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DD depression anxiety and panic attacks

4 replies

Mrsmadevans · 05/07/2018 16:50

It has all come to a head today , she has failed her exam she took 2 weeks ago and she is terribly upset . She has a history of depression and anxiety for years off and on , always refusing medication. I immediately made an appt with the GP for her and told her that enough is enough now , she needs help with this to be able to finish her midwifery degree. I have told her to get a sick note for uni for the end of this week and next and to see how she is before she goes back to placement . In the meantime l am just wondering if there is anything else l can do ? Thank you for your advice in advance . She is 24 and up until this exam she had been hoping for a first . She is so down , not suicidal but very upset.

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Chatterboxnz · 05/07/2018 21:07

I think CBT would be helpful for your daughter, if she is proactive about wanting to help herself. She would need to be fairly committed to the process, even if some of the things seem a bit silly.

Basically, CBT works on the theory that thoughts, feelings and behaviours are related. For example:
I see that it is sunny today. I think "Oh it is sunny, I am going to have a great day" so my behaviour is I go to the park and see my friends. My feelings are happy.
I see that it is raining today. I think "Oh it is raining, I am going to have an awful day" so my behaviour is that I stay at home. My feelings are bored and sad. It then becomes a self-fulfilling prophecy that every rainy day is a bad day, because my "automatic negative thoughts" are that rainy days are bad.
It may help for her to look at Rational Emotive Behaviour Therapy (a branch of Cognitive Behavioural Therapy) that identifies unhelpful thought processes and changes them to a more realistic thought process. Often what happens during depression and anxiety is our thought processes are skewed because we can see a lot of negative things around us. Logic doesn't often play a role because we are driven by automatic negative thoughts which drive our feelings and behaviours.

First step, I think she should sit down and identify who she is. This sounds really silly, but get her to look at who she is in context with her family, her friends, her classmates. Who she is as a person, for instance her personality, her desires, her ideas for the future. If she has trouble thinking of who she is in context with other people, or they appear negative, prompt her by saying things like "I see you as...." make sure that she knows she is more than the degree she is working towards.

Have her practice some form of mindfulness or meditation. If she is an active person, tai chi may help as it is done to music that is 60bpm. This mimics our resting heart rate and encourages the body and mind to relax. The movements are fluid and with practice she will be able to do this without focusing too much and can just relax. If she prefers she can try yoga or meditation.

This step is perhaps the most important and requires her to be fully committed to it.
She should start a thought journal. She must be fully involved in this, even if it seems completely stupid to begin with. It does help and I find that often people are too quick to give up on it.
When she has an automatic negative thought, for instance "I failed this exam, I fail everything" then she needs to use her thought journal (preferably as often as possible to begin with).
Situation: She needs to describe the situation, it may be helpful to include who she was with as well as what she was doing. For instance "I am at uni and have just gotten my results back, I have failed. There are a lot of other students around me that have gotten their results back too".
Feeling: Here she identifies all of her feelings. She should aim to give them a percentage rating as well. For instance: sad 20%, scared 20% Hopeless 60%
Automatic Negative Thought: Here she identifies her automatic negative thought: "I failed this paper, I fail everything, I will never be a midwife. I should just give up."
Evidence to support this thought: "I failed an important test so I must be a failure at everything.
Evidence that doesn't support this thought: "It was one test. I can make up the test another time. My exams don't determine who I am as a person."
Alternative thought (more realistic thought): "I can ask my lecturers what I can do to pass my papers. They are there to help me."
New feeling: "Relieved 50%, disappointed 40%, sad 10%

The thought journal doesn't necessarily "fix" the feelings, as the person is probably still going to experience feelings of sadness etc about the thing that has happened. It is designed to promote more realistic or helpful thought processes as opposed to purely pessimistic processes. At the moment, it is likely that she isn't able to see a way out of everything, as she can't think of an alternative. By breaking everything down in this way, she is taking some emotion out of the situation and thinking critically about what actually happened.

Hope this helps some.

Lisa (Dip Child and Adolescent Psychology, BA Applied Science Psychology, PgDip Education guidance and counselling, in progress BA educational psychology and statistics).

Mrsmadevans · 05/07/2018 21:26

Omg thank you so much Chatterboxnz that is just amazing , I will tell her your reply , thank you a thousand times , you are right she feels a complete failure , thinks l am disappointed with her , I most definitely am not, l am disappointed for her because l saw the huge amount of work she put in to it . Thank you again.

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Chatterboxnz · 06/07/2018 03:38

No problem. Hopefully it will help some. I am trained in psych and counselling so should be useful :)

Mrsmadevans · 07/07/2018 20:14

Thank you it was extremely reassuring and comforting, she has been to the GP who has px CITALAPRAM and given her a note for her Uni , she is home for the following 2 weeks at least until she has seen the GP again. Thank you again l am most grateful Flowers

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