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Therapy, anyone?

Old 09-04-2007, 06:37 PM
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Therapy, anyone?

Staying sober and eliminating caffeine has helped somewhat with my anxiety but I still don't feel as well as when I was on antidepressants. I quit taking them cause they made me gain a whole bunch of weight. They were prescribed by my GP and I have never seen any kind of therapist or mental health professional.

I'm not adimantly opposed to getting back on the antidepressants but I think I should give therapy a shot. I have generalized anxiety disorder (according to my GP, anyway), and I've had a couple full blown panic attacks but not since I started tai chi and meditation. I've heard that CBT can be pretty effective, so I'm thinking it's time I look into that.

So my question is for anyone who's done therapy. When "shopping" around for a therapist what should I look for, what kinds of questions should I ask? Does it matter if I see a psychologist, psychiatrist, councellor or therapist? Also, did you find therapy helpful? Any other comments, questions or suggestions are welcome.

And will there be a free initial consultation so I can "interview" prospective therapists or do I just have to make an appointment and pay for the visit as though it were a "session?"

Thanks in advance for any advice.
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Old 09-04-2007, 07:14 PM
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There is online CBT at www.livinglifetothefull.com and at www.moodgym.com. I can't advise on therapists however. I havn't been to a therapist/psychologist in years. Psychiatrists tend to focus more on the medical basis and medications than the therapy. Hope this helps.
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Old 09-05-2007, 05:24 AM
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Hi Scarlati,

I have been to all kinds of therapists and psychologists, even psychoanalysis, which got me nowhere. I think CBT will be very helpful and I recommend it.

I donīt know how it works in the States, but I got my therapists from my GP. He recommended them to me and I went to one session to assess them. I usually told them about the problem and asked them how they intended to help me. If I didnīt like their methode, I told them and went on to the next one.

To me itīs a collaboration. Tell them what you told us, and ask them how they intend to help you. Some people say they can cure you in 6 sessions and demand a lot of money, beware of this.

I will think of some more questions. In the meantime, good luck!

Love and light,
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Old 09-05-2007, 01:48 PM
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Thanks

Thanks, ladies.

My insurance company's web site has profiles of all the in network mental health professionals in my area and their profiles list the techniques they have experience with. I'm only going to contact people that list CBT and have experience treating people for anxiety and alcoholism. With my insurance I don't need a referral from my GP so I'm free to just start calling around.
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Old 09-10-2007, 06:49 AM
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Scarlati,

Fortunately, I have a good psych on same issue. My psychiatrist was very good at talking me down.

Im in outpatient rehab for alcohol w/d, as well as panic/anxiety.

If ur not satisfied with the one ur with, keep shopping around........Ur bound to find the right one.

"Try on enough shoes, and you'll find the pair that fits"
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Old 09-10-2007, 07:03 AM
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Hi Scarlati,
I think the best results come from a mix of therapy and antidepressants. For drugs, a psychiatrist is what you need. For therapy, either a psychologist or psychiatrist would work. When you 'shop' around for docs, you need to ask specific questions regarding what you're looking for. If you like CBT, (guided imagery, in vivo exposure, challenging faulty thinking, diaphragmatic breathing, etc.) it works great for most people w/anxiety related disorders.

I've never heard someone not charging for an initial session. In fact, most 1st sessions are More expensive then the subsequent ones. You can ask the doctors if they will work on a sliding scale, meaning adjust their cost according to your means. Most docs devote 10% of their business to sliding scale, the successful ones that is.

Dr. Young is a force in the CBT field for anxiety disorders. He and others have written great books on anxiety related disorders. CBT requires some homework, so be prepared to work a lil to overcome your anxiety.

I wish you the best,
Dave
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Old 09-11-2007, 03:06 AM
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I wouldn't advise antidepressants as a good therapy for anxiety/panic. Antidepressants increase the level of serotonine in your brain but there never has been any proof that anxiety patients (without depression) have a lack of serotonin. Yes, these drugs often help because they make you feel so good you "forget" about your anxiety but they often come with a lot of negative side-effects.

There could be a lot of physical causes for anxiety/panic like hypothyroidism, hyperventilation and so on. I made a list here http://www.soberrecovery.com/forums/...c-attacks.html

In my case the anxiety is probably caused by hypothyroidism and a history of alcohol abuse. I am visiting the endocrinologist next friday but I will also start my CBT course this week.

One more link why antidepressant can cause damage to your brain http://www.antidepressantsfacts.com/...oglycaemia.htm
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Old 09-15-2007, 09:32 PM
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Thanks for all your input, everybody. I met with a councelor last week and I really liked him. And I expected to need months of therapy before my condition improved but he helped me see some things about my unhealthy thought patterns that have made me feel much better in just a couple days.
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Old 09-15-2007, 10:05 PM
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Originally Posted by nakur View Post
I wouldn't advise antidepressants as a good therapy for anxiety/panic. Antidepressants increase the level of serotonine in your brain but there never has been any proof that anxiety patients (without depression) have a lack of serotonin. Yes, these drugs often help because they make you feel so good you "forget" about your anxiety but they often come with a lot of negative side-effects.

There could be a lot of physical causes for anxiety/panic like hypothyroidism, hyperventilation and so on. I made a list here http://www.soberrecovery.com/forums/...c-attacks.html

In my case the anxiety is probably caused by hypothyroidism and a history of alcohol abuse. I am visiting the endocrinologist next friday but I will also start my CBT course this week.

One more link why antidepressant can cause damage to your brain http://www.antidepressantsfacts.com/...oglycaemia.htm
You're right that antidepressants aren't right for everyone. Having said that, I still believe anti-D can be wonderful for a lot of people. For some it can be life-saving. And studies have shown the most effective way to treat depression, anxiety and other common disorders is a combination of drugs and therapy. Yes, we still don't know what deleterious effects anti-D will have on people, or how they really work, but we do have the outcome studies and the overall results are they do much more good than harm. They save lives. Quality of life goes up too.
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Old 09-15-2007, 10:09 PM
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Glad you found someone. In case others are looking, I wanted to share some thoughts.

The therapeutic relationship is essential for making meaningful change (there is a ton of research that supports this finding). Finding someone you are comfortable with is REALLY important.

Find someone who's orientation you feel like you can work with. CBT, DBT, Psychodynamic, etc. (As an FYI, the research most supports CBT as the most effective for anxiety related stuff)

You asked about what kind of therapist/degree is best.....and the answer is....it depends. I think first and foremost, the person needs to have experience and expertise in your area. Be VERY wary of anyone who says, "I handle everything". My professional bias would be to look for a clinical psychologist (PhD/PsyD), because they are the highest trained professionals in the field.

With that being said, don't be snowed by a bunch of letters after a person's name, I'd be much more likely to refer to someone who specializes in a certain area (e.g. substance abuse), then a generalist who has a PhD/PsyD. Substance abuse in particular is a very complex area, and you want to make sure whoever you see has experience in the area.

Finally.....talk to your primary care provider. They should know some locals they feel comfortable with. Rarely will a provider keep someone on file who doesn't do good work, because referrals go both ways.

Best of luck with your new person!

-p

ps.. Afraid2Succeed is completely on the money about therapy + meds as the most effective treatment. An often misunderstood anti-D idea is that suicide risk goes up on Anti-D's (ideations were reported to increase, I think it was 2%-->4%, but the attempt % did not increase). There was actually a huge spike in suicide attempts AFTER the black box warnings came out for SSRIs....not because they all of a sudden caused more attempts, but because SO many people quit cold turkey or didn't go on them, and they became suicidal OFF the medication. So
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Old 09-15-2007, 10:16 PM
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It's so funny that the therapeutic alliance accounts for most of the benefits in therapy. Doesn't take 4-5 years of training to develop that.
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Old 09-15-2007, 10:19 PM
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Originally Posted by Afraid2Succeed View Post
It's so funny that the therapeutic alliance accounts for most of the benefits in therapy. Doesn't take 4-5 years of training to develop that.
That's incorrect. The therapeutic alliance has been found to be a major contributor to outcome success, but it isn't the sole contributor. Carl Rogers spoke of the importance of the therapeutic relationship in a number of his books, quite interesting stuff. "A Way of Being" is a classic, and was the pre-cursor to "On Becoming A Person"...both of which are modern classics.

And it is 6-7 years.

-p
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Old 09-16-2007, 06:47 AM
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Originally Posted by pedagogue View Post
That's incorrect. The therapeutic alliance has been found to be a major contributor to outcome success, but it isn't the sole contributor. Carl Rogers spoke of the importance of the therapeutic relationship in a number of his books, quite interesting stuff. "A Way of Being" is a classic, and was the pre-cursor to "On Becoming A Person"...both of which are modern classics.

And it is 6-7 years.

-p
in the program that I was just kicked out of (long story, Dont get me started) the internship was built into the 5 years. I guess if you include post-doc training, it's 6 years.
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Old 09-18-2007, 06:10 AM
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Yeah, depending on your research (4-5 years), one year internship, and then post-doc (since you still aren't licensed until afterwards), I figure 6-7....of course, if you want to be a neuro, it is a 2 year post doc. My neuro work is more pharma based, so I'm going into a health sub-speciality instead.

-p
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Old 09-19-2007, 05:55 PM
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One thing to think about is that different ssri antidepressants work differently from one person to the other (in my experience). I am on Cymbalta 120mg for depression, anxiety, big time OCD and actually joint pain associated with Lyme disease. It works great for me. I wouldn't even consider going off.

My wife has tried 3 or 4 different ssri's and has had her best luck with Cymbalta also, worst luck with Zoloft.

Anyway good luck, finding the right therapist/psychologist is tough.
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Old 09-22-2007, 10:57 AM
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Smile Hello all,

I'm glad to be back...and so grateful for this site. It's amazing just reading the great recovery stories, and the support that has come to so many.

I've been in therapy, with this particular therapist for about 6 years now, and I'm feeling kind of a plateau. I'm on Celexa, and have been on other SSRI's too. My therapist thinks I should try something to treat ADD as well. I'm not so sure, but I know that I have issues with organization and attention.

Thanks for being there!
Lena
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Old 09-22-2007, 12:11 PM
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Just an update for anyone interested.

I ended up with a Licenced Professional Councellor. I've had 2 sessions and am already turning my life around. It seems that a lack of self confidence has been a major contributor to my anxiety so I'm doing some activities to build that up. I'm already feeling more sociable and energetic. Anxiety is still an issue, of course, but I'm getting out of the house a lot more and have made some new friends. And being more socially active has been keeping my mind off drinking. I still have a way to go to build the life I want but I'm moving in the right direction.
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Old 09-22-2007, 12:33 PM
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Good for you, Scarlati! Keep up the good work. So glad you found a therapist. That has saved me on many days. :help
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