A health update

Last month, when I went through the results of my reader survey, somebody said that they wanted to know more about my CBT. It was a fair enough suggestion since I'd written about my therapy sessions in depth until they suddenly dropped off the radar.
Yachts at Plymouth
The truth is they all became one and the same. It felt like every single session went the same way, with the same conversations, the same exercises, the same homework, and this didn't seem useful any more. Why would I write a post every Thursday saying exactly the same thing? Rather than explain this, however, I decided not to say anything at all. I supposed nobody was really that interested, so they wouldn't notice if I just stopped mentioning it. Until I read that response, when I realised that actually people do care. At the time, I wasn't in the right place to start writing updates so I just left it sitting there until I was ready. Which is now.
My final CBT session was something like my twelfth one- I lost track of exactly how many I had. It consisted of creating a plan in case of setbacks, which was essentially a long way of saying "Remember what you learned in CBT". My therapist assured me that I wasn't being thrown out on my tod, but that it was more of a trial run to see how I coped alone and I could always return if I needed to.

I didn't return. Neither did I use the plan we created for setbacks. That's not because I didn't have any setbacks but because I just couldn't see how helpful it was. Of course it was never going to fix everything, and of course it relies on me actually putting into place the strategies I'd learned, but my problem was how analytical I am. I knew what I had to do and I knew what I was supposed to do and it was for that very reason that it didn't work for me. The one thing that has stuck by me is that saying something true does not mean I'm arrogant, so here goes: I was too intelligent for it. (I still feel hugely uncomfortable saying that so it's a comfort that my colleague, after I explained this to her, told me that she and my boss had said the same thing- it's not working because I understand the process too well). That's not to say it works if you're stupid, but the purpose was to have someone teaching me new strategies. My problem was that I knew the strategies, I just couldn't apply them and, because of that, the sessions didn't teach me anything new. As soon as I stopped having to report to someone every week, I stopped following the strategies. I was going through the motions, playing up to it, doing everything perfectly like the good little perfectionist I am, but not actually meaning any of it. Without the pressure of someone holding me to account, I dropped the pretence.

So did it help me? Not in the long run, no. I tried my best, I really did, but it just didn't work for me. With some coaxing from my workplace, I went back to my doctor (who, after leaving the surgery for a new permanent role at Christmas, returned towards the end of my therapy sessions and I was so happy, I cried) and, as always, he was incredible. I was already on the maximum dose of Citalopram so he suggested weaning me off that before starting me on Mirtazapine. 

The two weeks of reducing my Citalopram dose was hell. I had a week on 20mg then a week on 10mg and it was awful. Luckily, my doctor took the precaution of signing me off for this period so I didn't need to worry about work. Once the course of 10mg was over, I started on the Mirtazapine and it instantly worked wonders.

I was a little apprehensive because the biggest side effect is increased appetite and weight gain. The last thing I need is to gain more weight! Thankfully, I seem to have completely missed out on this effect. Another, more positive, side effect is that Mirtazapine acts as a sedative so it's taken at night and supposed to be great for people with sleep problems. Like the weight gain, this is a side effect that hasn't materialised with me. I do find it makes me feel very heavy and lethargic about an hour after taking it but it hasn't helped me sleep and, actually, has made me experience more sleep paralysis, which is something I'll need to tell the doctor when I next see him.

Other than that, it's been fantastic for me. I feel so much more like myself and so positive about the future. This has also been helped by the support of my work, and the new hours I'll be working come September. Of course, I'm not saying medication is always the answer but, in my case, Mirtazapine has proved to be a wonder drug!

Here's to the future, eh?

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  1. Mirtazapine is the one that worked wonders for me, too :) I'm actually well enough now to have started reducing my dose! I'm so glad you've found something that works for you and I can 100% relate to your issues with CBT too. x

  2. I did CBT a few years ago and I felt the same, the exercises they gave me just seemed pointless.. I'm sure it helps some people, but it didn't help me!

  3. Please know that you are not alone in this. My therapist made me feel like there was something wrong with me because CBT did not work for me either. In fact it made me feel worse. I hated it that much that the thoughts of going was giving me more anxiety. After that I gave up therapy altogether. As for my meds the doctor refused to believe that the withdrawal I was feeling was terrible so I managed my come down from anti depressants too. If you ever want to talk you can DM or email me at any time and ill be happy to tell you how I came off them XX

  4. I think CBT works for some things but not others. I used to have severe agoraphobia and CBT worked for that, I believe because it's something very specific and almost black and white (either you can go outside or you can't). But I later had it for general anxiety and it just wouldn't work. My therapist basically kept forcing me to 'believe' things and would get annoyed when I didn't. If I could just choose to have helpful beliefs then I would! But it's just not as simple as having a person telling me to change how I think.

    Amani x

  5. That's such a shame about the cbt i understand that it doesn't work for everyone but at least you gave it a go. Glad to hear the doctor has been a great help and work, support is such a big part isn't it. X

  6. I never actually went to a therapist as the waitlist was a year at that point, but I bought a few CBT books and I felt like I really really wanted it to work but just couldn't make it. Like you say, I understood the processes full well and I understood the concepts, and for that reason it just wasn't going to work for me. I'm glad that the SSRIs seem to work for you though!

    Nicola //

  7. Your CBT experience sounds similar to my own, I just found the whole thing really condescending. And it doesn't help that any doctor I tell that too makes it out to be my fault, which made me feel worse. Unfortunately I'm still fighting for anything that works for me and to get someone to actually listen to what I'm saying, it's been like this for 11 years, even a suicide attempt wasn't enough to warrant helping me. I'm glad you managed to find something that works for you and that you're feeling much better, I really admire how open you are about it as it's not an easy thing to talk about xx

  8. I also take Mirtazapine and find it works wonders for me! Although I have noticed a bit of weight gain :-( I used to suffer from really bad night terrors and I find it helps me sleep. And I haven't had any problems with night terrors since taking it. I'm not a fan of CBT either but my psychiatrist says I have to go :-( Thanks for writing this post Becky! Sometimes I can feel very alone so this post has really helped me xx

  9. That's great that you've found something that seems to be working for you. I haven't actually got to the stage yet of going to the Dr's, but it's promising to know so many people in the comments too have found something that works for them.

    Lizzy from Nomad Notebook

    1. If you're having problems, I seriously recommend making an appointment. I know it's really scary but it's amazing how much help you can get.

  10. I'm just over halfway through a course of CBT for anxiety and I think it's starting to work very very slowly - my therapist is great, and he recognised immediately that - in his words - I'm too intelligent, so whilst he's working on the CBT angle he's also digging deeper sometimes without me even realising until later. He's also recommended a book and a theory (?) called 'Mindfulness' which lends itself to mindfulness cognitive therapy which is sort of an offshoot of CBT, I suppose, but it involves meditation and training your brain to break some of its associations between thoughts and feelings/behaviours. It's been proven to 'rewire' the brain in depression cases and increase instances of spontaneous remission in cancer patients, according to my therapist, and at this point i'll give anything a try so i bought the book!

  11. I am sorry that CBT didn't help! There are many many types of therapy though, and it sounds like your counsellor was not one who believes that counselling theory is not one-size-fits-all. In my opinion as a brand new (aka inexperienced) counsellor, your counsellor should have recognized that you were not responding to CBT and talked about other types of theories to try with you or referred you to a different kind of counsellor.
    With that said, counselling isn't for everyone or for every issue/stage and I think it is so great that your doc found a medication that is helping!
    Again. I am sorry that counselling didn't help, but I also wanted to say how much I appreciated being able to read about your experiences and your perspectives as a client! :)

  12. I didn't feel that CBT worked for me, I've tried it twice in the past few years. My doctor's suggesting I go again though as I've had a relapse and had to give up work. I'm trying to decide whether to give it another go or just stick to medication.
    Kittie Kat

  13. I'm glad the med change is working well for you, I think medication gets a bit of a ln unnecessary rep nowadays! CBT didn't work for me either, in fact it made me worse!Again, i knew what I needed to do and strategies but when unwell I just couldn't! For me, mindfulness really was the turning point and even tho i dont consciously use it regularly, I end up using the learning naturally to help slow down (but not stop) and accept the thoughts.

  14. I had some sessions of CBT and, while they helped me to a point, they never 'cured' me. At the time I was housebound with anxiety, after CBT I was able to go out with someone I deemed a 'safe' person. But I have never progressed beyond that stage.
    I'm so glad that you've found a medication that helps you, it can be such a long road trying to find what works for you.

  15. To the future! *drinks from imaginary champagne glass*

    Mirtazapine worked really well for me too. The sedative effect is a definite bonus! I've had CBT and also much more in-depth psychological therapy and I think my CBT experience was probably similar to yours. I could understand the reasoning behind the exercises, but I just couldn't make them resonate with me emotionally. The long term psychological therapy, however, has changed my life. I feel like my therapist has actually got to the bottom of things and put time into truly understanding me. CBT felt a bit like just putting a plaster on the wound, rather than actually sorting it out.


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