I’ve suffered from panic attacks for as long as I can remember. Only I didn’t realise until recently that that’s what they were. To put it into context the last time in my life that I remember feeling calm and confident was before puberty. Earlier this year I went through a particularly rough patch, my weight plummeted 10 pounds, I was nauseous all the time, I couldn’t sleep, I felt my world was collapsing in on me. Everything I knew or thought I knew about myself and my life was turned on its head. I knew that it was finally time to get professional help. Frankly, I shouldn’t have waited so long.
Navigating the National Health Service is a story unto itself but finally I found a great private psychiatrist and for the first time in my life I felt that someone was truly qualified to understand and help me. I was diagnosed with a “moderate” case of anxiety and depression. For “severe” cases patients are prescribed both drugs as well as therapy. For “mild” cases patients are only prescribed therapy and not given the option of drugs. For “moderate” cases you get to choose whether you want to take drugs or not as well as therapy. I opted for no drugs as I wanted to have a go with just the therapy to see if I could conquer my symptoms au naturelle. Plus if that didn’t work I could always opt for drugs later. This is an extremely difficult and personal choice which each individual in the same situation has to make for themselves. I don’t judge other people for choosing the drug option. You have to do what’s right for you!
In terms of therapy I was prescribed Cognitive Behavioural Therapy (CBT). I was told by my doctor that CBT by itself has the greatest success rate of any other intervention (whether drug or therapy) for treating anxiety and depression. Its premise is that your thoughts control your moods. If you can learn to change your thoughts, then you can change the way you feel. Cognitive therapists believe that negative thinking patterns are what actually cause you to feel depressed and anxious. This is not a treatment for the fainthearted as there is a lot of individual responsibility placed on the patient for their own health. You start by reading a book on CBT which has exercises that the patient must complete (I was recommended The Feeling Good Handbook by Dr David D Burns). There is a lighter version of this book available if you want to get a taste what CBT is all about called Feeling Good. During sessions with your CBT therapist you share your homework and discuss how you are applying the various techniques.
All of the exercises in The Feeling Good Handbook are about identifying the “distorted thoughts” and applying different techniques to combat those negative thoughts. When I first read through the list of 10 distorted thoughts I could instantly recognise that I regularly use all of them. Do any of these sound familiar to you?
1. All-or-nothing-thinking – You see things in black or white categories. If a situation falls short of perfect, you see it as a total failure.
2. Overgeneralization – You see a single negative event as a never-ending pattern of defeat by using words such as “always” or “never” when you think about it.
3. Mental filter – You pick out a single negative detail and dwell on it exclusively, so that your vision of all of reality becomes darkened like the drop of ink that discolours a glass of water.
4. Discounting the positive – You reject positive experiences by insisting that they “don’t count.” If you do a good job you may tell yourself that it wasn’t good enough or that anyone could have done it as well.
5. Jumping to conclusions – You interpret things negatively when there are no facts or support to your conclusion. This is broken into two further subcategories – mind reading: when you arbitrarily conclude that someone is reacting negatively to you without checking it out, and fortune-telling: when you predict that things will turn out badly.
6. Magnification – You exaggerate the importance of problems and shortcomings, or you minimise the importance of your desirable qualities, also known as “binocular trick.”
7. Emotional reasoning – You assume that your negative emotions reflect the way things truly are.
8. Should statements – You tell yourself the way that things should be the way that you hoped or expected them to be.
9. Labelling – An extreme form of “all-or-nothing” thinking. You label yourself or others with negative labels.
10. Personalisation and blame – You hold yourself personally responsible for an event that isn’t entirely under your control or you blame others/circumstances for your problems.
This list might seem a little overwhelming. Who knew that there were so many ways to twist your thinking?! My biggest challenging is to put a kibosh on jumping to conclusions. I’m a terrible mind-reader and fortune-teller. In fact I’m doing it right now mind-reading what you might be thinking as you read this blog post!
The good news is that there are many techniques that you can learn to combat the twisted thinking plus there are lots of worksheets every step of the way as you read The Feel Good Handbook. Regardless of whether or not your feelings would classify on a clinical scale of anxiety or depression I think we can always improve ourselves and we should always strive to feel better and be better. Isn’t that what life is all about? Otherwise I think the world would be a very boring place indeed.