Would Going Back On Medication Be A Step Backwards?

[TonyG]

It's not a step back its a way forward, I have been taken off one medication with the intention of starting a new drug with less side affects, Now I am medication free and feel great, but if my anxiety gets unbearable again I will be back on meds straight away, How could it be seen as a step back, as far as I am concerned if someone else feels that way about my progress they need to walk in my shoes and see what I have seen and do what I have done before they pass judgement on me.

 

[Anarchy]

Hi Mit,
I was thinking about these when I was away from my internet connection:

and twist something that might be helpful into a sign of weakness on my part.

I have been terrible at actually using the techniques, I really struggle with the discipline and having the space and time. It's my failing that I haven't made the best use of what I learned on the course.

Those look like the situational, automatic negative thoughts, that come with low mood.

Situational, in the same sense that if you go to a place you haven't visited for a while or hear a song from the past, it can trigger a whole lot of associated memories which you wouldn't ordinarily have.

The same thing happens with mood. If we are in high mood, we get access to memories and thoughts associated with it - and they tend to be harmless.

Low mood, gives us less access to the memories and thoughts associated with higher states of mood, and much more ready access to the thoughts associated with low mood, and a lot of those are automatic - I've read (it's also on the mindfulness audiobook at about 2:30 ) of people in a group setting being shown a list of negative pejoratives or negatively associated words; "lazy, embarrassing, shameful, failure, burden..." and applied to any individual one of us, they hurt like hell,

In the group setting though, everyone there who had experienced low mood, could recognize applying those terms to themselves - and once they realize that everyone does it, those thoughts loose their power to hurt. It is the low mood which is bringing them to the fore. they don't represent any great external truth, they're just thoughts.

the mindfulness is to allow us to spot and to compassionately accept those thoughts as thoughts, and the feelings of throat tightening, stomach churning anxiety, as internal states, rather than as reflections of an outside reality

3:38:17 (from the 5:14:54 youtube version) it is suggested that you don't start Mindfulness Practice whilst in a depressive episode, that you wait until the worst of it is over.

For learning the mindful meditations, that is probably true, however the approach within the "mindful way" is mindfulness based CBT, and CBT is certainly not contra indicated for people experiencing low mood. The CBT aspect is probably more effective at lifting depression than chemicals are (and in the milder states of depression, the SSRIs are not significantly more effective than placebos Dead Link Removed but do have significant side effects that placebos do not have).

Regarding relations with your family. Clearly I don't know, and you do have first hand knowledge - Here's the bind though; what cognitive filter are you using to interpret the signals you get from your family?

could you be viewing interactions through the shite coloured filter of low mood, and discounting the positive cues, while over amplifying the negative cues and then ruminating on them?

Relationships are not static, they are highly dynamic - could your relationship with your family be in a feedback loop? with your increasingly low mood and low mood mediated responses reinforcing negative interactions and throwing cold water onto positive ones? then those feeding back and reinforcing your low mood?

Please let me know if any of this resonates with you, and if any of it does, please feel free to show this to your T on your next visit

With regards to the relationship dynamics, do you think it might help to see if your partner and T would be interested in your partner attending a session with you, especially in terms of understanding negative feedback loops and how to begin to break out of them.

Hugs
@

 

[Mit]

Thanks everyone for the support and guidance.

Good on you and your partner for recognizing the increase in symptoms and taking appropriate measures!

Thank you. I hadn't though of it as a positive response in this way...

considering the increase and severity of symptoms and because your NHS therapist thinks there is a risk of self harm (do you?)

That is a very hard question to answer objectively. My experience when severe anxiety attacks come is a feeling of total desperation and terror. I find it so hard to cope with, that I would do nearly anything to stop feeling like this. I also feel that if something very bad were to happen (like I lost my job) I wouldn't even want to try and cope with the consequences, I wouldn't be able to. Over the last few weeks I have thought about 'it' most days, looked up methods on the web, and having actually tried once before, I guess the answer to your question has to be yes.

That is overly harsh. Mindfulness is not a judgmental practice where you take yourself to task for not being good enough.

Those look like the situational, automatic negative thoughts, that come with low mood.

I'm sure you are both right. There is a local mindfulness sitting group locally, for people who have done a course and need support to continue with the practise. I keep promising to go along, I'm sure it would help, along with the video link, thanks for this.

Thanks for all the thoughts @Anarchy, there's a lot to think about in what you say. I hadn't considered low mood could increase access to negative memories but it makes sense. I think that does happen to me. I also know I struggle with core beliefs that aren't helpful. For instance I feel I shouldn't be getting all this attention from friends on the forum, because I don't deserve it, there are many people who have suffered much more then I and are more deserving of everyone's help.

Even when there are facts to counter my negative core beliefs I am still unable to really believe them. As a child I missed lots of school due to being in hospital much of the time, and I wasn't very bright, or so I came to believe. My teachers told my adoptive parents I shouldn't take any exams because I was so far behind academically. This reinforced my absolute belief that I was stupid and would never get a decent job or have a career and I left school thinking I was for the scrap heap. In my thirties I went to night school and on to university and got a science degree, and now have a career and reasonably paid job. But I still think I am stupid, I think all my work colleagues are much smarter and better at their jobs than I, I always feel like an 'also ran' in a horse race. I don't understand why the facts of my life don't change my core beliefs.

As a child, teenager and young man I believed no girl would ever want me. Having repeated surgery on my deformed genitals made me feel ashamed, and I sincerely believed I would be laughed at or a girl would be horrified if they saw the 'real me'. I didn't have a girl friend until I was 30, and my first experience of sex. I now have a partner, two sons and a step son, a family. But I still think I am unattractive, and I am still ashamed and embarrassed by my physical appearance. It seems I just can't change my core beliefs. I wonder if other find the same?

When I tried to explain (for the first time in my life) to a senior social worker, the impact childhood trauma had on my development, She told me and every other person in the meeting that people experience much more serious trauma in their lives than I had, and do not engage in odd behaviours under the pretence of 'coping strategies'. Hearing that took away what self esteem I had left, made me feel I was undeserving of help, and set me on a path to believing I should have coped better and there was something intrinsically wrong with me. Five years on and I still believe these things.

At home the result of low mood and anxiety is that I withdraw, become irritable and impatient. I find normal home life stresses upset me far beyond what is rational, so I can't engage and support my kids with school issues, home work, making sure they go to bed at a reasonable time and are up in time for school. Even having to do work on our home affects me, causes major anxiety attacks and leaves me in tears. I know it makes no sense. I have asked my partner if she would like to come to therapy with me but she's not keen, she hates talking about private matters to anyone else.

I'm sorry for the long reply. I'm truly grateful for all the thoughtful comments and help.

Mit

 

[ms spock]

@Mit

The act of realising that your mind has wandered and bringing your attention back without criticising yourself is central to the practice of mindfulness.

 

[ms spock]

I guess the answer to your question has to be yes.

I really feel for you and I hope that you get as much help as possible immediately. Suicidal ideation is a serious matter, and I have great empathy and sympathy as I have suffered them as well.

I also know I struggle with core beliefs that aren't helpful. For instance I feel I shouldn't be getting all this attention from friends on the forum, because I don't deserve it, there are many people who have suffered much more then I and are more deserving of everyone's help.

It is hard to have self esteem when you have lived with and through what you have lived through.

Even when there are facts to counter my negative core beliefs I am still unable to really believe them. I don't understand why the facts of my life don't change my core beliefs.

Because you are a human being who has been traumatised.

It seems I just can't change my core beliefs. I wonder if other find the same?

Yes I battle with them every day. It is really hard. You are not alone.

When I tried to explain (for the first time in my life) to a senior social worker, the impact childhood trauma had on my development, She told me and every other person in the meeting that people experience much more serious trauma in their lives than I had, and do not engage in odd behaviours under the pretence of 'coping strategies'. Hearing that took away what self esteem I had left, made me feel I was undeserving of help, and set me on a path to believing I should have coped better and there was something intrinsically wrong with me. Five years on and I still believe these things.

That Social Worker should be drawn, quartered and fired from a cannon in to the sun for saying such a thing to you. I am SO angry to read that you were so minimized.

These so called professionals can be SO dangerous and so damaging for us Trauma Survivors.

At home the result of low mood and anxiety is that I withdraw, become irritable and impatient. I find normal home life stresses upset me far beyond what is rational, so I can't engage and support my kids with school issues, home work, making sure they go to bed at a reasonable time and are up in time for school. Even having to do work on our home affects me, causes major anxiety attacks and leaves me in tears. I know it makes no sense. I have asked my partner if she would like to come to therapy with me but she's not keen, she hates talking about private matters to anyone else.

It makes a lot of sense to me - knowing your background as briefly as I do now.

 

[ms spock]

Ha Ha Ha! My best one yet! @Mit

It is in the nature of the mindfulness student to forget to not criticise themselves!

 

[ms spock]

Really take care of yourself @Mit

 

[Mit]

Heart felt thanks to you @Ms Spock, and take care of yourself too..

 

[Anarchy]

Experiencing those feelings of low self regard, despite evidence to the contrary, seems to be very common. We've had it rubbed in for so long.

Trauma is totally subjective, there can never be a measuring scale. I can validate the feelings of not feeling deserving, but cannot support them with logic. I suspect that you more than fulfill the criteria for PTSD. I will go as far a s suggesting that your experiences in your first few years have probably left you with developmental trauma. A big part of that is difficulty with mood disregulation, and attachment eg, trouble with being able to feel wanted or loved.

With regards to your partner attending therapy, I'll be blunt to the point of rudeness, that discussing relationship issues with a t is probably less embarrassing than having them discussed in a coroner's court. I don't want to hurt you with that, but I do want the choices to be seen in their full context.

The social worker was only showing its arrogance, I'll try not to offend any traffic wardens with a comparison.

I have a really hard time dealing with narcissistic individuals, and the more I've thought about what you wrote, the more I'm seeing the social wanker and teachers as trading in very destructive cheap and abusive appeals to feelings of shame. Absolute scum!

They know, either explicitly or implicitly that if they can trigger feelings of shame, that people they trigger them in are likely to follow any path -They offer to avoid feeling more shame.

I bet you that that social wanker would never have risked making that remark under cross examination.


Sorry this is a somewhat disjointed, it has taken several days to reach this stage of disorganisation. I hope there is some of it that offers you validation.
@

 

[Deleted member 1860]

I do suffer from depression, so perhaps I just have to accept there will be periods when medication can be helpful.

This more than anything points to why you may need to be on medication for an extended period of time, maybe life.

Are you comparing yourself with others with PTSD who don't have deep depression and see them functioning without medication?

That is, you need medication for your depression, and not so much PTSD (even though they go hand in hand.)

If you asked the same thing on a depression board, everyone would be telling you that its not a step backward.

If you truly do have a chemical imbalance in your head, then therapy and every other coping/self-care mechanism in the world may not be enough to help you. That is, you could be beating yourself up because of something physical being wrong with you. Its the same as the severe diabetic who can't control their blood sugar through diet alone. They need the meds to function (an ultimately survive).

 

[Anarchy]

@itsKismet "chemical imbalance" occurs only in drug company marketing blurbs. They have never been demonstrated in brains of depressed people.

Even if they had been demonstrated, that observation would not necessarily have any more relevance to explaining problems of affect than brain tissue having the consistency of cold porridge has explanatory value.

For milder states of depression, SSRIs are no more effective than placebo see the meta analysis in the paper I like to previously for a peer reviewed discussion of this.

What does work, and cannot be explained by the self limiting neo kraepelinian paradigm, are some of the psychotherapies, for example Beck's CBT, Teasdale et Al's mindfulness based CBT, and linehan's DBT, the last being the most effective treatment available for suicidality.

While drugs company marketing plays up a non significant comparison to placebo for depression, what it drastically plays down are the highly significant downsides, such as a doubling in the rate of completed suicides, over a quarter of patients experiencing serious sexual problems and the added stress that they cause in already stressed relationships, and for females, a doubling of each of miscarriage, birth defects and neo nate deaths.

I know you mean well, but please, let's have a more informed forum here than unsupported appeals to opinion on unspecified depression forums.

 

[Mit]

I bet you that that social wanker would never have risked making that remark under cross examination.

This is so true. For six months we did everything they said, no matter how awful or damaging it was to us and our children, none of this was subject to scrutiny by solicitors or the courts. But in the end we had to say no more, so they called a public law order meeting (precursor to care proceedings, we stood to have our children taken away from us) at which we were able to have legal representation. And suddenly things changed. Our solicitor believes social services own legal advisors told the social workers they had no grounds to do what they were doing and it would be thrown out if they continued and we got into court. I can't describe how frightening it all was.

I have a theory that my therapist agrees with. The social workers triggered a psychological reaction contributing to my current frequent severe anxiety because their behaviours had strong similarities to the doctors and nurses who did so much to me when I was a child. They all had power over me and made me do things and did things to me that were distressing. The feeling and fear of loss of control is often at the route of my anxiety attacks.

They know, either explicitly or implicitly that if they can trigger feelings of shame, that people they trigger them in are likely to follow any path -They offer to avoid feeling more shame.

Yes - I felt totally ashamed as a child and do even more now as an adult. My private coping behaviours (developed in response to childhood trauma) caused the problems we endured five years ago. I was forced to tell all our friends that social services thought I might be a risk to children. In doing that I had to describe my childhood and on-going medical problems with my genitals, the surgeries, and most painfully I had to try and explain my secret sexual coping strategies, that I found thoughts of my childhood sexual abuse arousing and masturbated to actual recollections and fantasies. Most of them didn't understand and were disgusted by me. The shame and humiliation is still crushing and very raw, five years later. Trying to develop self belief and stop punishing myself is where I am now, but progress is very, very slow.

Are you comparing yourself with others with PTSD who don't have deep depression and see them functioning without medication?

Yes. I guess I just assumed everybody who suffers from PTSD also experiences depression to some degree. I shouldn't have just assumed that. The therapist I have just started seeing again is contacting my doctor to discuss medication, but has also suggested I wait and see how I respond to therapy with her over the next two weeks. She helped improve my mood when I saw her previously and is hoping she can do the same again.

Thanks for indulging me, and allowing me to talk about my problems.