Who would be the best health professional to see for this?

[Chocolateiseverything]

I have suffered with poor mental health for as long as I can remember (probably from the age of 5 or 6).

I am now almost 50.

From childhood I have had major anxiety, worry over everything, overthink everything, I had various OCDs as a child (which included believing that my food was being poisoned and as a result I have disordered eating), I always had huge existential fears, long bouts of deep depression, I have always been hyper but in my mind not outwardly (like I have a machine on overdrive inside me). I have never been able to concentrate on things due to my over active mind and as a result feel I have achieved very little in my life (career wise etc) which then creates a downward spiral into self loathing and a huge lack of confidence which then obviously triggers off my depression. I am not great around people but put a front on and pretend I’m doing fine but secretly want to spend all my time alone. I’m then left in a dark place and vicious cycle of anxiety/depression/lack of interest/more lack of confidence………
I can never switch my brain off, it feels like a separate entity to the rest of myself.

I have spent years going back and forth to GPs, explaining my issues and getting nowhere really, I am still very much the same despite trying so hard and desperately wanting to get to a better place.
Over the years I have tried various antidepressants (which make me feel worse physically as I have digestive issues), have had lots of different sessions with CBT (I have tried so, so hard with this as it seems to help so many), have had several bouts counselling over the years, tried hypnotherapy and recently tried EMDR (it was via zoom and maybe because of that, I felt it didn’t help). I exercise, don’t drink, smoke or take drugs, I really try to look after myself. None of these have had any lasting impact with my issues and it’s actually getting worse now I am in my 40’s (I am definitely in perimenopause but these issues have, as I say, been with me since early childhood and I don’t know why).

I am so very tired and drained from it.
I always said to myself that if I was still suffering by the age of 50 I would pay to see someone privately.
But I don’t know where to even start, especially as I don’t really know what it is that I actually suffer/struggle with? No GP etc has ever explained or suggested anything.
Could I benefit from a session with a psychiatrist (I have never seen one) to start to at least get some understanding as to what my main issues is or could be?

Like I say, the GPs that I have spoken to haven’t been too helpful and it’s hard trying to articulate how I have felt my entire life, in a 10 minute GP consultation, so 45 or so years on, here I am still struggling.

Please forgive the predictability of this question but how was your childhood? We learn/absorb information at a higher rate during the years between 3-10 than at any other time in life and if you developed negative core beliefs during that time these have to be unlearned/debunked (which is possible) in order to think differently about yourself.

Maybe a psychiatrist to have a full assessment. You might want to consider ADHD alongside anxiety disorders. It's a shame that you haven't been able to tolerate any medications but that's something you could talk through with the psychiatrist as well.

I would start with a private psychiatrist as currently you have no diagnosis

What on earth has that got to do with the OP's question about which qualified registered professional to see, and why are you trying to armchair-diagnose her online?

OP book in with a private psychiatrist, get a diagnosis, see what recommendations they make about where to go from there as they can suggest whether or not to go with medication, therapy, type of therapy etc.

I recommend Psychiatry UK as they have a huge range of psychiatrists and aren't as expensive as some other companies (and you can access them under Right To Choose for some things so you could get free care/treatment faster than on the NHS). You have to put which mental illness you suspect you have when booking with them, but you can also ring up and ask them what the best thing to do is.

Yes GP's are a jack of all trades, but a master of none. Their standard approach is a referral to CBT and SSRI anti depressants medication like Prozac etc.

But the research shows these approaches aren't very effective for the majority of mental health sufferers. Most people come off them due to horrendous side effects and them simply being ineffective.

Depends on what you want from the mental health professional you seek.

Is it to get an official diagnosis? Medication? Then a Psychiatrist. Also remember, Psychiatry is not a 'hard' science like physics, it's can be subjective, this means that different Psychiatrists may give slightly different diagnoses and treatment recommendations. For e.g. someone I knew was diagnosed with Schizophrenia for years, given anti psychotics, but still had angry outbursts. Another psychiatrist then went onto diagnose him with schizo-affective disorder, added mood stabiliser lithium, and he became much better. So don't take any Psychiatrists diagnoses or medication recommendations are set in stone. It's very much a trial and error, to see what works and what fits for you.

Or if it's not about medication, and instead to get to the root of your problems, and tackle them through talking therapies? Then a registered chartered Psychologist. Look at the British Psychological Society.

From what you've told me it sounds like Generalised Anxiety Disorder, with comorbidity of re-occurring Unipolar Depression. In the UK treatment options are limited....you would be given SSRI's (which as you know are not great), CBT (which is also not that good), psychotherapy (not effective in clinical trials).

The ground breaking medical treatments in mental health are actually the Psychedelics, e.g mushrooms, DMT etc. These would also address your existential worries.
Clinical trials show they are the next big thing in mental health care. Currently in the UK Compass are conducting trials for treatment resistant depression with the use of psychedelics. See if you can join?

Or just go to the Netherlands where magic truffles are still legal, there are companies out there that do tourism packages where a safe space, 'trip buddy' is given etc. Look into it, lots of people swear that it has changed their lives, more than any current anti-depressant has.

Because self awareness and self knowledge is desperately important, and the vast majority of mental health issues are rooted in childhood experiences, even for those who have an seemingly uneventful upbringing. See the multiple Stately Homes threads. I work with people like the OP all the time.

From my armchair in my consulting room.

It depends what you want OP. If you want a diagnosis then by all means a psychiatrist may be able to give you one. If you want to understand more about yourself and how you are living your life and perhaps why you make the choices you do then how about an integrative counsellor? Go in with an open mind with a view to commiting to it long term.

Psychiatrist, definitely.
Its possible you have undiagnosed autism or ADHD (there are many undiagnosed women who as girls didn't present as "stereotypically autistic" like boys did when they were children).
Lifelong mental health issues with an overactive mind and feeling like you are putting on a "front" suggests possible autism imo.

My heart is literally breaking for you. To be in your late 40s with no meaningful help from your GPs is staggering. As other posters have suggested, I would seek out a private psychiatrist for a full analysis. Wishing you well. X

A good Psychiatrist could really help, not just with diagnosis but with other medications GPs don't have the experience to prescribe. There are a lot more treatments then just standard antidepressants.

It might be worth your while reading up on Adhd in females. It sounds like your situation is more complex then that but it could be part of the puzzle. I hope you can find the answers and the support you need. You might find it worthwhile to join some groups on FB if you're on there for neurodiverse women, you may find some of yourself reflected there, what you've written reminds me of similar posts Ive read. Some of it feels familiar to me too, including the bad reactions to medication, I do have something that helps with the GAD, old style tricyclic, but nothings ever helped with my other conditions.

If you want more medication go to a psychiatrist. Totally agree there. But it seems you don't.

So I'd look for a counselling psychologist. Very specifically that name (not a counsellor). They're trained to doctoral level (like a psychiatrist and clinical psychologist) but in actually giving therapy - and more than one type.

You have multiple issues (which shouldn't be diagnosed online..) which have existed for a very long time. There's literally no chance that CBT could have resolved them all. In your case it's more like a sticking plaster to help deal with a few if the symptoms in, probably, a limited set of circumstances. I'm saying that so you know you've not failed here, you've been failed.

EMDRZ can be very powerful too, but again in your situation, it's not enough. A few sessions online could be good for someone who has one thing that's been a problem, for a shorter period of time.

You need someone who is trained to look at the whole problem and not bits here and there. So first step is higher level training.

There are counselling psychologists on the NHS and some also work privately. If you find one in your area it may be worth contacting him/her to ask about your options. You are going to need longer term therapy - none of this 6-12 sessions business. So it can be expensive. If that's out of your budget then ask them about local possibility in the NHS and what you need to say to GP to get you on the right track to see one. There will be at least one waiting list to get through I'd imagine.

More info about counselling psychologists: www.healthcareers.nhs.uk/explore-roles/psychological-therapies/roles/counselling-psychologist

@Chocolateiseverything I hope you feel able to come back to this at some stage. I was thinking of you yesterday. I think what you're experiencing might be what my DD feels, but is too little to articulate properly. Parts of it reverberate for me too. Existential dread, still got it, little repetitive routines to try and keep specific anxieties/panic at arms length, intrusive thoughts, I have a hot ball of anxiety in my gut right now thinking about all this. Woke multiple times last night with that ball of dread on my gut.

I suspect you didn't get the support you needed as a child. My parents certainly weren't cut out to help, one was well meaning but suffering through their own PTSD, the other was emotionally abusive before leaving when I was 12. My DD in contrast is accessing support and has been on and off since she was 6.

When I read self loathing in your OP, I can relate to that, I feel worthless a lot of the time. Followed my parents footsteps, married someone emotionally abusive. I feel like I should be able to fix this, fix me, but I don't have the tools, you don't have the tools. We were let down by the people that should have seen we needed help when we were little kids. That's the one big difference between a lot of the ND and PD people in my generation and the one growing up now. My DC have been in early intervention since they were 5-6-7, depending on the child. They are actively being taught what they need to cope better and function in a world where most people think differently to them and hopefully they'll be taught enough self belief that they can hold out against the messages that world gives them.

Your brain functions differently to neurotypical people, you haven't failed, you've done everything you should, you were never taught what you needed to know to get out of this cycle. I don't think it's hopeless, you need help to find that other path. A psychiatrist and spending some time on forums with neuro diverse people or those with Personality Disorders could give you a new direction. Don't let the name fool you, not every PD is actually disordered, finding the 'label' can help you find what you need to get on the path to feeling this less often. A psychologist I saw briefly (money reasons) and was really good recommended the book the happiness trap, it's ACT therapy, Acceptance and Commitment, it's more about acknowledging and moving on from the past, focusing on what you need now. Even with a brief time I found it more useful then CBT. Wishing you all the best.

Wow I can totally relate to this. So sorry you have been suffering for so long.
I am just trying to get a diagnosis for adhd or add as I scored high on a test. It answers all the questions as to why I’ve had such a hard time with racing thoughts and emotional dysregulation over my lifetime especially when hormones were fluctuating. I’m no medical expert but have you ever looked into the condition? 🤗