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Overwhelmed with feelings of hopelessness. Is someone available to talk?
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I believe that I can help you.
I know that you are feeling desperate right now, but almost every tribulation can be overcome.
You have gone off line at the moment and so I will not be able to continue the chat without you. However, I shall save the chat and you can pick it up when you come back on line.
Hi there - i'm back.
ok Here you are :)
I am ready to help.
Not sure where to start...
What is your biggest stressor and how is it affecting your life?
Health anxiety. I have been in an acute period of dealing with it for the last couple of years, and am at the point where I feel like it will never go away, and I will never again be happy.
What is your health problem?
I have not been diagnosed with depression, but I'm almost certain that this health anxiety is also causing depressive issues.
No health issue has been diagnosed, it's simply anxiety over the fear of illness.
So this appears to be a question of an anxiety disorder, perhaps Obsessive Compulsive Disorder (OCD).
Do you imagine a particular disease or is it a general feeling?
I live almost every day in fear for when I will develop a health problem. My fears kind of jump around, but are always with respect to any terminal illness. Cancer, neurological, etc.
Have you had any psychotherapy or are you taking medications for this?
I have previously tried Lexapro (did not work), and am currently taking Zoloft, which obviously is also not working. I have had some cognitive behavioural therapy, and most recently just returned from a two month inpatient stay in a mood and anxiety disorders program.
What was that program like?
It consisted of mainly group based therapy, as well as different psycho educational groups (relationships, boundaries, etc.).
Which did not address your issue, I presume.
I'm not sure if it was the components of the program itself, or simply the change of environment, daily schedule, and diversions for my mind, but I did feel much better while there.
However, since being back (about a month), I have slid back into just where I was when I went in.
What is your daily schedule like at home?
I don't really have one. I realize this is a problem. Much of the classes that addressed transition back into daily life I missed, as I had a miscarriage a couple of weeks before the end of the program.
Are you married? Do you live alone or with husband or partner?
I am married.
How would you describe your relationship?
He's a wonderful man. I was married previously, to someone completely different. Awful man.
Were you very abused?
Emotionally, I suppose. Not really anything more than that. He was horribly jealous and controlling.
When did your obsessive thoughts about illness begin in relationship to your first marriage?
Well, I've been a bit of a hypochondriac since my teenage years, however, the disabling thoughts began shortly after that relationship ended, and my new relationship began.
How were you a bit of a hypochondriac (your term) since you were a teenager?
I would have health worries from time to time, but I was able to dismiss them relatively easily, and was not disabled by them. But they were also about serious illness.
How was your home life growing up?
thank you so much for talking to me, by the way, I'm so sorry to be taking up your time.
I am here to help you and I want you to feel that you have made some progress when we are finished. I am happy to help you, and you need some support.
My home life was good. I'm an only child, and my parents were older when they had me. They are still together.
Did you ever witness or experience anything traumatic or horrific, or ever have a serious illness?
My mother is what I would call a general worrier. My father is not, however has very obsessive tendencies. I do not recall experiencing anything traumatic as a child, and never witnessed serious illness.
Can you illustrate or describe your father's obsessive tendencies?
He is just very, very repetitive with things. For instance, he would obsess about lights being turned off, and would literally follow my mom and I around, turning them off the moment we left a room.
Or, even today, if I go to visit them, he is obsessed with ensuring my travel plans to return home are made, and asks me about them incessantly.
That is OCD - a classic example. Did you know that at least 2 out of 10 people with OCD come from families where other family members had this condition. It is, in part genetically based, and it is also LEARNED behavior.
How about your mom's worrying?
Her worrying is really just that she's afraid...of everything.
And how does she deal with this worry?
What does she do then, physically (pacing, hand wringing) or verbally?
Verbally, I suppose. She won't fly, won't drive on the highway, is petrified of heights of any sort, won't come to visit me in the city, etc, etc.
One moment, be right back.
I will respond while you are away.
She is suffering from extreme anxiety and some of this thinking may also be obsessive. OCD is an anxiety disorder and you have two parents who suffer from anxiety and have:
-probably inherited their genetic tendencies
-learned by their modeling behavior, to react as they reacted. That is the way children learn how to respond, whether or not the responses are appropriate.
One more question. You recently had a miscarriage. Have you had one before or have you had problems conceiving? Do you have children?
I don't have children, and this was my first miscarriage.
Have you tried to have them?
Do you want children?
Have you previously tried and failed to conceive?
I do. We had been trying for a few months. Well, not actively trying, but not "not trying".
This is not a long-term stressor on your life, then. Do you have any long-term stressors?
hmmm, my previous relationship, I suppose. some of my friendships too.
You have had cumulative stressors during your life. Stress is considered as a factor in obsession and can make a person vulnerable to fear, anxiety and osbsession. Combined with your tendencies and learned responses, this is probably WHY you have these obsessions.
but why over health?
It is very hard to know and sometimes it is not one reason.
perhaps because it's something I cannot control?
Why over making sure the doors are locked?
You made a good point. It is something you cannot control and can and does strike all people.
NOW, what to do about it.
So then, million dollar question. How do I treat it?
We are on the same page.
Because I cannot go on in a constant state of fear and hopelessness. My mind wanders to places I really don't like.
First, you need to find a therapist who specializes in anxiety disorders. You can perhaps find one at psychologytoday.com but read the entries carefully because many will claim they can help anxiety but few are truly capable.
Second you need to speak to a doctor or psychiatrist about changing your medication. Psychiatrists usually do not do much psychotherapy, if any, but they know about psychotropic medications.
I've kind of thought that a medication that addresses the OCD might be in order.
Your current medications are ineffective and you might suggest to MD or psychiatrist that you would like to try clomipramine (Anafranil), and also try a low dose of an antianxiety medication known as lorazepam (Ativan) which work for general anxiety.
They seem to be very hesitant to prescribe Ativan.
Not because it is inappropriate but because using it a lot can be habit forming, but moreover, because doctors live in fear of the DEA and there are many drug seekers who want to get Ativan or other benzodiazepines. Nevertheless, used prudently is an appropriate and effective medication. You might have better luck with a psychiatrist is your own GP is reluctant. Many doctors will prescribe it as it is the most effective for general anxiety disorder (GAD).
Let me recommend a self-help workbook written by professionals.
I sure hope something helps, because at this point I'm about ready to check myself into a psych ward.
That would be rash when you have other things to try first. You should never have to reach that point, but I do understand that you are feeling overwhelmed.
I guess it's just that it provides a feeling of safety. Being at home, alone, with my thoughts, does not.
and this book will be coming out in a few months:
You need to find a job or a routine and stick to it to distract yourself from these irrational but overpowering thoughts. This will go a long way.
Register for a class.
Volunteer at a school or nursing home or library.
yes, I know. I think that's part of why the program helped me while I was there. Distraction.
Work on this problem from all angles and it will help you to focus your mind on real things.
Well, thank you very much for your help.
I shall keep you in my prayers for complete recovery. I see that in your future as long as you try a multi-pronged approach.
Elliott, MAE, LPCC, NCC, CCMHC