Today I want to talk about my experiences with Cognitive Behavioural Therapy (CBT), which I was prescribed in order to help with my anxiety and depression. In case you're unaware, I had a nervous breakdown in April 2012, this was a result of ignoring my symptoms of depression and anxiety until I basically snapped. I currently take medication for these illnesses (a mixture of antidepressants and anti-psychotics). My very supportive GP suggested that CBT might be useful for me, particularly with the anxiety. It took me nearly a year to feel mentally strong enough to be able to cope with the demands of CBT. In case you don't know, CBT is a talking therapy that aims to challenge maladaptive thoughts and behaviours which contribute to mental illness.
My CBT took the form of weekly two hour group therapy sessions, over a course of six weeks. The course was lead by 3 psychologists and there were about twelve participants in the group. It was structured really well, each week focussed on a completely new area such as an overview of mental illnesses,maladaptive thinking, unhelpful behaviours, coping mechanisms, healthy lifestyle and preventing relapse. The structure of the course was good, as it focussed on a completely new area each week it meant that you didn't become overwhelmed by having information overload. Initially, the group format really scared me, I'm a bit socially anxious, so I was incredibly nervous about going there about my mental health. It took a lot of courage, in the end I was grateful for the group format because everyone was so supportive and it made me realise that absolutely anyone can be affected by mental illness. There was a real mix of people: a retired lady, a fellow young disabled lady, an ex-soldier, it really was quite diverse. We were set homework each week which forced us to reflect on the course and to look at mental illness in a problem-focused rather than an emotion-focused way.
CBT was eye-opening for me. I've had anxiety ever since I can remember and so I thought I knew all there was to know about it. However, CBT really made me understand why my anxiety was so debilitating and hard to deal with. I got an insight into why thoughts and behaviours are the lifeblood of anxiety. We were shown 'thinking traps' (http://youth.anxietybc.com/thinking-traps) and I realised this was the only way I thought! I also realised that avoidance behaviours (which I engage in A LOT) were a sure fire way to exacerbate anxiety.
A problem I picked up on with CBT, is that it almost seems to good to be true. It breaks down anxious and depressive thoughts and behaviours into such a simple and obvious way that you read it and think that's all anxiety/depression is so it should easily be a cure for these horrendous illnesses. In reality, anxiety/depression is so much more than just a set of thoughts and behaviours and that's why I don't see CBT as some miracle thing.
Having said that, CBT has definitely helped me in numerous ways. Initially, I thought it was a waste of time as I still felt low and like a worry doll. However, I've noticed real differences in the way I'm thinking and behaving, albeit these are quite subtle, but hey, I'll take any improvement!
Some examples of improvements include setting myself realistic goals. People with anxiety/depression often set themselves huge unattainable goals, because they expect incredibly high standards of themselves. One thing I used to do was tell myself I needed to find a full time job right now and if I didn't I was a failure otherwise. Now, I've realised that full time work is never going to be an option for me, my cerebral palsy just makes that impossible. CBT has really helped me manage my expectations, I've come to terms with the fact that F/T is not possible and there's no shame in that. It's helped me realise that maybe volunteer work is a good option to start with, so that I can see what I'm capable of, and to build up my self esteem which is at rock bottom.
CBT has also helped my positivity, and to lose a bit of the negative focus. Here's an example: in the past two years I've had four surgeries and six lots of botox to help with my cerebral palsy. My last surgery on 29th May has been a brilliant success. I had my tendons released in my hand and muscle removed from my thumb - the result is a beautifully open hand and I'm so so happy. Meanwhile, my leg is just getting worse and worse, and the consultant has told me further muscle lengthening surgery would be a big, big risk. Now, pre CBT I would just have focussed on the negative and get really angry at myself. I used to blame myself for the fact my disability was getting worse, instead I've realised that I have no control over my CP, so there's no point worrying about it. I'm complying to my treatment recommendations so I'm doing all I can, and that's a positive thing.
I think CBT has helped me accept having anxiety and depression and the fact that recovery is a continual process and that there isn't an end point. I've always had anxiety, I'm convinced it's a part of my personality and therefore I'll always have it. Initially, this may strike you as defeatist and pessimistic, however for me, it's a positive thing. I've wasted endless hours wishing I could be 'normal' wishing that I would just snap out of anxiety and depression. I've resented the fact that I have them. That isn't healthy and probably feeds them. However, I've realised, that by not fighting them, by not trying to 'get better' it means they've lessened their grip on me. I have more control. I ignored the symptoms of depression for a good two years and as a result it made me incredibly ill. I've realised by accepting the fact depression & anxiety are always in the background it's probably a good thing. It means I can be aware of possible triggers and just to take good care of myself basically. I suppose this is all part of the steep learning curve that is mental illness.
So for me, I'd say that CBT has certainly helped, it hasn't got rid of my mental illnesses but it's definitely given me a different perspective. I've gained a good insight into anxiety and depression, such that I'm able to recognise unhealthy thoughts and behaviours and it's equipped me with strategies to deal with them. I only completed my course six weeks ago, so it's still early days, I won't know if it's had a long term impact yet. I think the real test will be how my mental health will be in the winter, as I'm certain I get a touch of SAD.
Thanks for reading and feel free to tweet me (@thisisamy_) if you have any questions!