when counselling and medication don't work - what can you do instead?

[Iwillneverbesatisfied]

I have anxiety and PTSD due to prolonged workplace bullying and discrimination. I still work there and I'm struggling as the matters have not been properly addressed. Being disabled (multiple disabilities) makes me a less attractive candidate to other employers and this current climate also limits opportunities. I am actively job searching to no avail and I've used up all my sick leave entitlement. I can't afford to take any more sick leave nor can I afford to just quit - we have no savings and DH is in a company where several people have been made redundant already so we fear for his job. I need to keep mine, even though I am so unhappy. HR have not helped but my doctor is being great. I tried sertaline and that did not help. I tried counselling and mindfulness and that did not help. I guess because the problem (work) is always going to be there. My work are questioning my performance and my behaviours, even though they created the PTSD (which my doctor diagnosed me with). I do not know what else to do to make me feel better until I find other work (which might never happen or be a long way off). I've asked for an exit package but my union do not think I will get one and if I do, it might not be enough to keep me going financially until I find something else. I feel so trapped. I'm constantly crying and getting headaches and bad thoughts. What can I do if medication and counselling does not work?

Go back to your gp and ask to review meds-if sertraline doesn’t work, something slightly different like venlafaxine might. If /when that gives you a bit more stability, look at other counselling options: maybe another modality might help-cbt, which is very solution focused, or something like EMDR which specifically addresses to emotional and physiological responses to trauma. Steady away, one day at a time and keep seeking ALL the options of support that you can.

What kind of counselling have you had?

Sounds horrendous for you. Can you plan your escape? Survive on a lot less? It might be worth considering. I went from £56 to £4k , it was well worth it, mental health wise

You sound very ground down by it all

First things first, try a different med. Sertraline is always the first one offered usually followed by Citalopram as they are the most widely tolerated and quite versatile. They are not the only option. Try a few alternatives. If You have no respiratory or heart problems I would ask your GP about trying Propranolol which will only treat the physical symptoms of anxiety but will at least get rid of that sick sense of dread.

Secondly counselling is great and I personally have found it an invaluable support but it isn't always the answer. I've heard very good things about EMDR therapy for PTSD. In my personal opinion mindfulness is bullshit. Its fine for a bit of mild anxiety and depression but for PTSD level anxiety, it's like trying to fix a burst pipe with plasticine. Look into a few different types of therapy that could help you, interview a few therapists to find one you can really work with.

Thirdly, nothing I've suggested will make a blind bit of difference in the longer term if you don't get out of that toxic workplace. Take it from someone who has been there, a year down the line you will be wondering why the hell you didn't tell them to stuff it sooner.

From what you've said about them questioning your performance they could well sack you soon anyway. Is one or two or three more months pay worth the toll its taking on your mental health? It wasn't for me. I wish I'd told them to shove it up their arses and fuck themselves with vigour.

Apply for anything. Even out of your field. Even if it means spending 8 hours a day doing mind numbing data entry tasks. Sign on with agencies for temping work if you have relevant experience. Even if you end up working two jobs at once you'll still be happier than you are now. Being bullied drains you in a way people can't understand unless they've felt it. Trying to keep up that professional front while they chip away at you is exhausting, I know. I've been there, going steadily downhill yet refusing to quit in case of financial disaster even though it was making me suicidal with unhappiness and my desperately worried therapist trying to prop me up emotionally and taking my calls at ridiculous times of the night, practically begging me to just quit. He even offered to see me for free if I couldn't find another job and you know what? I ended up getting sacked anyway for 'not really fitting in.' Looking back, God knows what I was thinking. My therapist was right. No job is worth your mental health. I was crazy to stay.

Is there any possible way to absorb the drop in pay? It doesn't have to be permanent. Just enough to give you some wiggle room to get back on your feet.

My doctor has given me beta blockers and I started them today. I know they will help with the physical side of anxiety and PTSD. I'm a bit worried about side effects though.

I have tried mindfulness and I have the headspace app but its shit. I sometimes text the SHOUT helpline but again they only just listen rather than offer advice. I've tried counselling via Zoom (I'm vulnerable so can't go anywhere) but again they just listened and didn't offer any advice or suggestions and weren't very disability aware - they actually questioned my capability to do the job if I am disabled. I felt worse, not better. I know I can do the job, I just need adjustments which my employer isn't giving me.

I have multiple disabilities and I know that puts employers off even though I've never ever been unemployed, I've always been able to work (with adjustments). I have a lot of qualifications so maybe they see me as over qualified? Most of these qualifications are very niche which limits my options although I've tried to get some different qualifications to widen my options.

We do not have any savings. I really can't afford to just quit. DHs workplace are doing redundancies and my job is the secure one.

Its just shit overall.

My union guy is saying my health is more important but on the other hand, the grass might not be greener and that is definitely a fear.

Have you had a referral to the mental health team? Your GP cannot formally diagnose PTSD, you'd need to be seen by a specialist for that. Whilst waiting lists are (extremely) long, being under a psychiatrist and secondary MH will give you more treatment options.

Hi my GP said he believes I have PTSD and referred me to some online websites and also to anxiety UK who confirmed I have PTSD. I have also had occupational health therapists confirm I have anxiety and PTSD.

I don't have anything in writing to confirm it, unless you count the OH reports. I have had counselling remotely. I do have all the symptoms of having PTSD - flashbacks, insomnia, tremors, panic attacks etc

I take them a lot and have never had any side effects. I don't think most people do, they're generally very safe. And yes, mindfulness is bullshit in my personal opinion. I don't really think counselling will help you as it is mainly about being listened to but proper structured trauma therapy likely would. You're unlikely to get it on the NHS though. (speaking from experience)

The grass is definitely greener OP. Union guy is right. It's not going to be any worse and from what you have said, your job is far from secure. Have you involved Occupational Health regarding these adjustments?

Maybe try including a covering statement in your CV about your varied work experience and stating that you want something different, faster/slower paced, more people oriented. Whatever bollocks will get you hired basically. Just get out of that environment while there is still anything left of your mental health to salvage. How long have you been there? If more than 2 years you would likely win an employment tribunal for constructive dismissal based on what you have said here.

I am currently going through an employment tribunal process. My employer are trying to get me to settle out of court, union guy is helping, I was off sick for a year, then furloughed, then back at work cause could not afford to stay off, now I'm off sick again (no pay) because all the things they promised they would change and put in place, never happened. I think they just made these promises to shut me up.

First of all, I am sorry your employer has been so crappy. Nobody should be treated by anything but consideration within their work place and it is really, well and truly, disgusting that it still is such a rife issue.

PTSD treatment is much less successful when the person is still involved with the root cause - it causes re-traumatisation and does not allow for phase 1, stabilisation to occur.

You do need to ask for an OH referral - message me if you would like a recommendation for someone to propose (personal, and has been used by several people I know who have trauma-based diagnoses too).

Has a psychiatrist diagnosed you? It's a little bit unclear from your posts - if you have not seen a psychiatrist you need to request to see one and have a formal assessment and diagnosis. This will open up more treatment options for you.

I have personally chosen to go down the "hippie" alternative route and engage in therapy, but do not take medication - I have a slightly different diagnosis. It is a long process. There are lots of other options though with medications, and with counselling types - do you know the modality that your counselling is based on?

I personally found several types of medicine, and several types of counselling really awful - many made me worst not better and I had almost given up hoping I would see any improvement.

My work have an OH organisation they refer us to so I would need to go with them. They've been okay so far but employer tends to ignore most of what they recommend.

I haven't seen a psychiatrist, no. I think lockdown is influencing the support I get referred to. My doctor said I had PTSD, recommended the samaritans, mind and anxiety UK. I get online (not face to face) counselling through Anxiety UK and the woman is experienced in PTSD but I don't think its helping. No idea as to modality.

I tried counselling, tried mindfulness, tried yoga, tried sertaline, tried Kalms, tried going for regular massages, tried going for walks, tried listening to music, tried listening to headspace - nothing is working for me. I think the only solution is to change jobs and honestly, I'm searching all the time to no avail. I can't just quit either.

Ok, I would ask for a referral to see a psychiatrist for a diagnosis first off - it will give you some more options, and you will be in the "system".

Unfortunately, your work don't have to follow the recommendations in OH reports, but it doesn't look great on them if they are doing so with no good, solid reason. What kind of things have been suggested?

You say: I tried counselling, tried mindfulness, tried yoga, tried sertaline, tried Kalms, tried going for regular massages, tried going for walks, tried listening to music, tried listening to headspace - nothing is working for me

How long have you tried these for? How is your sleeping, and your routine? Are you using drugs/alcohol at all to numb or block?

I tried counselling for 18 months through our Employee Assistance Programme, had a break, then started again with an apparently more experienced counsellor in PTSD (with Anxiety UK). I tried mindfulness for a 30 day course. I was on Sertaline for 3 months. I've tried the other things for a while too. I'm now on beta blockers (started this week)

Do I really need to see a psychiatrist as I thought my doctor saying I had PTSD would be enough? and he's referred me to the counselling and given me the beta blockers and sertaline. He's been signing me off work sick and also helped me with a PIP application for this and my other disabilities.

OH have recommended things like disability awareness (for my specific disabilities), working from home, a fixed desk, a buddy/mentor, things like that. I've gotten none of it so far with the pandemic used as an excuse (although the last OH report was a year before the pandemic hit....)

I do not drink and never have. I have never taken drugs either. I do not smoke. I try to eat healthy although lockdown has made me pig out a bit out of boredom!

Oh I should have said I have had CBT (referred by doctor) and that didn't work for me either. It just felt stupid and awkward.

I have been diagnosed with PTSD and Generalised Anxiety Disorder and suffered with intense anxiety since I was 17. You definitely need to see a really good psychiatrist. SSRIs and other drugs are dependant on your unique chemistry. You will find what works for you and you’ll be happier than you ever thought you would be but only if you search for the right medication and therapy. Wishing you all the best - you can do it.

does anyone know if beta blockers can be taken if you get the flu vaccination - I am due to get the jag next week as I'm in the vulnerable category.

Beta Blockers are a range of medications and a range of ingredients so you need to ask your GP.

If you are getting your flu jab because you have asthma though, you should not be taking beta blockers.

They CANNOT ignore occupational health recommendations. I don't think that's even legal!

I didn't stop taking propranolol when I had my flu jab, didn't even think about it. Pharmacist knew I was taking it so I'd hazard a guess that its fine.

Yep, agree with others. Try a different medication. It can take a while.

Employers can ignore OH recommendations. They shouldn’t but they can. I’m guessing you work for a public sector organization because tbh the private sector would have dealt with it quicker.

I would try to get a global settlement to leave and drop the tribunal action. Get a decent employment lawyer. I don’t think there is any future in your current job.

yes public sector. They are "giving me time to recover" without realising it is them giving me support that will make me recover!

Could you continue in the same job area but something with less responsibility and away from the bullies? Just something to bring in a salary while you chip away at the MH issues?

unfortunately I've already had a few internal transfers. I've been badly treated in each one. It makes me feel like its me that the problem (it isn't, doctor and union say it isn't but I feel that way).