BIL stuck in loop of self destructive thought. He has agreed to get help now but how?

[Spidermama]

DH's oldest brother has had mental health issues ever since I have known him but because he's high functioning and very bright he has been just about coping with life.

However, he's having a bad time (episode?)at the moment and having chatted together he's agreed it's time to see someone.

In a nutshell, he always lives in terror of something. Real proper fear. He lives on his own and the fear and thoughts seem to go round and round in his head. He thinks up what would be the worst case scenario, then worsens it, then worsens it some more until he's gone right down an ever narrowing channel of fantastically far-fetched horrendous possibilities which he really believes might actually happen.

He has become incredibly inward looking and solipsistic and paranoid. I just can't seem to help home move on or break the old destructive thought patterns so I feel out of my depth.

Anyway he has agreed he needs help so how should we go about this?

Thanks.

The first thing that comes to my mind is maybe some CBT?

The theory being that the way we think controls the way we feel... so if we get help in understanding why we think the way we do, it might help to alter those thoughts and then sit with our feelings a bit better

Not sure if that makes sense (I can't put it into words very well!)

GP is the main route into all sorts of therapy etc.
Maybe you could accompany him to appt if he would find it helpful?

Thanks NNB. So is that Cognitive Behavioural Therapy? What does it do?

I guess it's unikely to be available on the NHS?

well he needs to go and see his GP.
they can then refer him on to someone who can help.
unless he has money to go private though it will not be instant. NHS waiting lists for mental h ealth services are dire in most areas and it can take months before you get an appt.

Yes Tigana he's happy for me to accompany him and I think it would be useful for some context.

I was wondering if the GP is the only way as sometimes it's such a long winded procedure. He had two sessions of counselling and was also given prozac after going to the GP before. I really think he needs more.

CBT is available on NHS in some areas

It's the treatment of choice for depression for NHS because it's 'cost-effective' (CBT is generally time limited... ie, is done in about 10 sessions therefore is cheaper than long-term psychotherapy)

Well worth asking GP about it

Oh ... he's in Bupa.
He just said, 'Does Bupa cover fruit battishness?'

DEFINITELY worth investigating if BUPA fund CBT type therapies

he can ask for a referral to a psychiatrist, or for CBT and the GP has to do it (assuming it's available iyswim?)
as NNB says CBT is available in some areas so it's def worth asking about

IME it's really worth getting a psychiatrist referral though. they can be another gateway into alternative therapies (such as cbt and stuff) and they also have a much, much better knowledge of which anti-depressants will be appropriate as they use diff ones for diff things.

CBT should be available on nhs...but i expect it is limited and probably a bitpostcode lottery-ish.

No clue how to access via bupa...not clued up on non-nhs stuff....do bupa have generalists who can refer you onwards?

well he should contact BUpa and ask them cos that will give him a massive head-start.

as I say, the nhs waiting lists are generally woefully long.
I had to wait 4 months to see a psychiatrist after 2 suicide attempts

That's shocking Thisisyesterday. I'm really sorry.

When you finally got to see someone, how did it go? How are you now?

it is shocking isn't it?
at the time i was an angst-ridden 19 yr old who refused to accept that anything was wrong with me. so it was a long time before things got any better but I am fine now!

I'm glad to hear it.