Fatigue 1, Ellie 0

Can’t concentrate at work today. I feel tired and anxious. Pain is bad too so I came in late.

I don’t know what has brought this on. I feel the need to eat a load of crap. Last night I ate a load of chocolate. Then I always feel sick and hate myself more. I don’t know why I do it.

I have lots of ideas for blog posts but for some reason I’m struggling to get them written. I have nearly finished a post about my book challenge so far, as we have just passed the half way point of 2018! Actually, I have lots of ideas in general and things I need to get done, but I’m finding myself procrastinating instead.

The fatigue is hard today. My body feels heavy, tired and achy. I just want to crawl into bed. Only 3 hours left at work then I can go home to pyjamas, dinner and a pre-football nap!

Love,

Ellie

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Enjoying nature

I’m away in Germany for a few days, and I’m having a really nice relaxed time catching up with friends.

The weather is absolutely beautiful, and so I’ve spent most of the weekend outside. Apparently here, swimming in lakes is a big thing, and we went to a lake yesterday, and another one today, and lay out in the sun reading and then went for a swim.

It was bliss. (Once I got over the initial feeling of cold water!!) I am not a strong swimmer, so I didn’t go very far, but it was really nice and refreshing.

Picture of a beautiful lake and a bright blue sky

Nature at its finest – sehr schön

I’ve heard that swimming in cold water is meant to be good for anxiety. I can believe that as I felt very calm – It felt so nice, like a weight had been lifted. I also felt like it helped me relax my body, so the achy-ness calmed down. I was in the moment, and enjoyed the moment. For that short time I wasn’t worrying about anything, I was just enjoying the feeling of being in water, and the sun’s warmth.

I know there’s a lake quite near me at home where you can go swimming, so maybe I’ll give it a go…

Last weekend I was camping with scouts, and this weekend I’ve been outside a lot too. It’s reminded me how beautiful nature is and that it gives me a chance to relax and breathe some fresh air. The lovely weather definitely helps though – it makes nature sparkle! It makes me happy, and anything which makes me happy is good in my book, especially if it’s actually healthy!!

So that’s my new goal for the rest of this year – go outside more. Go to the countryside. Go to the park. Enjoy nature and allow myself time to really relax, because I never really stop, but maybe I should sometimes.

I hope you can enjoy nature too!

Love,

Ellie xx

When you least expect it

I was on training today at work. It was based on Compassion Focused Therapy, and I found it really interesting. I can really identify with the model and I want to learn more about it.

I knew that a lot of it resonates with me, but I didn’t expect what happened. At work I have my shit together (most of the time anyway), and I don’t like to bring my issues to work, particularly in front of a group of colleagues.

We were doing a visualisation about the compassionate other. We had to imagine the “ideal” compassionate other – the characteristics they would have, it could be a real person we know or imagined. Obviously this threw up some stuff for me. The description of strong, caring and committed reminded me of S, of what S used to be to me.

He was my compassionate other, he made up for my lack of self-compassion, and obviously I don’t have him anymore. At one point I realised I had tears streaming down my face. I was getting panicky, I half ran out of the room, to the toilets. By that point I was hyperventilating, full panic attack and I couldn’t stop crying.

I kept telling myself I need to stop because I’m at work. I managed to slow my breathing eventually. Tried to get the tears under control. But the voice in my head, the self-critic, was so loud. It spiralled:

You’re pathetic

You are a failure. You can’t even get through training at work, how can you do your job?

You’re a hypocrite. You want to help others but you’re a mess yourself

You are alone and always will be.

You messed up your chance at happiness

You don’t deserve to be happy, you don’t deserve to be loved

No one will ever fill that space.

How can you be a therapist when you can’t even manage your own shit? You should give up.

Others must think you are incompetent, broken, a mess.

I hate you

You are a failure. You are not good enough. You are unlovable.

It was pretty intense. Some of my colleagues came to see if I was ok, I felt very embarrassed. I am absolutely mortified that this happened at work.

My brain took me straight to some difficult places. I thought about hurting myself. My self-talk was so negative, so critical, so angry – I know I would never speak to anyone else like that. It made me doubt myself in so many ways – professionally, as a person, as a friend, the list goes on.

I don’t know if I’ve written about this on my blog, but in September I am due to start training as a CBT therapist. Today I genuinely considered emailing them and saying i won’t be taking my place on the course. I’m terrified. If a 2 day introduction to compassion focused therapy training can do this to me, how will I cope with training as a therapist? Maybe I can’t do it, maybe I’m not doing as well as i thought I was.

I was not very self-compassionate today, which was ironic given the topic of the training.

I didn’t expect a response like that at all. I knew it might press a few buttons, but this was a physical response. I had no control of my tears and no control of my breathing. I got pins and needles in my hands and felt dizzy. It had been several months since my last panic attack, and I had almost forgotten how horrible they are.

This was nicely followed up with a migraine this evening. I feel exhausted mentally and physically. I’m trying to be kind to myself now… I am having a quiet evening, reading my book, had a sleep to try to get rid of the migraine. I have texted my therapist to tell her what happened, I want to talk about it in our next session: I clearly have issues around compassion, around attachments and around S (duh!!) which need to be dealt with.

Love,

Ellie xx

Those bloody forms

As with any NHS funded CBT, I had to fill in my favourite forms ever* on the first, middle and last sessions. The PHQ9 and GAD7 (AKA those bloody forms) are measures for depression and anxiety respectively.

The scores are used to determine the severity of the condition, the cut offs appear to be up for dispute, but these are the scores they went off:

PHQ9 (depression)

0-4 none

5-9 mild

10-14 moderate

15-19 moderately severe

20-27 severe

GAD7 (anxiety)

0-4 none

5-9 mild

10-14 moderate

15+ severe

When I started, my scores were 18 (PHQ-9) and 13 (GAD-7), on the middle session 17 and 13, but by the last one they were 10 and 9. I know they are just numbers but I don’t think I’ve ever scored so low on them! And, even better, I think the scores decreasing actually matches how I really feel – a lot better!

I think my baseline is probably higher than the average person. So most people (without anxiety or depression) would score 0-5 on both as their baseline, but I actually think that even if things were amazing, I would never score below about 6-7 in either test. I am an anxious person and probably always will be, part of that is my personality. Likewise with depression, I tend to be a bit pessimistic and I am hard on myself and always have been, that’s part of who I am. I’m ok with that though, as long as my depression and anxiety are at manageable levels, it really doesn’t matter that I’m never going to score 0 on those bloody forms!

So I’m pretty pleased that according to my scores on that day, my depression has gone from the high end of moderately severe to the low end of moderate, and my anxiety has gone from the high end of moderate to mild.

Progress is good. I know the numbers aren’t reliable, for example when I completed the questionnaire the first time, I wasn’t entirely honest on the PHQ-9 and my actual score would probably have been 20+, but as an indicator, they are useful.

Love,

Ellie xx

*in case tone can’t be inferred here, this is definitely sarcasm!

Reflecting on CBT

I had my last session of CBT for fatigue this week. We were only allowed 8 sessions, but they have been quite spread out.

I found it really useful in some ways, but in others I am still dubious about using CBT to manage fatigue.

I am definitely more aware of how my fatigue, pain and mood are linked together. I have known for a long time that pain and fatigue cause my mood to be lower, but I came to the realisation that also my mood affects my pain and fatigue.

We looked at the “boom and bust” cycle, which is evident from my activity diaries. This is how it goes: I feel ok, so I make lots of plans and make myself busy (boom) but then it becomes too much, and I feel like I can’t cope, so I stop everything (bust). Then when I start to feel better, I start over committing to things to make up for my (perceived) failure, and so on and so forth…

Being aware of that cycle actually really helps. Even though that’s simple and anyone could see it, now I really understand it. It helps me understand my fatigue and also understand my needs. So now, when I’m feeling good and like I want to make LOADS of plans, I try to be more balanced. So, if I know I have a busy week, I try to leave the weekend relatively empty, or if I have a busy weekend, I make sure I have some weekends without plans. The ideal seems to be having plans on one day at the weekend and not the other, but that’s not always possible.

I think I feel more in control of my life than I did before. Now I am more aware of how certain things will affect me, I can sometimes control some of those things. I know that I will still make the same mistakes sometimes (hard to unlearn a life of constant busy-ness!) but I feel more in control and that makes me feel more positive about things.

The CBT helped me to change the way I think about things, and reminded me of the skills I learned before when I had CBT. I still find the thought traps really useful, I’m a big offender where they are concerned. It’s funny (in a weird way) that I have all these issues with anxiety and depression, because I spend a hell of a lot of time giving my clients advice and support for the very same issues I have myself.

Has anyone else had CBT for fatigue? (Or anything else actually?) How did you find it?

I’m planning to write several more posts on more specific things we covered in my sessions. I am feeling in a writing mood at the moment so I have lots of ideas for posts, just need to write them!

Love,

Ellie xx

Friends matter!

I’m all smiles today. Tired, but happy. I’ve spent the weekend staying with my best friend, we had a lovely chilled time and it was so nice to catch up properly with no reason to rush around for once.

Friends are such an important part of wellbeing. In the 5 ways to wellbeing* (more info on this on the Mind website) connect is the first on the list. It has been proven that connections, social networks (in real life rather than Facebook!), friendships and relationships have a massive affect on wellbeing.

I am a very social person. I have a lot of friends and I like being around people. Sometimes Often I get socially anxious, especially when I’m around new people or new situations, and I definitely need my ‘me time’ too; socialising sometimes makes me very tired, but other times it energises me. I guess you could say I’m an extroverted introvert, or an ambivert?!

I know how lucky I am to have the friends and family that I have around me. When I am feeling low I start isolating myself, but I know this makes things worse. I have been reaching out a lot more lately, and have reconnected with some friends I had lost touch with. So please, reach out to friends and family, find ways to build connections in your life. Friends matter!

Love,

Ellie

*will probably do another post on the rest of the 5 ways to wellbeing

Hello anxiety

Today I had to go to a presentation evening because I achieved an award through scouts. I was dreading it. It turned out to be so much worse than I expected.

Even though I knew most of the people in the room, I felt so anxious. Knowing I had to stand up in front of people and answer questions was anxiety provoking. Waiting for that moment was agonising.

I got through it. I found the whole experience incredibly awkward and was literally shaking, but I got through it.

Then someone came up to me and started criticising the way I run my cub pack. Because of my already high levels of anxiety, it really got to me. Instead of being angry, I was quiet. When she had gone I basically had a melt down in a cupboard. Tears and panic. And then I couldn’t stop crying. It really got to me. Cupboards seem to be my new place for panic attacks. Oh dear!

Now that it’s over and several hours later I have stopped shaking and crying (although my eyes still feel like they’ve been crying – you know when they feel dry and sting a bit?) I am feeling quite angry about the situation. I don’t really know why this person was there, and I don’t know why they thought that an award presentation was the best place to make me feel like crap, but for some reason it happened.

It really pressed my “not good enough” buttons. I worry that I am not a good cub leader. I know that I don’t manage to do everything all the time, but that’s because I have a full time job and a life outside of scouts that I have to fit in too. Obviously the last few months has been bloody awful for me, and I’m very aware that I haven’t been on top form in organising things.

Anxiety levels were really high this evening. It’s really sad because I had been feeling better than I have for ages this weekend until that. My parents said not to let her ruin it, but it’s really tainted the evening.

I kind of forgot how physical and how consuming my anxiety can be. I sat throughout the presentations shaking and feeling really on edge. I was unbelievably warm (not helped by the heater directly behind me!) All I could think was “I can’t wait for this to be over”, so I didn’t really get to enjoy it at all. When I had to stand up and answer questions it was really hard. I struggled to answer questions and when asked to say a simple sentence in german (it was relevant honest!), I couldn’t even do that, embarrassing!

Take home message – anxiety is still definitely something I need to work on. And the whole “not good enough” fear comes up in more contexts than I had realised. At least I can reflect on this now, and this is definitely an example I will mention to my CBT therapist this week.

Time for bed now, and hopefully tomorrow will be a less anxious day!

Love,

Ellie xx

Intrusive thoughts and distractions

Trigger warning: this post talks about vomiting, self-harm and suicidal thoughts.

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This is a hard post to write because I haven’t said (or typed) this to anyone.

I think intrusive thoughts are quite common in many different mental health conditions, but lately I’ve been experiencing a new one.

Every time I eat, I can’t stop thinking about making myself throw up. I haven’t acted on the thoughts but it feels like it’s getting stronger. I know that it can quite easily become addictive, a form of self-harm I guess.

It seems like a strange thing to worry about because I haven’t actually done it but sometimes intrusive thoughts become so intrusive that you end up acting on them.

I am still experiencing quite strong urges to cut myself at times. I haven’t acted on those thoughts since NYE, but the scars on my leg remind me every day. Actually it’s probably the scars on my leg that have stopped me. I remember how fleeting the relief was, and how guilty and bad I felt afterwards, and then I do something, anything to distract myself.

That’s how I’m currently managing the thoughts about making myself sick. The problem is that every time I eat I feel sick at the moment. I am struggling to eat properly, and then sometimes I just eat a load of crap, and then afterwards I feel bad. A lot of distraction is needed.

The more I’m typing this the more I’m concerned about my current relationship with food. Things are particularly bad at the moment as I’m really struggling with managing my wellbeing; I am stressed at work and I am still feeling awful about S, he has a new girlfriend and that is really hard. Every instinct tells me to harm myself in some way, that I don’t deserve to be happy, that I am a bad person, that I am fat.

The intrusive suicidal thoughts are hard too. When I am experiencing that, everywhere I go I see potential methods of suicide. I fixate on how I could end my life, where, when, how. To bring myself down from those, I try to think about my friends and family, all the positives in my life. I say to myself “not today”, and that keeps me safe. Once I am out of that dark place, I can’t imagine how I thought that way, but I slip in and out of these thoughts quite easily.

In CBT last week, I had to fill in THAT BLOODY FORM (PHQ 9 and GAD 7 – measures of depression and anxiety). I put “several days” for the question on “thoughts that you would be better off dead or of harming yourself in some way”, so my therapist asked about it. I was honest and said I sometimes get thoughts about self-harm and Suicide but I don’t have plans to act on them. She looked back at my first form from before Christmas and I had put the same, “several days”, but in reality it should’ve been “nearly every day”. I wasn’t honest on the first one because I was worried I wouldn’t be allowed the CBT. I should probably tell her that next time.

I keep writing these long rambling posts which were not what I intended to write when I first started typing, but it’s probably good to get it out. Anyway, back to the topic – intrusive thoughts and distractions.

I have been managing to avoid the behaviours by distraction. I am getting better at texting friends if I am struggling (not necessarily about how I am feeling) or going downstairs to spend time with my family and dog, and that can help sometimes.

My other favourite distractions are YouTube videos, reading fiction, colouring, my bullet journal and my mindfulness meditation app (I’m up to 155 days in a row!) Another thing that can really help is writing – either in my journal or here on my blog. Sometimes letting it out is the most healing thing.

I hope my ideas might help others a bit. What distractions do you use when you are struggling with intrusive thoughts?

Love,

Ellie

Progress

Progress is in the small things;

It’s getting through a whole CBT session without crying,

Going through a day without thoughts of self harm,

It’s feeling happy, even for a short while,

Remembering what it is like to feel proud of myself,

When the smile is real and there is hope for the future,

Making plans which I genuinely look forward to,

Little by little, step by step:

That’s progress.

Love,

Ellie xx

Identity

Today I listened to a podcast on the topic of identity (Estée Lalonde The Heart of it, it you’re wondering!) and it got me thinking. Who am I? Who is Ellie? How do I define myself?

Identity is something I have always struggled with I think. My lack of confidence means I always focused on who I am to other people… I am a daughter, a sister etc. For the vast majority of the time since I was 15, being a girlfriend was a major part of my identity.

When I was with The Ex, I became more like he wanted me to be. I started using slang language which was not my style, I wore what he liked me to wear, I rejected scouting, my school and felt very separate from my family. But none of that was really me. It was me trying to be the Ellie he wanted. Of course, being so controlling and manipulating, I didn’t realise that at the time at all, I felt like I was being myself. But there was the cognitive dissonance, where I was doing things I knew I didn’t agree with and trying to pretend that was me.

Fast forward to the age of 18, The Ex left me. I was in a state, to put it mildly. I didn’t know who I was anymore without him. He had made me feel distanced from my friends and family, my hobbies were gone, I had no clue.

I started to try and find myself, but I think I was in the mind of a 15 year old, because I never got to do that exploration at that age.

Then there was S. Things were so different, he seemed to like me for who I was, it was so strange not to be put down all the time. But now that S has left me too, I am starting to see that the me I was when I was with S wasn’t me either. I am like a chameleon, my need to please others means that I will strive to be whoever I think they want me to be.

The problem is, I’m on my own now and I feel so lost. I’m not a girlfriend anymore. I don’t know my identity but I want to find it.

I am going to try and work out who I am, for myself instead of for anyone else. I think it’s going to be a long journey but I am actually sick of my identity not being real, of being so scared of being myself that I forget who I really am.

Of course, my illnesses come into my identity, but they are not my identity. For too long they have been. I’m like this because of my anxiety, or I can’t do that because of my fatigue. No. I have to accept that my collection of illnesses are part of me, but I am more than just my illnesses.

I am fed up of moving around and feeling sorry for myself. Yes, S left, and yes it still hurts every single day, but being sad and going over and over all the what ifs isn’t actually going to help me. Moving forward and focusing on my future will.

Wow, that was not quite what I intended when I sat down to write this post! I think I’ll be writing more about identity as I go through my journey. I’d love to hear about your experience with working out who you really are!

Love,

Ellie