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Depression/anxiety - whats best - total rest or keeping going?

23 replies

kizzie · 20/07/2010 19:41

Just interested in views on this.
Im going through (another) extended period of depression/anxiety. Thought I was coming out the other side after 6 much better weeks but despite being on medication I seem to have crashed back down again.
My problem doesnt seem to be caused by anything specific (?).
Im back at work - which when im well i really enjoy.

From experience - is total rest the best option (even if its totally impractical) or is the best thing to carry on with as much as possible but try and get extra rest if possible?

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countrylover · 20/07/2010 20:40

rest is good but as we know, the bitch of insomnia doesn't allow us that when we need it most.

i found that the way i eventually got better was to MAKE myself do things even when i really really didn't want to do them. i'd be so exhausted that i just wanted to curl up and hide but by making social arrangements and forcing myself out of the house it actually gave me something to look forward to each day.

i'll be honest that sometimes i didn't actually enjoy the social occassion i went to and i would come back feeling worse but overall keeping some structure to your life i think is a really good thing.

i'm sorry you're feeling rubbish again but remember you always get better in the end. this is just a blip and you will feel well again soon.

'i know this is easy to write and near impossible to do but try not to 'think'. it's the thoughts which feed the anxiety and depression. every time you have an anxious thought describe in your mind what you can hear and see, in great detail. it takes a lot of practice but if you're really strict with yourself it eventually becomes second nature.

even now i still have a stomach flip and think, oh no..i\m not going to sleep toni....and then i can stop it in its tracks and the thought doesn't go any further because i'm too busy concentrating on the colours and sounds i can hear around me.

i hope that helps and i hope it's reassuring to know that if i can better than anyone can and you will too, i promise

kizzie · 20/07/2010 21:28

Thanks so much for that countrylover. (I can never hear too many times that I can get better again.)
Im glad you are so much better x

Its useful reading what you say about structure. Common sense says that should all be true. But I suppose I worry about the stories you read where people who just keep going and going and then collapse in a terrible state that they cant get out of.
(you wouldnt believe that I over dramatise when im like this would you !!!???)

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LaDiDaDi · 20/07/2010 21:32

I think that the best approach is probably to try to keep going but to make the things that you try to do pretty small and achievable and be happy to have "done" one thing each day.

orangeflutie · 20/07/2010 21:50

I think it's probably best to try not to think too far ahead and whenever possible fit something enjoyable in your day. If resting quietly is difficult try music. I've found these little things work for me.

PaulineCampbellJones · 20/07/2010 21:50

I try to keep going with a routine but try to leave myself a bit of quiet time as well. Being back at work has done wonders for my anxiety as I don't have time to think. But booking too many social things make me anxious when I'm having a bad period so I always try to have a get out clause just in case. Hope you feel better very soon. Oh and an afternoon nap works wonders !

kizzie · 21/07/2010 12:40

Thanks for the added thoughts. Interesting what you say about too many social things making you anxious. Its not always 'difficult' things that cause a prob is it

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NanaNina · 25/07/2010 23:30

I am currently recovering from a major episode of depression and anxiety and have just been discharged from hospital after a 3 month stay. This is my 2nd major episode - the first one being 15 years ago. I am on a tryclic AD as this seem to work best for me.

Even though discharged I don't feel like "me" at all and at best am about 60% of my old self. Fortunately my children are grown and I am retired which of course helps. I have a very good cpn who advises me to make lists of aim for the day (build in some activity) something pleasant and to have a rest if necessary. She then wants me to record the activity and my mood and I have to say I feel less depressed and anxious when I can force myself to do something difficult - meeting a friend, going for a walk, gardening,etc. This is the basis of CBT andit seems to work for me. She says that she meets so many women who say "I'll do that when I'm better whereas she thinks it is doing the thing you find difficult will help you get better. Time will tell for me, but I think it's a question of balance and make sure you do activites and eat well and get enough rest.

Hope you are better soon.

Lynli · 25/07/2010 23:42

I suffer from bouts of depression, I am well at the moment. I have recovered from the last bout without the aid of drugs, which is a first for me.

The things that help me are:

Gentle exercise, particularly walking in the sunshine.

Playing music, only happy sing along tunes, when trying to get housework done.

Reading something cheerful no murder mysteries, crime thrillers.

Try to eat well and get enought sleep, easier said than done.

Watch something funny, a good laugh really helps. Never watch the news.

I found the mood gym website very good, just google mood gym.

kizzie · 26/07/2010 20:11

Thank you both for replying. Ive had a particularly 'low' day today which in many ways i find harder than the anxiety to cope with.
Lynli - its encouraging to see that you have recovered this time on your own.

because i have been on ads (all be it low doses) for a number fo years now I really worry that they had some kind of permanent effect in my brain....

Nananina - im so sorry that you had a relapse. You have written me some very kind messages to me in the past. Im glad things are slowly getting back on track for you. You also seem so calm about it all. Fingers crossed your 60% steadily increases over the next few weeks x (Im on a TCA too - clomipramine/anafranil 50mg)

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NanaNina · 27/07/2010 22:59

Thanks Kizzie - like you I can't hear too many times that I will get better, and I do known that the vast majority of people with anx/dep DO get better, but at a different rate. Also there are the "set backs" which come out of the blue, as seems to be happening to you at the moment. IT's a long and winding path to recovery and sometimes we slip off it and it takes a while to get back on it.

I knew that my first episode was about the death of my very close friend, but don't really know what brought this recent one on, other than I had a bad food poisoning bacteria which lasted for weeks and I got very anxious when the GP suggested I might have been left with ME (also known as Chronic Fatigue Syndrome)- it wasn't this but I convinced myself that it was and I think that caused my relapse. Trouble is we never really know do we. As for being calm...................it's easy tapping away on a laptop but I can assure you that there have been times when my anxiety has been through the roof and I have been anything but calm!

Like you I often find the "lowness" of depression harder than anxiety, because I don't know how to deal with that, whereas with anxiety I do have some relaxation techniques to try, breathing deeply etc.

PLEASE Kizzie don't ever doubt that you will get better but no one can give us timescales unfortunately.

kizzie · 28/07/2010 09:48

Thank NanaNina - In some ways this has been the longest episode for me - which only adds to my fears re. getting better. But thank you for the reassurances.

Do you mind if i ask you which medication you are using?

I have booked a private cbt session for next week. Dont know if it will help but thought i would try x

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NanaNina · 01/08/2010 22:40

Sorry Kizzie - I did reply to you on Wed last week but there was some problem with the site and I have been away for a few days. I am taking imipramine 150mg per day (the entire dose taken at night) and 20mg diazopam x 3 per day. They wanted me to take one of the new SSRIs but I know imipramine got me better last time, so wanted it again and I don't get any side effects other than a dry mouth.

Re CBT - I really do think CBT is helpful when your mood has lifted enough to enable you to think a bit more clearly and more importantly I suppose for you to have the motivation to be able to engage with the therapy. My cpn has introduced me to the concepts and I am already finding it helpful. It's a therapy that's based in the "here and now" and is quite easy to follow which is another positive given the way I am at the moment.

Let us know how you get on

kizzie · 02/08/2010 10:51

Hi Nananina - thanks for replying. Glad you are getting some help from the CBT.
Im only taking 50mg of clomipramine/anafranil at the moment because i really struggle with higher (normal) doses. Apparently I metabolise medication like a much older person .
Although Im still really struggling at the moment I have got better before on this dose so going to try and stick it out for a bit longer if at all possible to see if it can work again.
Hoping that CBT may help with this too. Im also having some horrible obsessive thoughts and Ive read that CBT can help with this too.
Hope you have a good few days x

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MadameG · 05/08/2010 15:26

I'm late to this but wanted to reply to the topic.

I'm Bipolar and the severity of it has wavered greatly over the years. It kicked off in my late teens when I did take about 9 months off work (was signed off) and I was literally going to the shops in my pyjamas, sleeping all day and fell completely out the loop of normal life.

Other than then, I have kept going with work/ normal life as much as possible. I think its dangerous to give up because if you do you start to lose connection to a normal healthy life and can feel doubly isolated. I must admit, there have been times when at work or socially I've been pretty useless because of how I was feeling, but it still served me much better to try and maintain some semblence of normality, rather than sinking into it like I did during my 9 months off. I kept turning up at work even during serious, serious periods of having voices/ images in my head or bad self harm, and even if I wasn't the best employee (to put it mildly) it did me good to be around others. Telling an understanding boss is also hugely helpful. If you're having an off day then they will be clued up as to why.

Re CBT- when you're really stuck in heavy depression it can be too early for CBT to really work, I think. It can help for you to feel like you're doing something productive, but it certainly didn't heal me at all- finding a happier life did. I had 9 months of psychotherapy which was good at working through the demons, but its probably after that that CBT/ a similar therapy can help you move on through improved thinking methods.

It's good to have an arsenal of tactics to get you through major depressed days. Some that worked for me:

  • a hot water bottle
  • a big mug of hot chocolate
  • a ton of glossy magazines
  • endless episodes of Friends, Seinfeld, The Office etc
  • a big hot bubble bath
  • lavender oil or mandarin oil on your pillow (mandarin is amazing at helping anxiety, so comforting)
  • cooking a favourite meal, something cosy like thai curry or pasta
  • ringing a relative or friend for a long chat
  • going for a walk in a pretty park
  • buying a lovely bunch of flowers
  • 'happy' films on dvd- to this day i never watch psychological or dark films
  • buying some goldfish- when I felt really down and lonely it cheered me up to see them swimming about in the bowl!
  • odd one this, but i liked taking photos of anything and everything that looks pretty- i found taking photos of flowers, clouds and trees very soothing and made me feel like there is beauty and loveliness out there! daft but true
  • spending time with positive people only- negative or troubled friends can really suck a depressed person down

Lastly, a tip for the anxious insomniacs out there- if its 12 or 1am and you still can't sleep through worry, it can help if you decide to yourself that if you don't sleep at all that you'll either call in sick the next day or ring work to say you'll be late cos of a dr's appointment (therefore giving you extra time in bed). Chances are that just giving yourself that leeway will stop the 'oh god what if I don't sleep' thoughts racing about. Also, white noise like a fan can help, or sometimes I used to put the telly on a really low volume- just listening to it quietly stopped me listening to my own thoughts and helped me drift off.

Sorry that was very long and rambly! Just thought maybe my own experiences might help a bit.

kizzie · 05/08/2010 17:16

MadameG - thank you so much for taking the time to write all that. I cant tell you how much it helps me to hear from other people who 'understand'.
I agree totally re. CBT when you are in a very bad patch. Think it can do more harm than good. (she says from experience .) But as im functional at the moment im hoping it might be more help.

Do you manage with or without medication. Im still in two minds as to whether it helps me or not. Although i think Im in too precarious a situ at moment to even think about testing how I am without it!?

So much of what youve written rings true with me - thank you xxx

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EldritchCleavage · 05/08/2010 17:33

Kizzie, I think MadameG's list is brilliant. I would add eating as healthily as you can and getting exercise, preferably daily.

Music helped me enormously as did-on very bad days-going to the cinema, on my own or with friends. It was good because, while interaction is limited, you aren't alone. I got the very good tip of sending cards as a way of keeping in touch with friends I hadn't the energy to see.

Being at work is better than being at home on your own locked in your thoughts, I think, provided work is not too demanding. If it's going that way, maybe you could ask to do fewer hours for a while?

MadameG · 05/08/2010 18:34

No problem, my pleasure. If anything I can share will help then its all good.

Yes I think CBT can do more harm than good, you're right. I remember when I was doing it in group therapy, we were all too much of a mess to get anywhere with it, and although some of the ideas rang true and I liked trying to make some headway by trying it, it wasn't until my life improved and the depression calmed that I could think clearly about that stuff.

I'm not on any meds any more. I was for a very long time. I was on Citalopram (maximum dose), Quetiapine or Olanzapine (antipsychotics) and Valium sometimes too. The antipsychotics had a good value. I was completely climbing the walls without them, I had endless gruesome images in my head, a horrible voice saying terrible things and I had urges to do very violent things to myself. They turned me into a complete zombie but that was far preferable to being sectioned. The antidepressant (Citalopram) didn't do bugger all, I don't think. I was just as anxious and still heavily depressed. In my experience, antidepressants don't actually get to the root of the problems which have caused the depression, its kind of like sticking a plaster on a wound.

If you're not ready to come off them though then don't- you can always lower the dose in the future instead if you wish. I spent a long time weaning myself off all the drugs, and the gradual process helped me to find my feet with not taking them and feeling ok about it. Sometimes GPs will just stick you on them and want to keep you on them as they see it as an easy way to level you out, but its not always helpful when you could be seeing a therapist instead. I read you're on Clompiramine- I've never tried that one myself. Sometimes if you google about antidepressants you'll find helpful info about how other people have coped on it/ found it to use. I wish I'd done that sooner with Citalopram because it turned out to be a massive weight gain one. Do you see a counsellour/ therapist?

Everyone is so individual in terms of what will help them recover I think. For me, I needed love in my life and stability, and through my sister and dh I found that. For others, it could be that exercise/ a new direction helps give them energy and zest for life, or maybe changing jobs/ homes/ relationships or working through bad experiences with a good counsellour. At the psych unit I met people who had gone through things so shocking that you wouldn't believe; some were ready to recover and some weren't. But everybody can recover when they find their individual way to it.

I have to work at it, though, even now when my life is good. I listen to completely different music and watch different films to what I used to, as a lot of things will tap into the dark side of my brain and leave me feeling upset or disturbed. Ditto novels- I can't read most of them. Plus I lost contact with my psych unit friends which as it turned out did me a world of good as when I was trying to break free they were still in a dark place, and I needed to leave all the dark side of my life behind (But I should point out that these were not your average depressed people, they were extremely severe and always in hospital).

Also, my family are very clued up about what starts me going downhill, and my dh is a level-headed positive person who knows exactly how to help me if I struggle. There is huge value in having positive people around you, I had to have a complete reshuffle and cut some people off who I had been wallowing with/ commserating with for a long time.

But, like I said, everybody is different. You can and will find your way out of the tunnel. God if I can, anyone can. Trust me!

Just take baby steps and do whatever you need to do to stay functioning and build the things you enjoy into your day. You'll know when you're ready to lower or come off the meds eventually.

You can do it!

kizzie · 05/08/2010 19:53

EldritchCleavage - thank you too. The cards tip is a really good one.

MadameG - i think im at the point in my life where I need to do much more of what you're describing here. Ie. taking a proper look at my life and analysing what helps and what doesnt.

I have been in denial for a very long time. Before anxiety based PND 11 years ago (at the age of 29) I had no history of MH problems. And I think ive continued to think of this as a bit of a blip (i know- 11 years on!! .)

I have tried to come off the medication (i was on seroxat first) many many times - including very slow withdrawals but each time I have replapsed. And with each relapse depression has become more of a feature.

I have a senior (stressful/busy blah de blah) job which when Im well I love (really love). But I'm not sure I can keep pretending that its not affecting my health. In the past Ive always said that the relapses havent been down to the job (and I still dont think they are) - but it certainly makes it much harder to get better and I can feel the pressure to achieve bigger and better all the time on my shoulders.

Ironically this is why i love the job - never two days the same/ creative / challenging etc etc. But maybe maybe I need to take a step back. Would mean massive life change for us but I think if this continues I may need to face it.

Anyway - I didnt mean to write as much as this . The short version would be that I think i need to face the fact that for me pressure/stress/anxiety in some way leads to depression. Whether thats by changing brain chemicals over time. And I need to try and break that cycle.

Thank you so much again for all the advice x

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EldritchCleavage · 06/08/2010 11:36

Kizzie, have you considered another form of therapy? I did CAT (Cognitive Analytical Therapy), a sort of analysis/CBT hybrid, as the name suggests. I found it very helpful and it's a therapeutic model I'd recommend. There is a website for it-just Google CAT.

Citalopram did help me because it is supposed to be good for anxiety as well as depression (had depression with anxiety). I took time off work for intensive treatment ( I was not an in-patient but attended hospital every day, did an extra group session one evening a week) and that was key for my recovery-would that be an option for you?

I do think it was very easy for me to settle for the status quo for fear of things getting worse, when in the end I got well only when I started to fight for things to be better, if that makes sense.

MadameG · 06/08/2010 11:57

EldritchCleavage- that last line of your post was the exact same for me. I mooched along desperately unhappy for years, in a horribly lonely life situation and nasty relationship, and my job was completely unfulfilling too. Then something snapped inside me, I dumped the abusive guy, moved in with my sister and eventually left the job too. Life now a few years later is a different world and I don't need antidepressants etc.

Kizzie- maybe what you could do is spend some time writing down the areas of your life and how happy they make you- each part, from state of finances, to job, to social life/ hobbies, everything. Imagine what your 'happy' life situation would be and see if that clarifies what is currently triggering your anxiety or making you depressed. It sounds as if you suspect your job isn't working for you anymore, and is too much to deal with. Maybe you can start to consider your options re scaling back/ going freelance or whatever to make this a happy situation rather than a stressy one. Don't worry about coming off the antidepressants until your life is more peaceful and calm.

kizzie · 06/08/2010 17:30

Thank you both so much. Youve really made me think.
I will definately look into CAT.

One of the things Ive definately done in the past is as soon as Ive 'recovered' is go back to my old way of doing things. So working long hours / getting stressed over ridiculous things - because I think 'well im better now - so its fine'. Except its only fine till I crash again. The other thing I do is think - oh well i used to be able to do that in my twenties.... Without acknowledging the fact that things are very different now. not only the obvious fact that Ive got children - but also that Ive been really very ill at times and my stress threshold is much lower than it used to be.

Im so glad youve both found ways to make life work for you Smile x

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MadameG · 07/08/2010 09:49

I think you have to acknowledge your boundaries and respect them. I'm the same as you in that I can't function under strong work pressure, I just crumble. I have to do jobs that are either easy, extremely low stress or do something from home, which is what I intend to do when my baby starts school.

You probably need to keep stress everywhere in your life to the absolute minimum to give yourself the room to breathe and feel well.

I really recommend figuring out a 'de-stress happy life plan' for yourself.

Good luck, you can do it. x

kizzie · 07/08/2010 16:11

Thank you x

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