Things I've learned from CBT

Hello.

I've been doing CBT for about 3 months or so now and am just over halfway through my course.

I thought I'd talk about what I've learned so far and to a lesser extent, what you can be expected to do if you get offered CBT too.

First, an introduction. I have clinical depression and anxiety disorder. I believe they manifested as a result of the physical illnesses I have (Fibromyalgia & CFS.) I've been on medication for depression and anxiety for about 15 months now, and I am a lot more mentally healthy than I was. In the bad old days I used to lie in bed crying until late in the afternoon (or all day) because I couldn't face the day. I'd rarely get dressed if I wasn't leaving the house and doing things like eating and washing seemed like climbing Mt. Everest. I lost all interest in things I used to love doing, like reading, walks, and leaving the house.

Things are not that dark now, thankfully, but I still have depressive episodes - usually when my fatigue reaches hideous levels. I can handle pain better mentally than fatigue, probably because I've had a long history with pain. (I suffered a debilitating back injury before I reached senior school age.)

CBT is really important because it helps you to identify when you're getting stuck into a downward spiral of negative feelings. Every week I have to fill out thought records, noting down anything that's occurred in the week previously to make me feel sad or anxious. Then the CBT therapist gently asks questions about what's been written.

I'll give you an example. I have a lot of anxiety about letting people down. When I was well I was a woman of my word and if I said I'd do something or be somewhere I'd do it or get there, no matter what consequence to myself. These days I have to take every day at a time (as I don't know until I wake up if it's a good pain/fatigue day) so it's likely some of the time I have to cancel or reschedule plans. So I'd written that I was anxious about cancelling CBT the previous week because I had a lymph node up on my head, a hip injury and the ever-present fatigue.

The therapist would ask things like: Why do you feel this way? If you cancel or reschedule does that mean you're letting people down? Will the other party be upset with you or will they be OK with it? Or is it inevitable that everyone has to cancel or reschedule things at some point?

It's all done very cleverly so you kind of come round to realisations about yourself and the way you think without too much leading by the therapist.

So, things I've learned:

1. No one is as hard on me as I am myself or thinks as badly of me as I do myself.
2. I had to be hard on myself in the past because I've had quite a rough life, and I haven't yet adjusted mentally to being in a better situation. 
3. Things always go better than I think they will.
4. People are usually nicer than I expect them to be. 
5. Nothing is as scary in real life as it is in my head.
6. I've learned distraction helps quell the noise in my head and have finally started to read again.
7. I can't stop all the sadness or anxiety but being able to catch myself and change the subject mentally some of the time is progress.
8. When I start to feel anxious about events to come ask myself lots of 'What then?' and 'What's the worst that could happen?' questions. Sometimes the key to shutting down anxiety is as simple as having a plan B. 
9. If something sounds big and scary in my head, writing it down can make it seem less so.
10. To use getselfhelp.co.uk where they have lots of free resources such as thought sheets.

It's quite ironic that I post this just a few days after a massive down day but you have to take the rough with the smooth and hope for better days ahead, because they will come.

If you are having problems with depression and anxiety, please see your GP. I put off seeing mine for about three years because I was so scared I wouldn't be taken seriously and those are three years I'll never get back.

I will say that it's quite an undertaking to examine your thoughts in such detail, and it can be tiring, but it's so worthwhile. I recently went from going once a week to fortnightly as it was physically and mentally exhausting me. I think a physically well person would be OK with it, but it exacerbated my CFS.

Thanks for reading, and hugs to all who need them.