Cognitive-Behavioral Therapy

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Facing Misdiagnosis and Receiving a Bipolar Disorder Diagnosis

My deepest hope is to make you feel less alone if you were ever misdiagnosed or have encountered an incapable psychiatric provider along the way. I see you. I hear you. Your experience is valid. And this is mine. The first time I entered a psychiatrist’s office, I was diagnosed with major depressive disorder right away after being asked just a few questions, and I was put on an antidepressant that immediately sent me straight into mania. My psychiatrist at the time didn’t realize. She just switched antidepressants. My life proceeded to go down the drain. Throughout the next two years, I was in and out of the A&E, where all they did was put me on a medication drip and then send me home. The IV helped take the edge off, but I felt completely “out of my mind.” In 2017, my psychiatrist diagnosed me with bipolar II disorder. She said she’d just realized I had the mental illness. What haunts me to this day is that after getting out of the psychiatrist’s office with a prescription for two antidepressants, some other medications, and no mood stabilizer at all, it still didn’t occur to me that I ought to find a new psychiatrist. Just imagine — you go tell your psychiatrist that you’re suicidal, and she goes, “Oh no, lovely, why are you thinking like that?” She actually told me that — more than once. The problem was I was completely uneducated. I really thought my psychiatrist’s behavior was “normal” for a mental health provider. When I finally started reading about bipolar disorder, I realized she wasn’t a good psychiatrist. I’d attempted suicide a few weeks before I started to educate myself about my condition. I rang another hospital and switched providers. I developed a strong and powerful emotional bond with my new psychiatrist. I felt heard. I finally felt I was on the right path. I was put on a new medication, and my life got slightly better. But — and yes, there’s a “but” — from 2017 to 2021 I’d relapse every February, and I’d end up inpatient in March and April. I loved my psychiatrist, but she was a student—I was her first patient after she got out of medical school. She didn’t know how to handle my medication levels. She didn’t know how to keep a medication treatment plan without constantly making changes to it. Her lack of experience reflected on my stability and quality of life, which at that point was fully dictated by my illness. I not only had bipolar disorder, but bipolar disorder also had me. In 2018 I was admitted to a psychiatric rehabilitation facility two hours away from home. I left there with a borderline personality disorder (BPD) diagnosis. The consequences of this diagnosis destroyed me. My family started seeing a consultant who had extreme prejudices against people with BPD and fed them lies and misconceptions. Everything I did from that moment on was “because I had BPD.” “I’m hypersensitive and always have been.” “Of course, you have BPD.” “I feel strong emotions.” “Of course, you have BPD.” “I am impulsive.” “Of course, you have BPD.” The thing is, I was never tested for BPD — not by the team at the rehabilitation center and not by my psychiatrist after I left. If they had bothered to test me, they’d have realized I didn’t meet the criteria for BPD. I never have and I never will, because —plot twist— I don’t have it. However, BPD became my primary diagnosis. My psychiatrist talked me into starting talk therapy again, which has never worked for me. What does work for me is cognitive-behavioral therapy (CBT), but I didn’t find a therapist who specializes in CBT until late 2021. Then suddenly, my psychiatrist referred me to another hospital and left. Not only was I heartbroken, but the care I received there was appalling. I was literally told that I “had no hope left because I’d tried every medication.” After yet another admission when I was gaslighted, laughed at, ignored, and teased, I was diagnosed with histrionic personality disorder. I’d almost lost all hope. Maybe that doctor was right — maybe I was a “hopeless case.” But as I’m writing this, I’m on day 309 of my real recovery. At that point, I met the doctor who saved my life — just a few days after getting discharged from that hellhole. A friend of my parents’ gave me his name and number. Both of my previous personality disorder diagnoses were thrown into the bin — and what a relief. I got diagnosed with bipolar I disorder and panic disorder. I was put on a treatment plan which has undergone only minor changes in the past year. I’m in grad school. I was out of the hospital on St. Patrick’s Day. I just celebrated World Bipolar Day out of the hospital. I’m actually, happily living. There is hope. Don’t ever allow anyone to make you think there isn’t. And please, please, don’t make the same mistake as I did — educate yourself. If you think you have bipolar disorder, read about your symptoms and how they’re treated. It really can make a difference.

Dr. Aaron T. Beck, Creator of Cognitive-Behavioral Therapy, Dies

Those of us who are veterans of mental health counseling, psychiatry, and therapy are likely familiar with the abbreviation CBT, which stands for cognitive behavioral therapy. This form of therapy, known for its intentional, thought-monitoring process of thinking that alters behavior over time, was created by psychiatrist Dr. Aaron T. Beck. On Nov. 1, Beck passed away at age 100. Beck was trained in the late 1950s in Freudian analysis, a kind of psychoanalysis developed by Sigmund Freud which analyzes both the conscious and unconscious decisions each individual makes based on what Freud believed to be psychological drives. Beck decided to take Freud’s psychoanalysis methods and transform them into a kind of thought-process analysis that patients could do to help themselves both during a session and in daily life. He believed that his patients’ unconscious minds would generate “automatic thoughts” that helped goad on the symptoms of depression, anxiety, PTSD, and other mental illnesses and syndromes, and that given enough self-training and patience, patients could undermine these false assumptions of self and replace them with solid evidence instead. For example, a patient with depression may have internalized a pattern of thought such as “I am unlovable.” Beck’s therapy would encourage the patient to analyze this thought, pull from practical evidence like how the patients’ friends, family, and perhaps even pets loved them, so the individual is very much lovable. With time, patience and dedicated processing, patients saw marks of improvement in their mood and outlook on life. Beck wrote about his new therapy for patients in a book published in 1979, and psychology as we know it today has never been the same since. Since its creation, CBT has been used on a global scale by millions of psychiatrists and therapists. As explained by Seth Gillihan, Ph.D., in a Psychology Today article entitled “Why Does Cognitive Behavioral Therapy Work?”, CBT has been used for centuries under different names. Mindfulness could even be one term for some of the benefits that CBT brings to patients. Gillihan writes how CBT’s structure and system are not unlike an exercise program that individuals perform to get well over time. “Repeated and focused practice is an integral part of CBT,” Gillihan says. CBT may not be the right program for everyone, but millions have been helped by it every day. The loss of such a great doctor is certainly one felt by many — both patients and doctors alike.

Community Voices

Long, difficult weekend

On Saturday, I had a psychiatrist appointment over the phone. I spent the entire morning preparing, making sure I was physically taken care of, mentally and emotionally calm, using my breathing techniques, and had all my notes and safety objects around me. He called, assessed me, and it was over. He concluded that I "don't have a psychiatric disorder", which I think is an oversimplification but it is the answer I was looking for. I need my medical charts to focus on my yet-to-be-diagnosed physical health symptoms, not the already-managed mental health symptoms, and this is a great first step towards that.
[In reality, I experience symptoms of #CPTSD every day, but due to effective practicing of skills, the psych assessed that this no longer causes me significant dysfunctioning, and therefore he considered me clinically well.]
The emotional aftermath of this appointment was incredibly messy, with initial intense excitement, followed by paranoia about being "found out" (for what I'm not clear on), followed by an extreme exhaustion. I had trouble falling asleep, experiencing panic while lying in bed, as I often have in the past.

Then yesterday I saw my mom. It was another emotionally draining experience. I have to practice deep listening and loving speech so carefully, and use meditative thought to protect myself from emotion or concepts that have the potential to cause me harm. It is better, both in the moment and in the end, than the alternative, but exhausting work nonetheless. I woke up twice in the night with racing heartbeat and panic feelings.

I have also started cutting back on my medication recently. Although I've experienced a lot, I believe my increased difficulty at night has more to do with the dosage change. I have a lot of trouble at night during the winter, when the daylight is so scarce, so I have tools I can use when I'm not sleeping well. I can ask my roommates to bunk with me, use aromatherapy, set a bedtime routine, and I have a bedtime medication I use sparingly. If I'm up in the middle of the night, I can meditate, read, play or watch one of my safety games or shows, come on The Mighty, and I can get my roommates if I need help calming down. All that being said, I'm hoping my nights improve as my mindbody adjusts to the lower dose of meds and I continue to practice my skills.

#Meditation #CognitiveBehavioralTherapy #DialecticalBehaviorTherapy #5MindfulnessTrainings #Selfcare #CommunityCare

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Community Voices

Distraction Technique 101: Colouring #DistractMe #Relaxation

<p>Distraction Technique 101: Colouring <a class="tm-topic-link mighty-topic" title="Distract Me" href="/topic/distractme/" data-id="5cabee5faf2da400d4e56a41" data-name="Distract Me" aria-label="hashtag Distract Me">#DistractMe</a>  <a class="tm-topic-link ugc-topic" title="Relaxation" href="/topic/relaxation/" data-id="5c70a8c441645a00e6420fd1" data-name="Relaxation" aria-label="hashtag Relaxation">#Relaxation</a> </p>
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Community Voices

Is #Therapy helping me or just making it easier to hide and pretend I'm not sick?

#Fibromyalgia #CognitiveBehavioralTherapy #Trauma #PositiveThinking #ChronicPain #ChronicIllness
Like, how long are you supposed to "fake it til you make it" or "think positive eventually your thoughts will BE positive" I've been in therapy for years. I'm on more than enough drugs. I've had SO much therapy, that I'm at this point I feel like fooling myself. Like maybe I just got better at faking it is all. The coping mechanisms just helped me get better at hiding it. Happy 6 months since my fibro diagnosis. It's still pretty "light" compared to most people's I feel like. However, I know that virtually no chronic illness gets"better" over time. I'm 29. I think I need an "oh shit" bar in my shower. I already have a mat. I HATE thinking long term. I am on tinermittent FMLA however I work fulltime hours. I'm NOT ready to succumb. To anything. To #HashimotosThyroiditis to the fibro to #BipolarDisorder to any of it. I'm not ready to admit I'm "different" than other people. And I'm always comparing myself to others and frustrated. I KNOW I shouldn't. I KNOW I do a great job. I KNOW I'm managing fine. However, i AM different, and i can hope for "better" but that's it. No cure. No "normal" not the same "productivity" as everyone else. I hate it. I FUCKING HATE IT. I DIDNT ASK FOR THIS. I want to help my single mom sister, I want to control my emotions, I want to be better at work. I want to be independent. I want to be able to work my 8 hours and do laundry in the same day. I want to be able to read a whole paragraph without getting lost. #help

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Community Voices
julia

Please help! Starting therapy: is CBT ok considering I can’t find DBT professionals where I live?

I’ve been doing psychoanalysis for my whole life and for a while I’ve been really bad and progressively less functional.. so now I was really determined to start DBT but it’s just not possible where I live.. would you say CBT is worth trying?
#BorderlinePersonalityDisorder #DialecticalBehaviorTherapy #CognitiveBehavioralTherapy

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Community Voices

Has anyone tried CBT for BPD? Has it helped?

I'm in Cognitive Behavioral Therapy (CBT) for the second time. I'm wanting to know if anyone's tried it and if it's helped anyone? What has helped you be successful in CBT?
#BorderlinePersonalityDisorder #CBT #CognitiveBehavioralTherapy

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1st day of long awaited therapy! 🙌🏼 Go me!

Yet I can’t seem to shake this anxiety and this growing, overwhelming feeling. I’ve tried all evening to feel it and be one with it, to try to figure out what exactly I’m feeling... then it dawned on me, 1st day of therapy. It was emotional to say the least and I was a nervous wreck the entire time. At the end when we did a meditation exercise, to be one with our feelings, and I unexpectedly burst into tears. I expected to be anxious and to have scattered thoughts, unable to focus or concentrate on anything but my mind & my body screaming, as well as being so painfully aware of everything and everyone in the room. I wasn’t expecting the sadness that overcame me.

I know I have a lot of work to do to uncover trauma and to retrain my thought processes. I’ve waited so long and had wanted therapy to start so bad, but now that I’m here, I’m *terrified.* I’m so anxious that I can’t sleep. I could barely speak all evening. I’m really scared for what’s to come during this process and how I’m going to be able to cope.

Has anyone else experienced this when starting therapy? I’m so confused by my feelings and emotions.

#Depression #Anxiety #CBT #CognitiveBehavioralTherapy

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