Can't Battle OCD Without Some Relief from Physical Symptoms - Impossible Situation

[Keyboard Worrier]

17 hours ago, snowbear said:

Been there too! I used to really struggle to swallow any kind of medication. Then I learned to think of the tablets as cornflakes. You can semi-chew and swallow a mouthful of crinkly cornflakes whole no bother, or lumps of meat/potato/apples etc, so think of the tablets as you think of a food you like and hey presto - they go down a lot easier. Still took a bit of practise to get good at it and I can still only swallow one pill at time with a swig of water, but the rest of the discomfort/air swallowing etc is no longer an issue.

It's not even tablets lol, I had to ask for them in liquid form. 

That brings its own problems though.  Being a glass bottle there's no clear 'cut off' after pouring.  Some always dribbles down the edge...then that old medicine 'contaminates' the next one if I can't pour it carefully enough...I know, I know!   I always have to have a drink straight after, but can't spare a glass in my daily routine so have to keep a bottle in the fridge...then I feel like I've contaminated that with any medicine that was on my lip.  So now I'm having to wash my hands and face in the bathroom, then take the med by the kitchen sink, then go back through the bathroom and wash my hands and face, then back to the kitchen for a few sips of water...

And then it has to be small sips as my throat is on high alert by that point.  I have a lot of trouble swallowing food and water normally so every meal is a battle in itself now.  There isn't any food I like any more, almost everything hurts my teeth, throat, stomach etc so there's barely anything left in my diet.  Again, it's just another 'layer' to get through each day.  I wish I could have my teeth sorted as then I could eat a few more things again.  I don't see any way forward there though.  Made 4 attempts to see a dentist before Covid and failed to even get in the room each time.  Since Covid the local dental clinic has closed so it'd have to be a 'normal' place who are even less likely to understand my issues.  I'm considering asking for Diazepam when I do the next GP check in as I think that's the only way I'll get through emergency dental work if they become any worse.

 

 

[snowbear]

Hmm...

In my experience when things have become as restricted and ritualised as you describe there's not much anybody can advise that will help. The next step has to come from YOU.

So the question is, what are you hoping will happen to get you out of this situation?

Think of where you are as point A and a more tolerable existance as point B. Picture yourself moving from point A to point B. What needs to change - either inside you or from the outside world - to enable you to live with fewer rituals and less anxiety?

Diazepam is ok to get you to the dentist appontment(s), but you definitely don't want to be taking it regularly to get you through a day like the one you're describing here. That level of OCD won't improve with diazepam, it needs a change in thinking.

Are you ready for that? Have you made yourself suffer enough yet to be willing to change your thinking? Or are you still in the willing-to-suffer phase where the OCD rules you've set for yourself are more important than any degree of physical and mental torture?

I've been there, so I know the only way out is to move the goalposts, change the rules, consciously decide you can (will) compromise and then make some concessions to living more normally. It all has to come from within YOU.

I really feel for you. I know the utter misery and trapped feeling of being where you are. I hope you'll reach rock bottom soon so you become willing to start the recovery process and reclaim some quality of life.

[Keyboard Worrier]

14 hours ago, snowbear said:

So the question is, what are you hoping will happen to get you out of this situation?

A swift, painless death in my sleep tonight...  

I haven't ever seen a 'future' for myself.  By the age of about 12 I just wanted to 'go', never intending to have to face the rest of life, knowing it could only ever get worse, and therefore only taking short term options when necessary.  I've never really understood people.  I find the idea of physical relationships repulsive.  I don't like kids or pets.  I don't like anything really.  I'll probably never be able to work again.  So that just leaves many years of fear, pain & boredom as a burden on society...ideal!  But I also feel really 'alone' in all of this, ironic I know.  I think if I had someone that understood the issues, and could help practically and patiently, whether that's going for a walk or a drive together regularly to increase distances again, or actually coming with me to appointments or Tesco etc, I feel that would help make long term improvements and is the thing that I think I miss compared to all the other people that I've known and watched progress through MH issues over the years.  Trouble is, I don't know where to find someone like that at my age (might have more chance if I was working or at Uni or something) and most people my age are looking for proper relationships.  I couldn't offer them as much as they could me so it wouldn't be fair on them.  

 

15 hours ago, snowbear said:

Think of where you are as point A and a more tolerable existence as point B. Picture yourself moving from point A to point B. What needs to change - either inside you or from the outside world - to enable you to live with fewer rituals and less anxiety?

I think a move to a more suitable property would help considerably.  I have a small upstairs studio flat at present.  If I was ground floor with a private garden I could try to meet people outside again without the issue of vertigo making the stairs unsafe & unmanagable alongside the anxiety of a visitor.  It'd also give me an escape when the summer heat gets too much indoors, or there are loud noises going on like the washing machine, or if someone had to come in for maintenance.  Not to mention the benefits of a green space and watching plants grow.  I'd then hope to progress to visitors in the lounge (currently the lounge is the bedroom so that's weird for all involved as well as bad for contamination!)  GP, CBT therapist, optician & dental checkups could all be done at home hopefully...  While that might seem like avoidance, I see it more as cutting out a few anxiety layers in order to make something possible which at present is impossible.

However, that type of property doesn't come up for rent often, and as a single guy with no dependants and only benefit income, I'm at the bottom of the list for either private rental or housing association.  I spent many months trying to move before summer this year, as I had a feeling that would be the final straw for the vertigo, but just got refused everywhere.  I can't say for sure that I wouldn't be in such a bad position now if I had moved 6 months ago, but I strongly suspect I wouldn't.  I don't think I could even cope with a move now though...would hope Diazepam could help on moving day if I did find a property.

 

16 hours ago, snowbear said:

Diazepam is ok to get you to the dentist appointment(s), but you definitely don't want to be taking it regularly to get you through a day like the one you're describing here. That level of OCD won't improve with diazepam, it needs a change in thinking.

I'm aware Diazepam is only for short term use on extra bad anxiety days.  I think it has fewer side effects than SSRIs though, and much more immediate effect.  From what I've read & heard from acquaintances that use them, SSRIs don't do much for the OCD either.  Just 'take the edge off' anxiety which doesn't seem worth the side effects to me.  Tbh I'd rather try some heroin and be completely fearless & painless for a while!!   

 

16 hours ago, snowbear said:

Are you ready for that? Have you made yourself suffer enough yet to be willing to change your thinking? Or are you still in the willing-to-suffer phase where the OCD rules you've set for yourself are more important than any degree of physical and mental torture?

I don't think I'll ever be 'ready' as that can only come with an acceptance of the future.  I wasn't ready 10 years ago at my first CBT session, I wasn't ready when I was refused any CBT/treatment after 3 assessments in Jan 2020, and I'm still not ready now.  I don't know how to change that, I don't know how to 'want' to continue being alive.  I'm just hoping I can start to make changes without being 'ready'...  I have no idea if that's even possible.   

 

I thought I'd have something positive to write here today.  I managed to walk just over a mile two days ago, and drive about half a mile yesterday.  Not much but an improvement over recent weeks!  However, both nights have ended badly.  Around 5pm I started getting really hot & sweaty, and then had IBS issues throughout the evening and night, affecting my stomach and triggering vertigo as well.  I don't know if this is a side effect of the anti nausea med or if it's been caused by something I ate but again it just gives a massive knock to the system when I start to think I'm able to deal with these things a little better.  The dark nights really don't help as artificial light affects my vision badly.  I'm dreading it happening again tonight but just have to hope for the best for now!  I am intending to go for another short walk this afternoon.

[Caramoole]

1 hour ago, Keyboard Worrier said:

I am intending to go for another short walk this afternoon

Good Even when you don't want to, it's important you do.  If you can't go far, if you get dizzy, walk to the gate (or whatever) but do it.  At the stage you're stuck at it's hard to feel hope or any optimism.  That's because you view the future as more of the same.  Dream graded improvements of how you'd "like" the future to be even if you believe it will never be.

 

1 hour ago, Keyboard Worrier said:

think it has fewer side effects than SSRIs though, and much more immediate effect.  

Don't kid yourself Take it from someone who was addicted to them for 12 years.  If you take them apart from very occassional use your body will develop a tolerance to them & they become ineffective, the only way of changing this is increasing the dose....but again tolerance is quickly achieved.  End result you are in withdrawal even whilst taking the drug.  Getting off them is said to be worse than coming off Heroin.  It is a living Hell with anxiety levels that are difficult to imagine.

[snowbear]

2 hours ago, Keyboard Worrier said:

I haven't ever seen a 'future' for myself...

I suspect what you're really thinking is, 'Don't dare to dream of a future because it won't happen.'

The thing is, it's astonishing and astounding and amazing just what you can make happen when you put your mind to it.

2 hours ago, Keyboard Worrier said:

I think if I had someone that understood the issues, and could help practically and patiently, whether that's going for a walk or a drive together regularly to increase distances again, or actually coming with me to appointments or Tesco etc, I feel that would help make long term improvements.

Trouble is, I don't know where to find someone like that at my age and most people my age are looking for proper relationships.  I couldn't offer them as much as they could me so it wouldn't be fair on them.  

Fact: -

Go into a relationship or friendship telling yourself you have nothing to give and you'll reduce your chances of success almost to zero. Everybody has something to give. Be positive about the benefits you can bring to the friendship!

Where you seem to be struggling is in knowing what you contribute to the world. It doesn't have to be major, or heroic, just ordinary things like being there for someone, listening attentively, caring how they're doing... these are positive contributions you can make. Start out small, let it grow. Get chatting to people online. Join a dating site and just be upfront and honest about wanting friendship more than a relationship. There are plenty of other people in every age group out there looking for just friends.

What are your interests and hobbies? If you've let them all fall by the wayside due to OCD then pick one you used to enjoy when younger and take it up again. Get involved. You talk about the outdoors with a hint of fondness; what about gardening? I grow seeds in recycled food tubs indoors - you could too. What about getting involved in some chairty work, conservation or wildlife maybe? Do a free online course in whatever area takes your fancy. Places like Future Learn are great for getting your toes wet in a topic again.

Start chatting to people every chance you get. If you find it hard to physically chat, practise conversations in your head. Being an excellent conversationalist is about listening more than talking anyway. Feed back a few key words and get them talking more about themselves!

Consider a paid employee as a first step. If you get disability benefits you could use some of it to pay a helper/ companion for one hour a week to get you out and about on walks or drives.

Keep looking for a property. I plan to move to a bungalow in 10 years time, but already I'm doing a bit of research on what's available, where, cost etc. You can never be too well informed! If you've always got one eye on the property rentals in your area you're far more likely to find somewhere than if you just look for 6 months and give up.

The trick to success is to have a plan. Push yourself to achieve small goals. Try to devote less time to OCD and more time to these renewed interests and keep pushing the balance ever more towards doing other things with your time other than rituals. Ideally you want to get to a place where you have to put off some rituals because you're too busy with your other interests!

3 hours ago, Keyboard Worrier said:

I don't think I'll ever be 'ready' as that can only come with an acceptance of the future.  I wasn't ready 10 years ago at my first CBT session, I wasn't ready when I was refused any CBT/treatment after 3 assessments in Jan 2020, and I'm still not ready now.  I don't know how to change that, I don't know how to 'want' to continue being alive.  I'm just hoping I can start to make changes without being 'ready'...  I have no idea if that's even possible. 

I disagree that being ready requires acceptance of the future. The biggest motivator for me to change was accepting I'm getting old, haven't that much life left to go and wanting just a few home comforts before I die! You'll have to find your own motivation but whatever that is, change is possible. All you really need is to want something better than this 'life' (existence) you've got now.

 

 

 

[Hal]

3 hours ago, Keyboard Worrier said:

But I also feel really 'alone' in all of this, ironic I know.  I think if I had someone that understood the issues, and could help practically and patiently, whether that's going for a walk or a drive together regularly to increase distances again, or actually coming with me to appointments or Tesco etc, I feel that would help make long term improvements and is the thing that I think I miss compared to all the other people that I've known and watched progress through MH issues over the years.  Trouble is, I don't know where to find someone like that at my age (might have more chance if I was working or at Uni or something) and most people my age are looking for proper relationships.  I couldn't offer them as much as they could me so it wouldn't be fair on them.  

You might be surprised what you have to offer....you come across as smart with a good sense of humour in spite of all you're going through. If at some stage though you want to get in touch with other people in a safe context, I wonder if any of these services might be worth taking a look at.....

https://www.mind.org.uk/information-support/drugs-and-treatments/peer-support/finding-peer-support/

https://www.rethink.org/help-in-your-area/support-groups/

https://www.together-uk.org/peer-support/

.....They may be worth getting in touch with to find out if they offer online support and friendship initially, and then at some point possibly take another step towards physically meeting up with someone. 

Edit: Posted simultaneously with Snow

[snowbear]

@ Hal, you're so much more practical than me. Great links!

p.s. We both highlighted the same phrase. Great minds think alike.

[Hal]

4 minutes ago, snowbear said:

@ Hal, you're so much more practical than me.  

You haven't seen me trying to put flat pack furniture together

[Keyboard Worrier]

On 13/10/2021 at 14:55, Caramoole said:

Good Even when you don't want to, it's important you do.  If you can't go far, if you get dizzy, walk to the gate (or whatever) but do it. 

Don't kid yourself Take it from someone who was addicted to them for 12 years.

I have managed to keep up a daily walk for the last week or so now.  Still at a max of around 30 mins but fairly reliably each day.  Although I lack motivation, I am good with discipline so once in a routine, can continue to do the same thing regularly until I'm physically stopped from doing it.  (Usually due to IBS or vertigo).  That's why the pandemic has had such a major practical effect.  One miss is generally manageable, but once I've missed two that's when things become much more difficult...the lockdown meant I lost the ability to do all of the things outside that I had previously been just about managing.  I started to regain some of those things in Spring this year but then the hot summer caused even more issues with long periods of not even being able to get down the stairs let alone walk outside in the heat/sun. 

I still don't really know where the sudden, unmanageable panic attacks came from earlier this year though, that's the thing that I was really hoping meds could reduce now.  Either directly with some sort of sedative, or indirectly with anti-nausea/vertigo meds.  Would you say it's still worth asking for Diazepam for very rare use (an emergency dental visit, emergency property maintenance or a moving day for example) or are there any similar alternatives that might be safer?  I've got to message my GP this week to let them know how I've got on with the anti-nausea meds so this is the time to ask about any others.

[Keyboard Worrier]

On 13/10/2021 at 16:50, Hal said:

You might be surprised what you have to offer....you come across as smart with a good sense of humour in spite of all you're going through. If at some stage though you want to get in touch with other people in a safe context, I wonder if any of these services might be worth taking a look at.....

https://www.mind.org.uk/information-support/drugs-and-treatments/peer-support/finding-peer-support/

https://www.rethink.org/help-in-your-area/support-groups/

https://www.together-uk.org/peer-support/

.....They may be worth getting in touch with to find out if they offer online support and friendship initially, and then at some point possibly take another step towards physically meeting up with someone. 

Edit: Posted simultaneously with Snow

Thanks Hal...if only the smartness & humour were still present in real life!  

There don't seem to be any groups near me unfortunately, fairly common issue for this part of the country, I've tried Mind & Rethink already.  I did try a local OCD & anxiety group pre pandemic but that didn't really work out.  I'm not sure what to happened to it since the pandemic, I did wonder if it moved online but couldn't find any info about it.  I do have a few online acquaintances from other forums but again, none locally, which is a bit frustrating.

[Keyboard Worrier]

On 13/10/2021 at 16:50, snowbear said:

Where you seem to be struggling is in knowing what you contribute to the world. It doesn't have to be major, or heroic, just ordinary things like being there for someone, listening attentively, caring how they're doing... these are positive contributions you can make. Start out small, let it grow. Get chatting to people online. Join a dating site and just be upfront and honest about wanting friendship more than a relationship. There are plenty of other people in every age group out there looking for just friends.

What are your interests and hobbies? If you've let them all fall by the wayside due to OCD then pick one you used to enjoy when younger and take it up again. Get involved. You talk about the outdoors with a hint of fondness; what about gardening? I grow seeds in recycled food tubs indoors - you could too. What about getting involved in some chairty work, conservation or wildlife maybe? Do a free online course in whatever area takes your fancy. Places like Future Learn are great for getting your toes wet in a topic again.

Start chatting to people every chance you get. If you find it hard to physically chat, practise conversations in your head. Being an excellent conversationalist is about listening more than talking anyway. Feed back a few key words and get them talking more about themselves!

Consider a paid employee as a first step. If you get disability benefits you could use some of it to pay a helper/ companion for one hour a week to get you out and about on walks or drives.

Keep looking for a property. I plan to move to a bungalow in 10 years time, but already I'm doing a bit of research on what's available, where, cost etc. You can never be too well informed! If you've always got one eye on the property rentals in your area you're far more likely to find somewhere than if you just look for 6 months and give up.

The trick to success is to have a plan. Push yourself to achieve small goals. Try to devote less time to OCD and more time to these renewed interests and keep pushing the balance ever more towards doing other things with your time other than rituals. Ideally you want to get to a place where you have to put off some rituals because you're too busy with your other interests!

Thanks again Snowbear...you should probably be a counsellor!   Genuinely, you seem to be able to word things in a way that I haven't found from any therapists so far. 

My main interest for the last decade was cars.  Not really driving so much (causes too many intrusive thoughts!) but fixing, cleaning, modifying, car shows, car forums etc...  I met most of my 'real life' acquaintances of the time through cars, vehicle college course, carpark meets, buying & selling parts, helping fix or service cars...and of course it's all outside so no close human contact necessary!   But around 2018 I had to stop the physical stuff due to the vertigo & digestive issues getting worse, and my driving distances were getting shorter and shorter for the same reason, and ultimately I lost the only things that were helping me socialise.  I've found it hard to find new hobbies and adapt to that ever since.  I did like gardening for an elderly relative each week but also had to stop the heavy work and bending & lifting there as well.  I would like to get back into light garden work, and I know there are things that could help with that such as raised planters...but the lack of garden and space in general stops that.  I just have a couple of house plants lol.  I've tried lego recently but again due to the lack of space don't have anywhere to build large models, let alone display them.  I know I'm still in a transitional phase at the moment, trying a few different things, in the hope that eventually I find something to get into again.  Outdoor charity work in a communal garden or similar is something I'd like to try in future.  Though it still relies on being able to travel so not an immediate solution.  I'm also having vision issues with screens currently so an online course isn't possible at the moment, but again something for future.  

I do currently get PIP (although under review at present, another current stress lol) and was hoping to use some of it to pay for a support worker type person.  I just haven't been able to find anywhere that offers this service though.  Any idea where I could find a helper/companion or similar?  

 

[Caramoole]

41 minutes ago, Keyboard Worrier said:

Would you say it's still worth asking for Diazepam for very rare use (an emergency dental visit, emergency property maintenance or a moving day for example) or are there any similar alternatives that might be safer?  I've got to message my GP this week to let them know how I've got on with the anti-nausea meds so this is the time to ask about any others.

You could do, they are used for situations like this but should be kept for very occassional use.  Panic attacks and anxiety actually become problems from toleramce in long=term use.  Beat Blockers are another option for the pjysical anxiety symptoms.  There are other anti anxety medications (although I didn't find these effective).  Another medication that can be effective is one called Pregablin.  It's normally a drug used in epilepsy or for nerve pain but it has been found to be helpful for anxiety.  Again, it's best used at the lowest level that's effective to help negate any withdrawel effects.

Driving......get out there and do short trips each day.  I had many driving issues but made a point of driving everyday whether I felt like it or not.  I've sat in traffic at the head of a traffic light queue feeling so whoozy I doubted I could drive another metre.  I always could.....my brain told me I couldn't but automatically, I could.

You're being imprisoned by your own mind, as are the physical, bodily symptoms.  I know it seems like an impossible hill to climb but you can steadily start the climb back.  Use that disciplne

[Keyboard Worrier]

21 hours ago, Caramoole said:

You could do, they are used for situations like this but should be kept for very occassional use.  Panic attacks and anxiety actually become problems from toleramce in long=term use.  Beat Blockers are another option for the pjysical anxiety symptoms.  There are other anti anxety medications (although I didn't find these effective).  Another medication that can be effective is one called Pregablin.  It's normally a drug used in epilepsy or for nerve pain but it has been found to be helpful for anxiety.  Again, it's best used at the lowest level that's effective to help negate any withdrawel effects.

Driving......get out there and do short trips each day.  I had many driving issues but made a point of driving everyday whether I felt like it or not.  I've sat in traffic at the head of a traffic light queue feeling so whoozy I doubted I could drive another metre.  I always could.....my brain told me I couldn't but automatically, I could.

You're being imprisoned by your own mind, as are the physical, bodily symptoms.  I know it seems like an impossible hill to climb but you can steadily start the climb back.  Use that disciplne

Thanks Caramole,

I think I will ask for it as 'backup' but won't push for it if they refuse.  I had considered Propanolol as a beta blocker, but am put off by the fact the NHS site makes a big point about the first dose being likely to cause dizziness.  Just reading about it made me feel dizzy!    Suggested to take it at night before bed but I always feel really wobbly and weird at night which causes more anxiety in itself.  Not sure if there's any way to reduce the chances of that.  I hadn't heard of Pregablin but that might be a more suitable alternative to SSRIs for me so will look more into that. 

I wish I could get out and drive each day, that's the way I've improved on similar situations before, but it does feel different this time.  In fairness, I have always managed to get home again so far, but I just don't know whether it was really 'safe' or not, and whether I'm putting other people at risk.  I guess there's no sure fire way for us to know what's OCD/anxiety and what's the reality sometimes.  I do intend to try and start driving again though!

[snowbear]

On 17/10/2021 at 14:08, Keyboard Worrier said:

I do currently get PIP (although under review at present, another current stress lol) and was hoping to use some of it to pay for a support worker type person.  I just haven't been able to find anywhere that offers this service though.  Any idea where I could find a helper/companion or similar?  

Advertise on the government's  Job Centre Plus site. It's easy as pie to create an employer account, all you need is an email address. Then post a job advert for a care suppoert worker/ companion whatever you want. The screen takes you through the process and it's not complicated. Easiest way is to advertise for someone who's self-employed rather than an employee so there's no paperwork (I just do a simple bank transfer into my support worker's account after each visit and have no other paperwork to do), but if you do need to go down the employee route all the paperwork you need is on the government website, including free software to download for payments, P45, tax etc.

[Dakagraphics-David]

It's Just a thought... But what If I were the patient,  and you the therapist; What would you suggest to me?

[Keyboard Worrier]

14 hours ago, snowbear said:

Advertise on the government's  Job Centre Plus site. It's easy as pie to create an employer account, all you need is an email address. Then post a job advert for a care support worker/ companion whatever you want. The screen takes you through the process and it's not complicated. Easiest way is to advertise for someone who's self-employed rather than an employee so there's no paperwork (I just do a simple bank transfer into my support worker's account after each visit and have no other paperwork to do), but if you do need to go down the employee route all the paperwork you need is on the government website, including free software to download for payments, P45, tax etc.

Now that's interesting, I hadn't even considered anything like that!  Will have to look into it over the weekend.  

Must admit, I'm a bit concerned about the safety/security aspect of a 'random' person, rather than one from an organisation though.

[Keyboard Worrier]

14 hours ago, Dakagraphics-David said:

It's Just a thought... But what If I were the patient,  and you the therapist; What would you suggest to me?

I'd suggest a couple of weeks of intensive residential treatment doing both group and solitary exposures in a safe environment where other tasks are managed for you and the staff hopefully know how far they can push things without going too far.  Focussing firstly on being able to manage bodily fluids, pain & discomfort, and in turn the contamination fears and compulsions/rituals surrounding those.

However, there aren't any residential places near me and I haven't been able to travel far for over 15 years due to my damn stomach problems.  Even if I can mentally push the agoraphobia back to a point where I'm able to drive locally again, I still won't be able to drive anywhere near far enough to get to the nearest residential centre.  I haven't been able to travel as a passenger for nearly 10 years, and obviously no public transport, so driving myself has been the only option for everything for the last decade.

Currently I'm just trying to do little bits of each thing around all the usual daily/weekly tasks and getting nowhere really.  But the alternative to that is making improvements in one area, while making losses in another which isn't a reasonable solution either.  That's one of the reasons I've ended up in such a bad situation this time.

So, as a therapist, I guess I'd refer back to the standard 'Ok, well, maybe try sitting in a coffee shop for a while'...  If I had a pound for every time I'd heard that one!!  

Edited October 21, 2021 by Keyboard Worrier

[snowbear]

6 hours ago, Keyboard Worrier said:

I'd suggest a couple of weeks of intensive residential treatment doing both group and solitary exposures in a safe environment where other tasks are managed for you and the staff hopefully know how far they can push things without going too far.  Focussing firstly on being able to manage bodily fluids, pain & discomfort, and in turn the contamination fears and compulsions/rituals surrounding those.

When you're not in a position to take up whatever treatment options are available (or what you consider the ideal if it was on offer) then your task is very simple. 

You have to become your own therapist.
 

So, now it's time to put on your thinking cap. How are you going to organise yourself so that you're managing the basics of daily living, fitting in some exposure exercises and teaching yourself how to cope with body fluids and pain?

It's very do-able. What stops people is a lack of confidence in their ability to be their own therapist. But my answer to that is try it!

Look at the advantages! Your therapist is at your home, your therapist is on call 24 hours a day, your therapist knows every tiny detail about your life...

For those times you need a pair of fresh eyes to look at the situation you come to the forums and ask.

All you have to do is get organised, and break it down in to small steps.

Where do you want to start?

[Keyboard Worrier]

I want to start by just being able to manage the things I could manage 6 months ago.  I have no idea where to start now I'm in this deep.  

Had a really bad afternoon/evening yesterday after a reasonable morning.  I don't understand why or how these things have got so bad now.  I thought I was making some progress but it was the worst anxiety type attack I've had so far this year.

I had to have a second shopping delivery from a relative.  Stocks were low at the first shop so they dropped off the chilled items and popped to another shop afterwards.  In my 'normal' mind, it shouldn't make any difference, it was only a few extra items so very little bending and lifting, and they're not coming indoors, just leaving it for me to bring in...I don't understand why it would make any difference?  They messaged asking if I needed the items or could wait until next week...I was on the loo at the time as it happens, and as soon as I replied with 'need them today if you've got time' my bowels instantly cramped and my throat started getting 'damp' and catchy (weird explanation but I honestly don't know the name for it!).  Quickly finished in the bathroom and thought I'd do the washing up as a distraction and pre-empting that I may not be up to it later.  Within seconds of starting to run the water my bowels were on the move, reflux and belching had started, I was clenching and squirming but trying to breathe and calm but in that moment nothing seemed to be working.  Forced myself to continue washing up, albeit in a much more splashy erratic manner than usual than usual, repeatedly swallowing and feeling a bit wobbly and dizzy by now.  Dried up and straight in the loo for another urgent BM (making that the 8th BM visit of the day at 4pm!  How am I ever meant to go out around that...I barely even eat anything!!) and the nausea was very strong by this point.  Anti nausea med doesn't appear to have made any difference here.  Whole body shaking and vibrating, not able to breathe properly or calm my heart rate.  After that ferocious BM there was a sudden gurgling like someone unblocking a drain and the nausea reduced noticeably, but still way above manageable levels.

My guts were painful and shifting etc for the rest of the night, couldn't do any of the other tasks I'd planned, did manage to cook some dinner but could only eat a tiny amount, kept having to urinate every half hour, and the shaking and nausea etc didn't stop.  Knock on effect of that is that I couldn't get enough calories in yesterday night to have much energy today, and couldn't sleep much either, so that's knocked todays plans.  I couldn't take any OCD risks/exposures with food yesterday as I felt so bad I just needed to take the safest option to try and get something in and then try and get through the night until daylight when I find things a bit easier to deal with.

It's made me think that I really couldn't manage a visit from a helper or support worker now and shouldn't even risk trying to drive at the moment knowing how quickly this can come on and I would have been in a hell of a mess if I hadn't been at home with access to a toilet and water etc at the time.  If this is the sort of the thing that SSRI's are likely to cause for a week or two, I've got no chance of that. 

On a slightly more positive note, despite still shaking and feeling rough this morning, I'm still hoping to have a short walk this afternoon, and will put the washing machine on while I'm out but I'm not planning any more than that at this stage.

[snowbear]

Sounds like you had a bad day.

But here's the thing, if you want to get out of this rut then when you have a bad day you must draw a line under it and mentally start again the next day with the belief you're still moving upwards and forwards.

Good that you went for a walk and got some washing done. Keep up that 'achieve something every day, however small' thing going!

I'm not in the least surprised anti-sickness medication has no effect. Probably neither would anti bowel-movement medication or anti bowel-cramp medication. Why? Because this is all your gut responding to your mental state, its not about physical gut problems.

You know that already, I'm sure. But reading your posts it sounds as if you treat every bowel symptom as if it was gut-related rather than coming from the brain. (If you want the science of how it works, your gut and brain interact through the vagus nerve, one of the most powerful nerves in the body. The more stressed you allow yourself to become the stronger the gut response.)

What I'm saying is you need to begin reacting to a bad gut day by thinking more about how to relax and reduce your anxiety than you think about dealing with your gut. Break the cycle where worrying about your gut being bad causes worse gut symptoms which makes you worry more about your gut...

It's hard to believe until you gain some experience of stopping it just with your mind, but the cramps, wind, frequent bowel movements and nausea are all under your control. Get your brain out of worry/reaction mode and into 'it's ok, this is unpleasant right now, but I'm fine, I'm going to simply relax and this will settle' mode.

Try observing yourself as if you were an outsider. It will help you notice how your gut gets worse because you're worrying that you won't cope.

Have some relaxing 'distractions' at hand for when your gut gets bad. As soon as the gut kicks off you go into 'chill out' mode. Breathing exercises, meditation, stretch and relax your muscles, do something fun, or get on with a necessary task of daily living. Any time you get drawn back into thinking about gut or toileting, deal with the practicalities without fuss, refuse to get stressed about it and get back to 'chill mode' asap. Aim to get to a point where you can mentally stay in chill mode even while you take a break to go to the bathroom. (It will take a few weeks at least to get there - don't despair and don't give up!)

As well as your gut being driven by your mental state, the same is true for the nausea and dizziness. Again, practice observing youurself as if you were an outsider. Notice how your breathing quickens and gets shallower when you feel sick or dizzy. Correct it by slowing your breathing down and taking fewer, deeper breaths with your diaphragm. That will reduce the nausea. If the dizziness persists, go for the breathing in and out of a paper bag routine.

That's enough for now. Something to get you started!

Remember - you can do this. Baby steps to start, but as long as you don't give up you will get there.

[Wren]

Hello Keyboard Worrier, I just wanted to back up Snowbears excellent advice with my own experience. I have/had a lot of physical anxiety symptoms including IBS and I felt quite betrayed by my own body. Without realising it, I basically reacted by growing to hate my body and therefore alternating between dissociation from it and hyper vigilance which made the problem worse.

What is working for me is 'mindfulness of the body' practices (I can give more details if you would like me to) and treating my body like it is a pet or small child which I am responsible for looking after. Thinking in this way sounded silly to me at first, but it acts as adding a bit of space around the self hatred so compassion can start to creep back in. For example, when I feel the stomach rumblings happening, instead of saying to myself "oh no I can't believe this happening again, you are useless etc" I say "it's ok, I will look after you, no one is going to shout at you, it's a natural process, we can deal with this etc" - it makes sense when you think that if you shout at a puppy for peeing on the carpet it doesn't learn not to do it again, instead it will get frightened and end up peeing on the carpet again out of fear! 

So far I've gone from daily IBS to only having one incident in the past two weeks.

Hope you've had a better day. W

[snowbear]

10 hours ago, Wren said:

What is working for me is 'mindfulness of the body' practices (I can give more details if you would like me to) and treating my body like it is a pet or small child which I am responsible for looking after. Thinking in this way sounded silly to me at first, but it acts as adding a bit of space around the self hatred so compassion can start to creep back in. For example, when I feel the stomach rumblings happening, instead of saying to myself "oh no I can't believe this happening again, you are useless etc" I say "it's ok, I will look after you, no one is going to shout at you, it's a natural process, we can deal with this etc" - it makes sense when you think that if you shout at a puppy for peeing on the carpet it doesn't learn not to do it again, instead it will get frightened and end up peeing on the carpet again out of fear! 

  Exactly!

[Keyboard Worrier]

On 22/10/2021 at 21:32, snowbear said:

I'm not in the least surprised anti-sickness medication has no effect. Probably neither would anti bowel-movement medication or anti bowel-cramp medication. Why? Because this is all your gut responding to your mental state, its not about physical gut problems.

I was hoping this anti nausea medication would 'relax' things physically, so I could focus on pushing through the mental side instead.  It's an anti-histamine type rather than an acid reducing type.  I can't read up on meds (or anything bodily!) for more than a minute or two without making myself feel ill so can't do enough research to find out if the type of med I'm after even exists.  I can't seem to word things in a way for the GP to understand either.

I appreciate that the worst of this is being caused by anxiety (or panic), but it just comes on so quickly and so severely that I don't seem to be able to make any impact with breathing techniques or distractions as I could do previously.  Then the aftermath lasts for hours or days.  And latches on to any 'task' that I was trying to do at the time for weeks or months (based on previous events).  This time the washing up has been latched onto again (fairly regular latch since a bad D event in 2018) so each night since Thurs it's been really difficult, shaking, gurgling, gas, dizziness etc right up until the point I've dried and put away the last item, then it starts to ease off.  But that I can 'manage' and try to work with because it's not so physically severe and tails off soon after the event.  So for example I'll purposely push myself to clean the sink/bowl/drainer, or go through the cupboards writing a shopping list or something to stay in the situation a bit longer before going to the bathroom.   But I can only do that because of the lower severity and shorter aftermath.   Yesterday when I tried to walk I was still really wobbly & shaky (not sure if anxiety, bowels, cold or lack of calories!) and the vertigo at the top of the stairs was as bad as it was a month ago.  I did force myself downstairs but only managed a  much shorter walk than recent weeks and it didn't feel like any sort of success at all.  I was still shaking and needed the loo urgently when I got indoors again.  I've barely been able to eat anything for dinner the last couple of evenings either and the OCD around protein based items has meant I've ended up throwing out several protein based items that would otherwise have been dinner.  I can't work out whether I'm 'seeing' more in these things or whether prepared items genuinely aren't always cooked properly or good until their dates.  I still feel like there are just too many battles going on to have any idea where to 'start' and feel something to mask the worst of the physical issues for now is the only way I can make any real progress mentally.  Just repeating tasks through discipline doesn't work long term because it's not built on a decent foundation, so as soon as something goes wrong the whole lot gets knocked back to square one again.  Going back to an earlier post, I really don't know what a therapist would suggest both short and long term for this situation.

 

On 23/10/2021 at 09:09, Wren said:

Hello Keyboard Worrier, I just wanted to back up Snowbears excellent advice with my own experience. I have/had a lot of physical anxiety symptoms including IBS and I felt quite betrayed by my own body. Without realising it, I basically reacted by growing to hate my body and therefore alternating between dissociation from it and hyper vigilance which made the problem worse.

What is working for me is 'mindfulness of the body' practices (I can give more details if you would like me to) and treating my body like it is a pet or small child which I am responsible for looking after. Thinking in this way sounded silly to me at first, but it acts as adding a bit of space around the self hatred so compassion can start to creep back in. For example, when I feel the stomach rumblings happening, instead of saying to myself "oh no I can't believe this happening again, you are useless etc" I say "it's ok, I will look after you, no one is going to shout at you, it's a natural process, we can deal with this etc" - it makes sense when you think that if you shout at a puppy for peeing on the carpet it doesn't learn not to do it again, instead it will get frightened and end up peeing on the carpet again out of fear! 

So far I've gone from daily IBS to only having one incident in the past two weeks.

Hope you've had a better day. W

Thanks Wren, glad to hear that's had such a positive impact for you!

I've never been able to deal with kids or pets either though, so I'm not sure that's going to work for me. 

[Wren]

2 hours ago, Keyboard Worrier said:

I've never been able to deal with kids or pets either though, so I'm not sure that's going to work for me. 

Ah well ! In your description it sounds a bit like you are 'white knuckling' your way through your routines and ERP rather than fully leaning into and accepting the situation, therefore the anxiety won't reduce, which is probably, as you say, because you do not have a strong foundation of CBT. Have you tried going through some CBT worksheets (lots available free to download or get a self help book) in order to break down your problems into smaller more manageable tasks? 

 

[Keyboard Worrier]

16 hours ago, Wren said:

Ah well ! In your description it sounds a bit like you are 'white knuckling' your way through your routines and ERP rather than fully leaning into and accepting the situation, therefore the anxiety won't reduce, which is probably, as you say, because you do not have a strong foundation of CBT. Have you tried going through some CBT worksheets (lots available free to download or get a self help book) in order to break down your problems into smaller more manageable tasks? 

 

I never seem to reach acceptance, usually just circle back to denial eventually instead...   I guess I still don't understand how I'm meant to accept something that's being repeatedly proven that I can't manage it.  Maybe other people have some sort of strength that I'm missing there.

I did try CBT sheets given by a therapist a few years ago but I didn't get on with them.  Not sure if just don't have the right mindset but I couldn't really work out how they were meant to help.  I know I keep saying it but I do understand how CBT works in principle, what I don't understand is how to put it to practical use.