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10 years ago 0 +0 / -0 29

This program while titrating off of medications

THIS REPLY IS TO ASHLEY ONLY! NOTE: THIS WILL BE IN ALL CAPS SO AS YOU CAN SEE MY RESPONSE TO YOUR POST. YOU WROTE: "This is a great question. You may want to talk about this with your pharmacist or doctor. Health Educators are not doctor's so we are unable to give medical advice but hopefully some more members will be along shortly to share their experiences on titration and CBT. I DO TALK TO MY DOCTORS AND PHARMACISTS ALL OF THE TIME. DO NOT DISMISS THE INFORMATION THAT I AM PROVIDING YOU IN THIS CASE. YOU MAY NOT ANSWER ME FOR LEGAL REASONS, BUT YOU HAVE AN OPINION AND THEORETICALLY EXPERIENCE AS WELL. I DO NOT HAVE AN MD OR PHD BEHIND MY NAME, BUT THAT DOESN'T STOP ME FROM GIVING YOU MY THOUGHTS, EXPERIENCES AND OPINIONS BASED ON MY PERSONAL EXPERIENCE. In regards to [color=Red]Regarding (not "in regards to") that is improper English.[/color]a permanent solution CBT can provide that in a way. Anxiety is one of the most manageable metal disorders. Many people who put the work into CBT have little to no symptoms after some time. Keep in mind though that maintenance is required. By maintenance I mean stress management techniques, relaxation techniques, exercise, healthy diet and CBT techniques where required. It also depends on the severity of symptoms and if there are any other concurrent disorders. So I hope you are optimistic about treatment because you have a lot to gain from working on CBT. I think you will find the treatment results you are looking for. I know you just started the program but what have you noticed thus far? Any revelations or improvements? IN ANSWER TO THE QUESTIONS ABOVE. NO. Ashley, Health Educator The PC Support Team

10 years ago 0 +0 / -0 29

This program while titrating off of medications

IT PEOPLE ONLY!!!

The word processor used for this forum is extremely user UN-friendly. It needs to be undated with it utilizing the mouse's right button and the dictionary able to be used from that instead of having to check the whole document. Also this needs to be able to add words to a private dictionary like every other program, browser, email client, etc that is used today. This is so problematic that is almost disuades me from posting in a forum at all!!!! This is from a Firefox Browser. It doesn't work with Chrome either.

10 years ago 0 +0 / -0 29

This program while titrating off of medications

Ashley,

Thank you for your kind and quick response. Don't feel alone with the "in regards to" issue. I have seen newscasters use it. People that are paid to talk. That is pretty sad. It just happens to be one of my pet peeves and something I will catch before all else. I corrected another one of the Educators using the same phrase incorrectly...and yes I let her know as well. :)

As far as Davit, I do try to read his posts with temperance, but sometimes it is not easy when you are already dealing with so many of your own issues and need someone who understands and can give "tender advise". Having "forthright advise" has it's place, but for some people...me being one of them...I will shut down to "tough love" before responding well to it.

My biggest issue, as you saw my my other post, is trying to use this forum at all with the antiquated word processor that is at it's core. I can't believe this has not been addressed long ago as I have not had issues like this with any program on any site for longer than I can remember, unless perhaps the Radio Shack TRS-80 computer my dad had in the early 1980s...yes slight exaggeration...but only slight.

Be well,

Steven

10 years ago 0 +0 / -0 29

This program while titrating off of medications

Davit,

Well, it looks like I hit a nerve. If your method is going to be "tough love", that is fine. But use on on someone else. That way we won't have to argue. I will take my chances without your "insight".

Regards,

Steven

10 years ago 0 +0 / -0 29

This program while titrating off of medications

Ashley,

I don't question Davit's rights as to how he presents his views and experiences. I know all too well how the written word doesn't translate well when it comes to situations like this where having intonation and body ques to go by in addition to the words can make all the difference. Also, being able to get clarification on the spot if there is anything that is unclear.

I loath texting for that very reason and deal with a few people that use cell phones to text each other all of the time. It is creating a generation of people who's communication skills are horribly lacking. I won't even go into the rude behavior of leaving a conversation in the middle of a discussion or the poor grammar and ridicules abbreviations. I would literally outlaw them for everything except for use with the hearing impaired and for business use if I had my way.

As far as Davit's "style", it is a situation where he uses "tough love" and "take no prisoners" and I don't respond well to that approach. Some people do and thrive with it.

I have been in therapy for more years that many of my doctor's have been in practice and with enough different doctors and therapists through the years to know what I will and will not tolerate. I can tolerate having things brought to my attention that I don't "want to hear", but I will not tolerate a constant stream of it. I will shut the other person off. Something that comes with age I guess.

Steven

10 years ago 0 +0 / -0 29

This program while titrating off of medications

Katie,

I apologize for being dismissive. Over my 42 years in and out of therapy, I developed a very elaborate defense mechanism. I have learned (and got very good at...to the point of it being completely automatic) how to eliminate certain perceived threats. the key word is "perceived". This would of course include any idea that is contradictory to my own experience. Just in case you didn't read on one of these posts (I don't know now which one, but I am currently going through a titration off of Paxil, an SSRI that I have been on for 15+ years. the symptoms of the withdrawal were so intense in the beginning that I ended up in the ER without realizing what was causing them. The titration what being supervised by a doctor and pharmacist. I am now titrating at a slower rate and I am currently at 10mg per day from 60mg per day. I know I am much more on edge than normal because of this, so my defenses are on high alert as well.

Just out of pure experience and age, I am also less willing to "blindly" take someone else's experience as being one that would transfer to me as we are all different and what might work for you , might not work for me and vise-versa. I can apologize for my current state of mind, but I wold have to make a blanket apology as after I get off of the Paxil, then the Zypreza goes which was added to help me get off of the Paxil. then it's the Klonopin and then we will see about where I stand with the Tegretol. IT will be a while until I am balanced from all of that. How I do during each of those, only time will tell as each person handles things differently. I can only do what I can do. I cannot truthfully make any other statement than that.

I will say though, that I think you are very lucky that you are treating your issues at a very early age. All of my life has been ruined by sexual abuse at the age of 5 which only in Feb. of this year I truly realized did the kind of damage it did. I am very angry and bitter about the fact that it has taken away from me what it has. And let me say right now...I DON'T WANT AN OPINION ON THAT STATEMENT. I have heard it before and don't care at least at this point to hear anything again. If anyone cares at all that I feel comfortable using these forums, then they will not challenge me on at least that. In fact, if there is too much challenging of my posts, I will simply stop posting. I ask you is that beneficial? I deal with enough mental self-flagellation that I don't need any more external criticism right now.

Thank you,

Steven

10 years ago 0 +0 / -0 29

This program while titrating off of medications

Kaitie,

I do understand the concept of the forms. I understand that for some people they make sense right away. My issue with them is that they didn't "click" with me. It wasn't until I went to Session 2 without doing any of the forms (which I was lead to believe was something you shouldn't do) did I get some insight in to them. I am not saying that I am a convert just yet. I am saying that I am trying to figure this stuff out for if I don't understand something, I can't be benefited by it. That isn't the case of all things as Davit pointed out by using a car as an example..."you can drive a car without knowing the intricacies of an engine". As i said earlier, I no longer blindly accept much of anything anymore. Life has taught me that...whether that be good or bad, I guess it depends on the actual subject matter. Just as if someone said, "jump off of this building... there is a net that will catch you"...I would certainly not be the first to try. I would study the situation and analyze the outcome of others jumping and watching the results. Not a great example, I know...but it simply shows that I need to understand at least some aspect of something for me to do it.

All I was asking for regarding the forms was something that I could understand. It wasn't until I got to Session 2 and then read the "filled out" examples and then had anxious feelings that I could use to try the form out. I even attached the form to an email to Davit showing him that I had done one and also wanting to see if that was the right idea. Unfortunately, all I got was, " these forms are individual...between you and yourself" (paraphrased). I wasn't asking for a critique on the actual content or have the content analyzed. Just did I have to right idea. That was off-putting...to be blunt. Here I am trying to do what people (especially including him) were saying was soooo important and then I tried and get a response like that. To me...very disconcerting. But it could have been a miscommunication. Unfortunately with text based communication...that is a rampant problem.

I started this I think on the 18th and it is now the 24th. I have filled out 1 each of 3 different forms. My understanding is that I should be filling out more that that...at the very least, one per day....and the Diary portion is the same thing. Allot of the form based things on this simply are extremely limiting. It only allows for certain pieces of information and no more. In my case it doesn't allow for the fact that I am titrating medications. I can't put on a form that the symptoms could be completely a withdrawal symptom that happens to look exactly like Anxious Feelings or a Panic Attack. I have been told that I can start CBT at any point regardless of my medications. I have read 2 Sessions on the sister site regarding depression which I also suffer from. All of my symptoms are quite often interwoven. Having physiological symptoms on top of that where you aren't completely sure what is causing what is also an issue.

I have tried to figure out allot of this stuff over decades. Many things have changes through the years as well...mostly in that I have become worse and more things have been added to my diagnoses list. Without a support system in place, it is very hard to do allot of this stuff on your own...particularly when you are starting out in a new program such as CBT. To have someone who has already been through it come on like a CBT poster-child and then come on with judgement and extraordinary fervor is, at least for me..extremely off-putting. I have never liked groups because I was brutally harassed, verbally and physically growing up. Even though I wanted to part of a group and have friends like the others, it was better for me to keep to myself and play alone. Between the sexual abuse and the subsequent verbal and physical abuse I got from the other children, it cemented in my mind many of the characteristics that I still display. Now, I am faced with dealing with the aftermath of all of that. Also, being told (not here) that it isn't important to deal with the source of the issues, but to only deal with the behavior/symptoms that are occurring today goes against my base understanding. If something that happened long ago that is affecting you know, I don't understand how you can only look at the symptoms. All of my life, the doctors and therapists have looked at and treated the symptoms while never dealing with the source of the issue. If you put a bandaid on a bullet wound. Yeah, it covers up the hole, but it does nothing to repair the internal damage that has been cased. That is just my point of logic...and experience. The treatment that I have received since 1971 has been horribly lacking and ineffectual. Now that I have more information, I want to address both the symptoms so I can function, but also "fix" the damage that caused the whole thing in the first place.

I have gone on WAY too long here, so I will shut up.

Steven

10 years ago 0 +0 / -0 29

Session 3 and an example...didn´t know where to post this...

I have been reading Session 3 about Challenging Anxious Thoughts. I understand what is being said about "proving" if an anxious thought is true or not.

Changing a thought pattern by analyzing/questioning it, I totally understand and could do that. I see how that could make a big difference as far as "defusing" anxious thoughts.

In my case, my biggest fear is that it will cause me to loose controls of my bowels in public. This is a very real physiological response to anxiety or panic for me. It is a virtually guaranteed response/outcome.

How can you break the pattern where your body won't cause this kind of response? Keeping in mind that if I take medicine to "stop me up", it will in virtually every case cause a Crohn's episode (intense lower right quadrant pain like an appendicitis attack with overall feeling of flu-like symptoms [aches and low-grade fever]). A Crohn's episode will last about 3 days once started.

Dealing with the fear elements such as racing heart, sweaty hands, tingling, etc. are all symptoms, while very uncomfortable, will subside when the panic situation is gone and there is no tell-tale signs of them ever being there. In my case, in addition to those sensations and the feeling of wanting to be out of the situation itself, it triggers this bowel issue where I have to find a bathroom immediately or I will soil myself which will be not only embarrassing, but messy...causing me to go home and shower and clean my clothes. This interrupts everything you were doing and puts a huge thought in your mind to not leave the house for fear (and likelihood) that this will occur as it has occurred a number of times before. The urgent need for the bathroom can and does happen even at home where there is no threat of public embarrassment. I just happen to be close to the bathroom and can in almost all cases get to the bathroom in time to not have a mess.

As an example, a friend of mine was helping me to get out and go to a store I really wanted to go to. It is about 25 miles away and so there is a car ride involved and me as a passenger which I don't like to be, but with him, I trusted him completely and knew he would help me and not judge me regardless of anything happening. I was already anxious about the trip before we went as I am sure you can imagine. He was completely aware of the possibility of me needing to stop for me to use a bathroom at a moments notice. Well, about half way there, I needed to use the bathroom. Because this hits without warning, I told him to pull off the road so I could use a field to do my "business" (I live rurally). He said he would find a bathroom. Keep in mind that I cannot hold this back for very long at all once I have to go. We pulled into a random business and I had to go in and ask if I could use their bathroom...all the while holding everything back as hard as I could and trying to put on a good front for the people at the business. I basically made it to the bathroom with just a little mess. We then continued driving toward the store. After getting into the city where the store was located, I started to cry uncontrollably. My anxiety was extreme. He was very supportive and caring through all of this. We finally made it to the store and before going in, I tried to compose myself. While in the store, I had to go across the street 3 times to use a bathroom at a restaurant because of this issue (the store had no public restrooms). I was so anxious that I didn't even enjoy the store and finally said we had to leave after maybe being there 45 mins to an hour.

Once we were on our way back, my anxiety subsided completely and had an uneventful drive back home. That was a harrowing experience that was witnessed by someone. If that had been someone I didn't know so well and trust completely, it would have been even more disastrous.

Now, just like having a panic attack...this doesn't kill you, but this does cause a much bigger problem than having the symptoms/sensations of a panic attack that once resolved you can go about your "business" relatively easily.

Since my fear...the thought of public embarrassment is the big issue and it has proven itself multiple times (even at home), how do you deal with that cognitively?

My doctors (and specialists) haven't found anything truly wrong with my lower GI tract. They say it is anxiety induced and the only way to stop it is to eliminate the anxiety. This is after MANY exhaustive and expensive tests and trials of medications which had no affect without causing a Crohn's episode by "stopping me up".

In the following "experiment" (basically a visual one since I don't expect anyone to actually do this. Your imagination is plenty good to get my point) I'm not trying to be a "smart-a** here, but I wanted you to truly imagine living this scenario to give you an idea of what I am trying to figure out how to deal with so I can progress.

If you want to try an little experiment to know what it feels like, take a fast acting laxative and then get in your car or a bus or subway making sure you are with other people and go to a store that is about 20 minutes to an hour away. Then go in that store and start shopping for about an hour. Now if you can hold it in, in the first place until you can reach a bathroom, you are lucky. If you took a good laxative, you won't be able to do that. Then see what it is like have your anxiety or panic level raise with your normal symptoms plus this added issue. That is what I am trying to figure out how to deal with here.

10 years ago 0 +0 / -0 29

This program while titrating off of medications

Hi Kaitie,

I am glad to hear that I am not the only one who didn't do the forms from day one. I AM trying and it is just taking me time to try to figure things out.

I read through all of Session 3 and have yet another form. They are referring to previous forms. I don't know what is best. To stop reading since I have not done the forms, or to keep reading and then hopefully things will start to make sense and I will be able to fill out the forms to be able to work from. In some ways, this is all a big experiment for me. Since I don't have someone that can answer my questions as they come up, it slows me down and then other questions come up down the line as I am reading. Hopefully this will all balance out and I will be able to start doing the program as it was written.

As far as Davit goes, I am sure that he means well. I just don't think that he realizes how he comes off sometimes. For someone who is not trusting and yet desperately looking for someone to trust to help me through understanding these things (in this case), it is very hard. I am in a fragile state with the the med changes, the interwoven health issues, both psychological and physiological. Having something "thrown" at you puts people on the defensive...particularly those who have had experiences with many methods that didn't work in the past. I am realizing allot in these past few months that I have never thought of before. This is good on one hand, but on the other hand, truly shows me that I have been messed with by people that I trusted. That only makes a person distrust first...ask questions later.

Based on what little I know of Davit, he does have allot to offer, but it is only useful if it's delivery is appropriate to the person it is being delivered to. He mentioned how his therapist was "intense", but helped him allot. I know without question that I would have left that therapist in an instant because they were unyielding and self-righteous. He had to have courage to be able to deal with a person like that. I need someone that is more nurturing and willing to listen to me and able to tell where I am at and coming from. I wouldn't give someone like he dealt with the time of day...and if they persisted, I would have gone on the defensive and if they persisted, I would have threatened them with disciplinary action from the governing factors that control their license...something any doctor fears the most. When I am threatened, I threaten back. This is a "coping mechanism" that I learned working for a law firm for a number of years.

In any case, I can only do what I can do at any given moment. I am doing the best I can do at this point. Hopefully as time goes by and I gain more understanding, I will be able to better utilize this program.

In answer to you question about having a good therapist. I have one that I have only seem a few times. She is looking promising, but we haven't gotten into the "meat" of anything yet. She has done CBT before, so it is likely that she will be able to help me more with this. I am trying to get weekly appts. with her because having appts. every other week, just isn't enough. To much is happening and too much falls through the cracks.

Thank you for your response.

Steven

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