hygiene, lay off alcohol, coffee etc for a while. Assuming that thats all OK then do CBT.

I found that my low mood & self sabotage were directly related to my trauma and my low self esteem and view of myself. Once I learned the pattern of negative thinking I can now mostly self regulate, self care and as a result think objectively about most things. As poster above said these are symptoms not causes.
Good Luck!

CBT might be a good place to start if you are looking for coping strategies, and changing unhelpful behaviours. It's a very structured approach, with exercises/"homework" to do after each session. You can find self guided exercises or workbooks online to give yourself a taster before committing to working with a therapist.

However, in my experience CBT didn't really help me delve into why I had the challenges I faced - it felt more like papering over cracks to get me to function "normally" without addressing the root cause. The type of therapy that will help you really depends on what you want out of it - is there a past trauma you want to explore in a safe environment, do you want to understand how past experiences are shaping the way you act now, or are you more interested in a solution focused approach? Mind is a helpful place to start to understand the different options www.mind.org.uk/information-support/drugs-and-treatments/talking-therapy-and-counselling/types-of-talking-therapy/

It sounds like CBT would help you, but I am not a doctor.

Can you go and see your doctor and see what they recommend?

If you’re paying privately and don’t gel with the therapist, don’t be afraid to fire them and find a new one. It’s your health and money on the line.

You say you’ve been made redundant. Make sure you’re claiming everything you’re entitled to.

I did a self referral and saw the most amazing woman.

TBH I wouldn't waste time with CBT.

Look on the BACP website for someone local who treats low self esteem/depression/social anxiety - although I'm pretty sure they all will.. See this as the start of the journey.

Also - and I know you've heard this a million times before - get outside for a walk everyday (especially in winter), get enough sleep, try and eat well.

Interested to read the responses here as I feel the same and would like some therapy. I’ve had anti depressants for a while in the past after being reluctant to take them I found they really helped. Only a low dose for a couple of months, I realised my issues were definitely physiological as I changed nothing but felt happiness at small things again. I’d like to try therapy because my depression has become more anxiety and I really struggle with the physical symptoms.
Do you know what triggered your anxiety OP?

Its different for everyone depending on the source of your issues. . My depression is rooted in my terrible relationship with my narcissist DM. I didn't realise this until a private Counsellor got me talking about my childhood. CBT is challenging & finding coping strategies for your anxiety, negative thoughts & catastrophising, which I find is only effective once you're out of the rock bottom & not knowing why you feel the way you do. I would add, the NHS psychiatrist, Counsellor & CPN had no clear strategy other than how are you feeling, which solved nothing & it made me furious that I was being fobbed off with "you're educated & attractive, the world should be your oyster". How bloody unhelpful. Private guy was a revelation, he 'got' it, from day one. I can't tell you the relief.

Have you experienced any past or recent abuse or trauma?
Do your difficulties centre around a specific 'core belief' (eg, I'm defective, they'll abandon me if I show my true self, perfectionism).
These might give clues to a therapeutic approach. Otherwise I would decide which to tackle first of depression, low self esteem or social anxiety (behavioural activation for depression is likely to also have pay offs for self esteem and graded exposure to social situations so there will be beneficial cross currents, however your social anxiety might also be a barrier to increasing pleasurable activities and you might not persist due to not feeling worth it, so they would be better treated in a coherent formulation).
If you can go private look for a BABCP accredited CBT therapist.

Sorry, don't mean for you to answer on the thread x

Just some thoughts to consider

Go for a private assessment if you can to start the ball rolling in some serious nhs assistance.
My husband (seperated) felt exactly like this and then had a complete breakdown because of years of nhs mh failing him and brushing it off . It's no joke . Push for what you feel you need and dont put up with it if you are not happy with it , re treatment plan, meds etc

I think there is some evidence that the relationship with the therapist is as important as the type of therapy. I've had anxiety and depression in the past and had a number of therapists with different approaches and stuck with therapists that I felt at the time were not helping me or I didn't feel comfortable enough to be open with for too long. For me CBT was terrible. I found person centered relational therapy with a bacp therapist who I really felt comfortable with was the most helpful. Basically I would advice to shop around based on the therapist as much as the style. A lot of therapists do an initial consultation for free to see if it's a fit or not.

I had a pretty happy childhood, working class but well catered for and loved. Parents still together and united so can't really see a starting point.
Towards the end of high-school I started withdrawing from friends and my self esteem dropped, no bullying or anyrhing, just me.
I assumed at uni I would find my group but I never did - didn't leave with any solid friends. But I wouldn't put myself out there either so I guess it's somewhat self inflicted.
I would always feel 'not enough' for friends so might embellish and lie to see interesting.
I have had relationships, they've all ended on their terms, not mine. I have never been 'wanted' enough by a guy. Never moved in with, or engaged etc even in long term relationships.

I've had tests for thyroid etc because I cannot remember much and have chronic brain fog some days but I think it's down to the low mood rather than a physical illness.

I've tried all the holistic approaches, no caffeine, amazing nutritious diet, vitamin d, long walks, yoga, enough water, meditation.

In the past my GP gave me antidepressants (I think) and after 2 weeks I was having full blown panic attacks and horrific paranoid thoughts so was told to stop taking them. No further input or mention of it again so I never pressed the issue.

Ariane Sherine has written a slim volume called 'Talk Yourself Better' where she describes/unpicks and in some cases tests out many different variants of therapy, some I'd never heard of. She has interviewed a few people who have also gone through sessions of that type. That may be a good starting point.

Did you ever want the boyfriends enough? Fall in love, strong crushes etc? Were they interesting or boring? Were there other people you admired or fancied? Were you able to be your authentic self in the relationships? If you have felt 'not enough', masked a lot, made stuff up at times, planned what to talk about, overthought everything then that would have impeded you forming good relationships. Treatment for social anxiety would involve dropping those masking or pretending or safety behaviours, building confidence that it's actually easier to function socially without these rules and behaviours and addressing the negative core belief that you are not enough by collating the evidence for something more realistic like 'I'm loved by my family, I'm liked by x and y, I have helped z in the past, and mostly people don't actively think I am awful.'
However, the poor memory and brain fog don't fit. Yes depression can cause these, but you have had long periods of doing all the right things to treat depression, lifestyle wise, and no experience of trauma. I would look into other hormonal or physiological possible causes of these.

The question about the boyfriends is just to flip it to being ' were they what you wanted' rather than 'you not being enough', seeing yourself as the protagonist not them.

The boyfriends (2 main relationships) were defo what I wanted and we have lovely relationships. Clicked really well, agreed on all the big things, fun, playful and deep so pretty good on the surface.
The 1st one kept me very separate from his life and I began to feel like a dirty secret. He would wax lyrical about his friends gfs being lovely but never invite me along. I felt like my face didn't fit in his crowd and he was ashamed of me in some way.
We broke up when he had his head turned by another girl, but to his credit he ended it and didn't cheat.
The second one was perfect for me in every way apart from distance and eventually that is what ended it for us (visa issues).
Both made vague noises about 'in the future/when were married etc' but nothing ever more than pillow talk.

I have just realised with every relationship/fling I have never been the one to end it though, not sure if that's relevant.

I hope you do find a way forward OP. I had relationships end similarly in mid to late twenties. I suspect you might have been the one to pull the plug in either of those scenarios if they hadn't first. Talk it over with your parents if they are helpful. Think about what you want to change and make some goals. Good luck as you do x