Thursday, 23 November 2017

"I've had a lot of worries in my life, most of which never happened" Mark Twain

I thought I'd post a bit more about CBT, partly because I found it a very positive experience but mainly because, according to the statistics on this site, my last 2 posts have had the most hits in the shortest space of time of any of my other posts since I started this blog. (And that is without me sharing the links on Twitter).

I've also had lots more messages this week from people who I haven't spoken to / heard from in a while, most using the word 'resonated' in their messages. I'll be honest, I had to look the word up but I understand that my talking about the last few months has been useful to some people which makes me feel it was worthwhile to share it.

In my sessions with the Therapist we talked a lot about 'Worry + Rumination', which seemed to be at the root of my problems. (Remember, I was diagnosed with Generalised Anxiety Disorder not Depression so this post may not be as useful if you are suffering from Depression). When I think about it now, it does seem rather frightening to go from 'worrying', which we all do, to the point where the worrying becomes to intense you need medical intervention, but that just goes to show how things can escalate if you don't address what is going on in your life / don't acknowledge any physical symptoms you know are unusual for you. If you feel things are getting out of control DON'T WAIT.

In my experience, the act of worrying became overwhelming. The act of worrying about certain things, became so intense it manifested itself in physical symptoms. (Insomnia, chest pains, feeling like a cold wire was running through me, shaking). The act of of worrying about specific things gradually became an act of worrying about EVERYTHING. Looking back, things intensified when my son started school last September and I had to give up Freelancing.  It's impossible to get Ad Hoc childcare when you have no family help and after exploring the few options on the table I had to admit defeat and stop working. I felt like perhaps it was a natural break and time to just be 'Mummy'. But this then meant, I had more time to worry.  Worrying about having no purpose (I have worked since I was 13 and funded everything in my life on my own, University, homes etc), worrying about relying on my other half, worrying about money, worrying about if I had made the right decisions in life etc etc. I have since realised I was trying to distract myself from my worry's by an almost manic need to be 'busy'. I was helping with the reading at my sons school, making things to sell in the Local Art Gallery, selling honey, I also got a local job at one point. But when in March we had to sell the house, my worries exploded in my head. It is exhausting never being able to escape your own head. I had not slept properly for months, I was probably drinking too much and generally felt like shit. Sleep deprivation is not only a pain in the arse, it can also be massively detrimental to your health.

The information below is taken from 

* Our central nervous system is the information highway of your body. Sleep is necessary to keep it functioning properly, but chronic insomnia can disrupt how your body usually sends information.* During sleep, pathways form between nerve cells (neurons) in your brain that help you remember new information you’ve learned. Sleep deprivation leaves your brain exhausted, so it can’t perform its duties as well. You may also find it more difficult to concentrate or learn new things. Sleep deprivation also negatively affects your mental abilities and emotional state. You may feel more impatient or prone to mood swings. It can also compromise decision-making processes and creativity.If sleep deprivation continues long enough, you could start having hallucinations
seeing or hearing things that aren’t there. A lack of sleep can also trigger mania in people who have manic depressionOther psychological risks include:
*Impulsive behaviour
*Suicidal thoughts

You may also end up experiencing microsleep in the day. During these episodes, you’ll fall asleep for a few seconds or minutes without realizing it. Microsleep is out of your control and can be extremely dangerous if you’re driving. 

Immune system - Sleep deprivation prevents your immune system from building up its forces. If you don’t get enough sleep, your body may not be able to fend off invaders. It may also take you longer to recover from illness. Long-term sleep deprivation also increases your risk for chronic illnesses like diabetes and heart disease.

Digestive system - Along with eating too much and not exercising, sleep deprivation is another risk factor for becoming overweight and obesity. Sleep affects the levels of two hormones, leptin and ghrelin, which control feelings of hunger and fullness. Leptin tells your brain that you’ve had enough to eat. Without enough sleep, your brain reduces leptin and raises ghrelin, which is an appetite stimulant. The flux of these hormones could explain nighttime snacking or why someone may overeat later in night. A lack of sleep can also contribute to weight gain by making you feel too tired to exercise.
Sleep deprivation also prompts your body to release higher levels of insulin after you eat. Insulin controls your blood sugar level. Higher insulin levels promote fat storage and increase your risk for type 2 diabetes.Cardiovascular system - Sleep affects processes that keep your heart and blood vessels healthy, including your blood sugar, blood pressure, and inflammation levels. It also plays a vital role in your body’s ability to heal and repair the blood vessels and heart.People who don’t sleep enough are more likely to get cardiovascular disease. One analysis published in the European Journal of Preventive Oncology linked insomnia to an increased risk of heart attack and stroke.

Pretty scary how things can escalate isn't it? You can see how you one could quite easily get caught in a vicious cycle of ill health. Worry begins, then continues to increase gradually and is not dealt with, sleep then becomes affected, so you drink more Caffeine to deal with the sleep deprivation which in turn increases your anxiety, which in turn makes the worrying intensify, then you use alcohol to knock yourself out at the end of the day, then you simply stop functioning and you are ill, physically and mentally. The crutches you use to get you though the days only exacerbate the problem. Excessive use of Caffeine and Tobacco can make existing Anxiety worse. BUT, when I started CBT and looked at things from a different viewpoint, I saw very clearly how I had got into the state I was, and understanding it and accepting it was the first step towards getting better. CBT gave me hope things would improve and I understood that basically I needed to break the negative habits I had developed.  But you have to work at it. There's lots of repetition in CBT and homework and it will only work if you commit to it. It's by no means a quick fix but more like an alternative way of life. If I had recognised my worrying and ruminating was getting out of hand sooner I wouldn't have felt as bad as I ended up feeling. (There was a long waiting list to get to the one to one Therapy though. I think it took around 6 months before I had my first one to one session so don't want to leave it too long). 
You get lots of paperwork and exercises in CBT, some of it I just didn't get at all so didn't even bother with. I particularly struggled with the idea of  'Worry Time'. You are supposed to allocate a specific time of each day dedicated to worrying. When a worry pops into your head, you must write it down and then not think about it again until your allocated worry time. My Anxiety was so bad even the thought of this made me anxious. I said if I was going to allocate a certain time to worry I would worry that I would miss the time slot or just be worrying until worry time! The Therapist didn't push this particular exercise on me...
What I did find useful though was the idea of the 'Worry Tree' :

When a worry comes into your head, work your way down from the top of tree. The more you do this, the easier it becomes to let things go. You are not only challenging your automatic thought responses to situations (real or imagined) but you are gradually, over time, breaking the negative habits that are so detrimental to your well being. It's such a simple excerise but one I have found invaluable.

There are loads of free resources on line for all of this, but I also found this useful as a way of acknowledging my situation:

* Worry is future focused. It can lead to anxiety, stress, fear and imagining the worst will happen.
* Rumination is past focused. It can lead to depression, sadness, shame and regret, "If only...".

* These 2 things can develop into regurgitation. Constantly chewing things over, repeatedly thinking the same things, circular thinking patterns, bad thinking HABITS.

* By worrying or ruminating we are trying to reduce the distress but we make the problem bigger and often prolong it. It interferes with clear thinking, daily activity and our ability to cope. It also often leads to unhelpful behaviours to help us escape our thoughts (self harm, drinking, drugs, comfort eating etc). The more we worry or ruminate the stronger the habit becomes (so conversely the less we worry or ruminate the weaker the habit becomes).

* You CAN change this pattern. If you notice the mind is going down a worry / rumination route. Tell yourself:

1. I don't have to think about that right now, it can wait until I feel stronger.
2. There is nothing I can do about my thoughts - I can't stop them BUT I can choose not to focus on them.
3. What can I do right now that will hep me feel better? (refer to the 'Worry Tre'e, call a friend, go for a walk etc etc)
4. Right now what can I do that will take me one step in the right direction? Right now, not the future.

 Anyway, thanks for reading (if you got this far!), I hope this might be useful. Stay well and for anyone who see's themselves in this post, it will get better if you ask for help. xx

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