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

Advertisements

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

Pain

I miss S so much it really hurts. He is all loved up with someone else, they are moving in together shortly. I’ve finally deleted him off social media, every time I clicked his profile was emotional self-harm; it always made me feel worse. So now the temptation has been taken away, I can’t see it anymore even if I wanted to. (And if I’m completely honest I already tried!)

I know that’s a good thing to take that temptation away. I know that in general I’m doing pretty well. But somehow that doesn’t change the pain and the ache of losing him, missing him.

I feel like after 6 months I shouldn’t still feel like this. I know there’s no time limits to put on grief, I know that’s not how it works. But it feels like I should be ok by now, I should be moving forward.

I hate myself for missing him. I hate myself for not being the person he loves anymore. I can’t help but feel very lost, very lonely. I don’t want to be on my own but I can’t imagine feeling safe again, being able to trust someone. I thought after the ex, and all of that pain, I had found someone that was good for me, but then S left me too and now I’ve realised nothing at all in life is certain.

I know I’m upset about them moving in together and that’s what has brought up all this pain again. I want it to go away, I want to be ok. I want to be strong and happy and confident, but tonight I am in pain. I feel like a lost child and everything feels too much.

My birthday has brought up feelings too – thoughts of where I “should” be in my life at this age, thoughts of where I thought I would be but I’m nowhere near. My birthday has been difficult for years, it acts as a marker of another year that I’m still struggling. This year it marks 6 months since me and S split up, and a reminder that the years keep going by and I’m still not ok.

All I really want in life is to be loved. I need to learn to love myself first. I know I’m up and down, I know some days are harder than others but I just wish things would be easier. I don’t have the energy for this right now.

I’ve just typed out my feelings because I needed to let them out. I’m ok, or I will be, but it all just hurts too much today. I think an early night is in order.

Love,

Ellie xx

Caterpillar cake

I have found birthdays hard for a long time, for a variety of reasons. This year I got a terrible migraine and found out that S is moving in with his new girlfriend, happy birthday to me.

I nearly stopped my mention of my birthday there, which isn’t really fair. It’s so much easier to focus on the negative and I know that I have a massive negative filter. Actually, my work friends organised a surprise birthday picnic which was super cute and lovely! We sat in the sun and ate lots of picnic food, and in the evening I went out for a lovely meal with my family. My birthday also featured a Colin the caterpillar cake, because what kind of a birthday would it be without one?!

I know I haven’t been writing much lately and I also know that I’ve been overdoing it, being too busy, trying to spin too many plates.

I want to get back into my good habits and routines. My sleep has been off the last few weeks, and I’ve eaten a lot of crap and I can feel that makes a difference to my energy levels and mood.

Next week I’m going on holiday so hoping to recharge my batteries and take some time to rest. I am completely exhausted again – physically and mentally. And so goes the boom and bust cycle…

Love,

Ellie xx

Back to therapy

I realise I still haven’t posted much about my CBT, and I do still plan to. Somehow everything seems to be busy all the time at the moment and I haven’t been making time to write, which is a shame because I enjoy writing!

Yesterday I went back to see my therapist, who I haven’t seen since before Christmas (because I started CBT in January and you can’t have two types of therapy at once!) It was really nice to see her and to talk things through. She said I seem to be in a different place and that’s true!

We talked about how things have been and how I have had lots of realisations about myself and the relationship with S in the last 6 months. She said I seem more like an adult, that I am taking responsibility for myself and I’m not waiting for someone else to fix things for me anymore. That was really nice to hear, and I actually agree. I think I’ve grown up more in the last 6 months than the last 6 years!

I’ve learned that I can deal with stuff myself. I’ve learned that sometimes I will feel really low and it will be awful, but I can still get through it. I’ve learned some level of distress tolerance, whereas before I had none – I always ran to S to make me feel better.

I feel much stronger and I’m owning my life now. Nothing changes by itself, no one is going to sweep in and save me. I don’t need saving actually anymore – I can save myself. And I’m building up my confidence bit by bit. Yes, I still have my lows, and I probably always will, but that’s ok because I know it will pass. And I know I have a hell of a lot of great people in my life to support me, but not to save me. I have better coping mechanisms now and I’m actually quite proud of myself. (Wow I never thought I’d feel proud of myself!)

Feeling pretty positive today, especially thinking back on yesterday’s session.

Lots of love,

Ellie xx

Into the darkness

That feeling of being detached

Of not being real.

Sounds seem distant

Except the buzzing silence in your ears.

Everything is in slow motion,

Only your response time could betray

That you are plunging into the darkness.

*** *** *** *** *** *** *** ***

Just felt like writing something.

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

Friday night

Friday night, sat at home, on my own.

This is a familiar scene now. Somehow Friday evenings are the worst. That’s the time I feel lonely. I put a series on the tv and I’ve spent the evening half watching, half focusing on colouring.

Colouring is so therapeutic. Something to concentrate on. Watching TV helps too, it draws me in.

But then I get to the end of the last episode and it’s suddenly so quiet. Lonely. Alone.

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