Don't know where to turn or what to do

One thing i struggle to do is isolate exactly what anxiety is.... here is a list of some of the negative emotions I feel and frequency I feel them - perhaps someone could point to which ones are official anxiety?

Generally sad and un-motivated - Every day.
Not wanted to answer the telephone or front door - 95% of the time.
Hating crowded social situations - weddings, parties etc - 99% (unless I know and am comfortable with most of the people there).
Sudden raised heart rate and tingling in my palms, as if looking over the edge of a building from a great height - few times a week.
Not being able to sleep, heart rate at 120 bbm all night, no sleep, nauseous with fear, loose teeth, bleeding gums, trembling - once last year, for 3 weeks.
Torment, frustration and a sense of being held back / thwarted - most days.
Despair and helplessness with thoughts of suicide - sometimes every day for a week, other times a couple of weeks without.
Lonely (in my soul) - most days.
Inability to relax and just enjoy something for what it is, without micro-analysing it or knowing that it'll soon be over and my problems / sadness / frustrations are still waiting for me as soon as said event are over - all adult life.
Inability to relax and let go - all adult life.
Seeking validation and approval for all that I do - all adult life.
Scanning every situation for threats/triggers and steering to avoid - all adult life.
Dark thoughts about seeking revenge on those that have crossed me in life, school bullies etc - all adult life.

Anxiety?

Oh, missed one.... feeling near the end of my rope and close to losing my temper and feeling irritable - most adult life - I guess part of scanning for threats and constantly feeling on the defensive or under attack from everyone.

Going by my husband's symptoms most of those can be attributed to anxiety and the low mood etc to depression - however they both fuel each other which makes it difficult to deal with.

Hi, How are you doing? hi)

Quote:

---

Originally Posted by Arty

Hi, How are you doing? hi)

---

Not bad today, thanks for asking.

I'm in a fairly upbeat mood as I've avoided all possible triggers. Yesterday was a really bad though so its very hit and miss, day by day. I pulled it round yesterday by forcing myself to the supermarket to help my wife with the weekly shop in the afternoon after sulking in bed 'till gone 11am. Whilst there I bought fresh ingredients to make a curry, so when I got home I could focus on something positive, with some help from a few bottles of beer.

I think my position is one of huge vulnerability and fragility, where it takes very little indeed to tip me over the edge and for me to then spiral into despair.

I can't help but ponder what the outcome of the psych evaluation will be - one assumes a different medication other than typical front line SSRIs?

I feel like I'm tip toeing round life and walking on my own personal egg shells.

I’d definitely say go in with an open mind - psychiatrists can give options for treatment that a GP can’t and I’ve certainly been surprised by suggestions from my pdoc in the past

Well done for making the curry. Keep on being kind to yourself, take each day hour by hour. Happy New Year!

Completely agree. Try not to pre judge what you're expecting - go with an open mind.
We're having curry tonight too! Happy Curry night! Happy new year!

This morning I had my appointment which turned out to be an initial clinical assessment, before being referred to a psychiatrist. I was with the chap for about 45 mins where we covered pretty much every angle of my mental state, both current and historic.

I tried not to self diagnose or put words in his mouth, nor was he willing to hint at any diagnosis, other than he said that much of what I had spoken about was covered under the broad spectrum of depression.

I guess my next session with the psychiatrist will be more conclusive - anyone able to comment on what the psych session will cover that wasn't covered today?

We spoke about drugs I'd tried at which point I respectfully said that my own research has pointed towards Wellbutrin (Bupropion) being a potentially suitable drug, to which he admitted that it was a common one they try off-label under secondary care - there is hope!

I've been back in work this week, so too busy to feel down during the day, therefore it's taken longer to kick in of an evening as my body and brain slows down away from work.

I explained today when quizzed about how I feel less depressed in work that it's a bit like an airline pilot coming into land a plane in a thunder storm, with high winds and poor visibility - the pilot is too busy and focused to feel anything other than to 100% concentrate and perform on the task in hand - only once the plane is at the gate and the engines are shut down can he or she then reflect on how they are feeling.

Hope that makes sense?

Completely makes sense. As to what the next appointment will be like, that varies from doctor to doctor in my experience. Just try to remember that they’re qualified and experienced in their field so their diagnosis and opinion on treatment is vital but you also should be able to have a say in what happens going forward

When I used to see Dr J he would let me ramble on for most of the session and write stuff down as we talked. He would somehow tie everything up towards the end of the session including medication or future visits. He was rather special and excellent in his field. I don't think I will have someone who is quite so brilliant again.
I hope that whatever your psychiatrist says to you works for you

Sounds like a good session and you sound fairly comfortable about it...

Is there any chance that a psyh will prescribe continuous all expenses paid holidays to Orlando?

I'm sitting here now on the sofa and can just start to feel a little anxiety/sadness creeping in and the pressure of "It's the weekend, this is where you're supposed to enjoy time away from work as part of your work life balance - this is supposed to be the good bit..." yet knowing thi sis unlikely to materialise, nor do I have the energy/will to make something happen.

Another description I conjured up today that might resonate with others is that when I'm in what is a traditional 'happy place', what ever that may be - Christmas morning watching the kids open their presents, a summer afternoon BBQ with family, relaxing by the pool on holiday etc.... in that whilst you might be smiling, whilst you might be going through the motions of being happy, that beneath the mask, you know that deep down inside, something's just not right. That you can't fully relax, you can't let go, you can't give in and be happy, as if doing so is to somehow release control, somehow saying everything's ok, when it's bloody well not... that no matter how 'nice' this event is, you can't just enjoy it for what it is as you know that soon enough, it'll be over and everything will still be awful again afterwards?

Or is that just me being a miserable sod?

He asked me how long ago it was when I was happy/content for any length of time and my answer shocked me. I was 7 years old.

Sorry for venting.

Hi there,
Well done for attending the appointment and it sounds like it went well.
Reading your last comment, it sounds like you are putting a lot of pressure on yourself. Also, please don’t apologise for letting your thoughts and feelings out on here as you are amongst friends. You are doing brilliantly maintaining your job and it is great that you are very much involved in family life. It is vey good that you reaching out for help. Your description of putting on a front will resonate with many of the people on here. Living with a mental health condition is incredibly exhausting so it is really important for you to be kind to yourself. Keep on chatting to us as we want to listen (nod)

Quote:

---

Originally Posted by Ovalbug

Is there any chance that a psyh will prescribe continuous all expenses paid holidays to Orlando?

---

Not sure there's enough room in the NHS budget for that, but wouldn't it be awesome?

Quote:

---

I'm sitting here now on the sofa and can just start to feel a little anxiety/sadness creeping in and the pressure of "It's the weekend, this is where you're supposed to enjoy time away from work as part of your work life balance - this is supposed to be the good bit..." yet knowing thi sis unlikely to materialise, nor do I have the energy/will to make something happen.

Another description I conjured up today that might resonate with others is that when I'm in what is a traditional 'happy place', what ever that may be - Christmas morning watching the kids open their presents, a summer afternoon BBQ with family, relaxing by the pool on holiday etc.... in that whilst you might be smiling, whilst you might be going through the motions of being happy, that beneath the mask, you know that deep down inside, something's just not right. That you can't fully relax, you can't let go, you can't give in and be happy, as if doing so is to somehow release control, somehow saying everything's ok, when it's bloody well not... that no matter how 'nice' this event is, you can't just enjoy it for what it is as you know that soon enough, it'll be over and everything will still be awful again afterwards?

Or is that just me being a miserable sod?

He asked me how long ago it was when I was happy/content for any length of time and my answer shocked me. I was 7 years old.

Sorry for venting.

---

Never be sorry for venting. It's better to get it out of your head here than leaving it to fester...

So what things are you doing this weekend?Who are you spending time with?

Quote:

---

Originally Posted by Suzi

So what things are you doing this weekend?Who are you spending time with?

---

That's part of my problem I think, or a symptom of it.

I'm not doing anything and will sit on the sofa until I go to bed on Sunday night for work next morning. That is my life. I'll be in the house whilst my wife and kids potter about, but essentially nothing will happen.

I don't have any friends and as my work role is field based, the couple of colleagues I get on well with live hundreds of miles away, not that I'd really want to socialise with them.

My role in life appears to be to get up early, work flat out all day as the main bread winner, get home any time between 6 - 8 pm depending on where I've been in the country that day, flop on the sofa fatigued, then repeat.

We don't go out anywhere and don't do anything.

There is no fun, no reward, no interest. I am bored to the point of tearing my hair out like a bear locked in a cage rocking back and forth.

The concept of doing this until I retire and then die makes me want to vomit with fear.

The natural reaction would be "Well go out and do stuff with my family....." not so easy.

I have two pre-teen children, one with special needs, the other who is not interested in going out and about, plus on the very odd occasion we do manage to get them out, they fight, argue, moan and complain and make it an utter misery for us all - there is literally no point in going out, other than to end up stressed to bursting and the kids arguing. Plus, they never want to do anything, go anywhere, or on miracle that we can get them both to want to go somewhere on the same day, they never want to do the same thing. As I say, the one with special needs amplifies this situation enormously. We are not the typical, happy-go-lucky family.

As for family, we only really have my mum and Dad who are now elderly and have very limited capacity to help/cope with the kids, especially due to the special needs element so we can't just drop them off with the grand parents for the day whilst we swan off to have a nice time - it just isn't that kind of dynamic. There is no other avenue for support, and the special needs is not severe enough to warrant official assistance.

What are my hobbies?

I love watching boxing on TV - big deal. I get an hour of TV to look forward to every few months if there's a big fight on. Hardly a social life or 'recreational distraction'.
I love classic cars and in days gone by have often had an old classic in the garage to tinker with, but financially that is not something we can support anymore so my avenue is watching car shows on Discovery to at least watch other people having fun with cars, or I'll watch bits and pieces on youtube - but I've pretty much 'finished the internet' now and have exhausted any potential avenue for enjoyment. It's like being a tap dancer with no shoes - you can only watch so many other people tap dancing. Plus, I don;t have the mental capacity to even think about tinkering with a car - as soon as I dropped a spanner on the floor, I'd collapse in a heap of despair, thwart and frustration, such is my inability to cope.

Plus, my social anxiety makes the concept of 'take up a new hobby and go out and meet people' an impossible proposition.

I have only just got out of bed having stayed there as long as possible. If I'm in bed, I'm at least cosy and comfortable and not reminded of how bored and miserable I'm feeling.

Even this 'victim' T shirt is starting to annoy me.....

#braindump

Thing is, things will only stay the same unless you make a definite change.
I have 3 children each with special needs of one description or another and physical disabilities myself and my husband with depression, social anxiety, panic attacks etc... We've found that actually we need to suggest places to go or things to do and rotate it so that everyone gets to have something they prefer etc... Things like cinema at the weekend - they do cheap childrens shows which are more relaxed. What about going for a walk in the woods? You can download things like nature spotting bingo type sheets or maybe go on a dinosaur hunt or something?

Quote:

---

Originally Posted by Suzi

Thing is, things will only stay the same unless you make a definite change.
I have 3 children each with special needs of one description or another and physical disabilities myself and my husband with depression, social anxiety, panic attacks etc... We've found that actually we need to suggest places to go or things to do and rotate it so that everyone gets to have something they prefer etc... Things like cinema at the weekend - they do cheap childrens shows which are more relaxed. What about going for a walk in the woods? You can download things like nature spotting bingo type sheets or maybe go on a dinosaur hunt or something?

---

I know - we just need to get the kids to stop arguing, bickering etc.

My parents treated us to a week in Majorca last year which we really needed, yet the kids made it a real challenge to the point we both agreed that we'd not bother again, even if we could afford it. It's not that they're ungrateful, they both appreciate things in their own way, it's just that they can't occupy the same space without the whole sharing, taking it in turns, he said, she said nonsense that starts up. They're both so utterly strong willed and hell bent determined, they simply will not back down to each other no matter what we do. We've been out before and threatened to cancel the trip, turn the car round and go home if they don't stop bickering, and they'll continue so we have to follow through with the threat. Next time we remind them of the threat and what happened last time, and they still carry on, so we turn round and go home again with at least one of them in tears. It's no fun for anyone. We have never been out as a family and come back all in agreement that we had a nice trip out.

But, that all assumes I'm up to it, which to be honest I'm not at the moment. Not only lacking any motivation to move, but then even if I can drag myself off the sofa or out of bed, I'm already at the end of my tether before we start, so as soon as the kids begin to even think about creating, I can't cope and spiral. I had to walk out of Lego Land on the verge of a nervous breakdown.

I'm a terrible parent. Or at least not in a fit state to be a good parent. It makes me so sad.

My kids argue and bicker all the time, it's just something I think most siblings do.
Maybe you need to tell them that it's not about them, you're going out and whether they like it or not! Maybe build in little treats along the way?

Lego Land is a nightmare place!
Are you based near me? Have you tried things like Alice Holt?

I’m with Suzi, my kids would go at each other non stop - and I remember me and my brother doing the same. That’s normal. To help, we had a two screen DVD player in the car and/or got them to put their earphones in and listen to their own music for the journey

Marc's car stereo takes a usb so we made up an album as such of various bits of music. We made sure that there was at least a few songs that each person would like and no track was to be skipped. It has been brilliant actually - everyone's favourites, but also some that each person really isn't keen on..

Counting motorbikes?
When I went shopping game?
There are hundreds of things you can do to break up the fighting and the monotony of the car journey.... Maybe trying to smaller trips out, rather than big things like lego land and just be together?

Thanks all, I appreciate the support.

Without rambling, there are a few main issues that make is difficult.

My son has autism, so just going somewhere like a normal family isn't an option - it takes military precision organisation, planning a full cooperation from everyone to still be left with a 50% chance of meltdown. Plus he REALLY doesn't want to go places, no matter how tempting and it's a battle to get him to want to leave the house. To hot, too cold, too much walking, who will be there, who won't be there, what food and drink will be there, what if this, what of that.....

My daughter in pre-teen and not interested in going out with her family. She has her own anxiety issues and is currently working with CAMHS due to self harming and has meltdowns of her own and also doesn't want to do anything. She's 'happy' in her room on her ipod or whatever and is nigh on impossible to coax out and about.

They simply don't want to go out and do stuff - we try suggesting walks in the woods, this and that just to get moans, complaints and every excuse under the sun not to go.

But, aside from all that - which would be challenging enough when NT, I'm not NT, and am in the pits of depression, which means I simply cannot cope or deal with any of that ^^. I just can't. If I could, I'd consider myself just down in the dumps, but ultimately able to rise above it and function. I can't rise above it and function. It's just too much to deal with. Hence dark thoughts of suicide when I'm at my lowest.

On top of all that, outside of my depression, I've got issues of my own to try and deal with, which I can't cope with due to my depression, before I even think about solving other problems.

I'm not trying to put obstacles in the way and find reasons why I can't just put a false smile on and jump in the car, but explain why it's a mountain just too big to climb at the moment.

My wife is also suffering from depression and is undergoing very traumatic counselling for issues gone by so her coping capacity is minimal at best.

Naturally all this puts a huge strain on our marriage, to add to the list.

Fair enough. Then what about doing things at home as a family? Playing a game or something?

Quick update - got my letter through to see the psychiatrist for March 27th. Disappointed it's going to take that long as I'm still struggling, but it is what it is.
Letter says to bring along my medication.... I don't have any which is why I need to see him.

Why aren’t you on any meds?

No meds at all?

Nope = no meds at all - which is the crux of the problem.

My med history to date goes like this...

Citalopram - left me like a zombie. No emotion whatsoever. No personality. Dead, but biologically alive - tried for a few months, but terrible.
Fluoxetine - kind of helped with depression about 50% but not the anxiety and gave me terrible, intolerable sexual side effects - used for a few years but was affecting my marriage and the side effects causing all sorts of other issues leaving me miserable and depressed.
Mirtazapine - Great for anxiety, but no use for depression, also made me very angry, irritable and horrible to live with, whist still being depressed.
Venlafaxine - Terrible allergic reaction to this so couldn't continue beyond one pill. Was almost for calling an ambulance. Like a junkie going cold turkey.
Sertraline - Sexual side effects kicked in before anything else and even worse than fluoxetine so knocked it on the head shortly after.

I've been off the meds and trying to cope for 6 months now, spiralling out of control, hence I had to relent and go and see the Doctor - hence I'm now in the system waiting for further treatment without meds.

My GP admitted that I clearly am one of those people that does suffer the sexual side effects of SSRI/SNRIs, therefore there's no point trying another half a dozen varieties of the same type - they just don't work with me.

One might argue, well surely not being depressed is better than having to live with sexual side effects? Maybe for some, not for me.

Without getting into too much detail as we've all got imaginations - the side effects aren't something that Viagra could help with, that isn't the 'problem'. The issue is that all sensation, feeling, enjoyment is missing. That then results is no end game or enjoyment overall. This is tormenting, frustrating and such an issue to me and my marraige that it makes me depressed, angry and utterly miserable - catch 22. Why such a big deal for me - we're back to the tap dancer who has their feet amputated to cure their sore hips scenario.

Effectively I've not found a drug(s) that treats my depression and anxiety without intolerable sexual side effects..... which isn;t actually true - I've found a drug that 'might' do all that as it has for many other around the world - Wellbutrin (Bupropion), but as we know, not available in the UK via GPs and must be prescribed via secondary care, which is where I am now... with my fingers and toes crossed.

I'm aware that even if my psych agrees this is something to try, that it might not work for me and have an open mind about other possibilities.

But no, no meds at the moment, hence I'm in such a state.

Can you call and see if there is a cancellation?

Quote:

---

Originally Posted by Suzi

Can you call and see if there is a cancellation?

---

I could, but unfortunately the nature of my work means I can't drop everything to attend a last minute appointment.
I work all over the country and plan my diary a good few months in advance.
The type of work I do means I can't cancel or rearrange appointments - with multi-million pound contracts involving numerous stakeholders, cancelling or calling in sick just isn't an option - I'm lucky in that the appointment date I've been given falls between existing engagements so I think I'll quit whilst I'm ahead.
I've been med free for over 6 months now, albeit it really struggling; I'll struggle on a few more weeks I guess.

Fair enough.

Just thought I'd update this as I had my much anticipated psych evaluation today.

We went through all the predictable stuff, discussed meds, history, how I’m feeling now etc and to be honest, I’m not sure how I feel about the suggestions/findings.

I hope they are not just based on my 45 mins of blabbering and more on previous notes/GP feedback etc.

In a nut shell they feel it’s a personality disorder rather than typical depression and that my best course of action is CBT.

That is not to suggest that medication will not help, but that it should not be the primary source of treatment.

It was also said that the challenge is that my way of thinking is possibly too heavily embedded to be significantly changed to achieve the desired result, but that pills might help the worst of it.

My enquiry into meds available in the USA and other countries led nowhere – i.e “not on the list = not happening”. Bupropion / Wellbutrin is not on the list.

I've been provided a list of their recommended/suggested ADs in their order of preference as Sertraline, Clomipramine, Trazoddone and Amitriptyline. But cited that all will likely carry undesirable side effects and sexual dysfunction. My research suggests that these are all available under primary care, so not the ‘special draw’ access I was hoping for at referral.

If I’m honest, I feel disappointed and somewhat let down/dismissed as a lost cause – i.e “Sorry, you’re just a stress head, but here’s some techniques to help you chill out and a selection of pills that might help”

I don’t know where to go from here, but there was no suggestion of follow up or after care and I feel the ball is very much in my court.

Thing is, despite trying to have an open mind, I can’t see CBT helping me overcome my zero coping mechanism issues and wanting to run away and cry at the slightest hurdle, nor my utter lethargy and lack of enjoyment of everyday life. It ‘feels’ clinical/chemical, not the result of a mind set that mood diaries and relaxation techniques could address, however that statement is based on my own ignorant perception.

Dunno – feel a bit abandoned and unsure of what to do next.

Perhaps it was unwise of me to put so much faith in secondary care.

I'm glad you've had your assessment. I'm surprised for CBT rather than ACT or DBT... They might also be avenues to explore...

I’m on amitryptaline and have take clomipromine in the past (which I was put on when in a psych hospital). Ami works differently from other ADs and is not usually the first one that’s tried and clomipramine is a 1950s drug that is very rarely used. What I’m trying to say is that I dont think you have been abandoned at all, and they’re thinking out of the box as far as meds go - so maybe that’s the case with other treatments itms?

Quote:

---

Originally Posted by Suzi

I'm glad you've had your assessment. I'm surprised for CBT rather than ACT or DBT... They might also be avenues to explore...

---

Problem is, I'm not convinced as my periods of very low mood, despair and contemplation of suicide suggests something more heavy duty than therapy is required.

I'm also disappointed in the rather generic offering of ADs and am not sure what to do.

I was expecting to be taken under someone's wing and guided through a journey of specialist care, rather than just casually dismissed with a suggestion that I might want to try this or that.

I feel let down and on my own to sort myself out.

Quote:

---

Originally Posted by Paula

I’m on amitryptaline and have take clomipromine in the past (which I was put on when in a psych hospital). Ami works differently from other ADs and is not usually the first one that’s tried and clomipramine is a 1950s drug that is very rarely used. What I’m trying to say is that I dont think you have been abandoned at all, and they’re thinking out of the box as far as meds go - so maybe that’s the case with other treatments itms?

---

Thanks - the list of side effects in the common or very common list makes grim reading, with sexual dysfunction near the top of the list in most cases.

I'm shocked that the ball has been left in my court. I'm almost coping at the moment, but being told to go and consider my options and click on a website for CBT self referral and chose from a menu of drugs is more than I can cope with. I feel lost and scared. Maybe I put too much of a brave face on it today and they thought I'm okay - despite me stating I'm not and need help.

It's like I've just been dismissed back to my GP and it's up to me to sort myself out. I'm more often than not incapable of sorting myself out, let along conjuring up the courage and fight to go and see a Doctor.

"So what pills have you decided to try next....?"

I'm sure it's not that simple at all! They wouldn't have referred back to your GP if they didn't think that was the most appropriate course of action for you..

Quote:

---

Originally Posted by Suzi

I'm sure it's not that simple at all! They wouldn't have referred back to your GP if they didn't think that was the most appropriate course of action for you..

---

But my GP will ask me which AD from the four suggested do I want to try next - answer, none of them really as they all carry well published sexual dysfunction.

Some say sexual dysfunction is better than depression and worth putting up with - maybe for some, not for me. It caused/worsened my depression and feelings of low self esteem/worthlessness. I'm not going there again and my marriage is under enough strain as it is.

I'll put myself on the waiting list for CBT and see what happens, although I can't help feeling it's not the correct route - I just don't get how mind training will lift the invisible heavy blanket that encases me.

Just because something is on the list of potential side effects does not mean you’re going to suffer from them. People react differently to each one. As for the ball in your court, most people like to have a say in what happens next .....

Quote:

---

Originally Posted by Ovalbug

But my GP will ask me which AD from the four suggested do I want to try next - answer, none of them really as they all carry well published sexual dysfunction.

Some say sexual dysfunction is better than depression and worth putting up with - maybe for some, not for me. It caused/worsened my depression and feelings of low self esteem/worthlessness. I'm not going there again and my marriage is under enough strain as it is.

I'll put myself on the waiting list for CBT and see what happens, although I can't help feeling it's not the correct route - I just don't get how mind training will lift the invisible heavy blanket that encases me.

---

Sexual dysfunction seems quite a common side effect with AD and for some one my age who lives alone the fact I'm pretty much none functioning in that department doesn't seem to matter. But you being much younger and in a relationship I can see how it would adversely affect you. I'm no doctor but have you asked your GP if there are any AD's which don't affect you so much in that department?

My husband didn't think that his last lot of therapy was going to help. He went along purely and simply to "cross it off the list and say I've tried it" and actually it's been a massive help. Don't write it off before you've even got there - but things like therapy only help if you're prepared to work hard at it.