(TRIGGER WARNING: Mentions of Suicide, Self Harm, and Childhood Bullying)
This session, we were to speak about previous depressive episodes, in order to create a "timeline" of events and declines in my mental health. We were also going to start to draw up a diagram of my key relationships (family, friends, any romantic partners etc).
In the week leading up to this session, I had a lot of times where I felt quite on edge and irritable. I do tend to have a hatred of sound sometimes, usually when I'm overwhelmed. It tends to be more sounds of people's voices rather than inanimate objects (the washing machine, music etc). The technical term for this is Misophonia, although I am not actually diagnosed with this. I find sounds of voices can instil anxiety in me, or even rage. I go into a fight or flight mode, where I want to either escape the sounds or yell at them in order to hopefully make them stop.
We did the usual PHQ9, GAD etc questionnaires in which I scored more severely for Depression than Generalised Anxiety (which makes me a good fit for this type of therapy, as it is specifically for Depression). We also went through my Symptom Review; where I picked out 5 most prominent symptoms for me in that past week.
As explained above, irritability was one of the main symptoms of my Depression in that week. I explained examples of conversations that had set me off, and how I reacted. I told my therapist about how I find it hard to process information when there is more than one voice speaking at the same time as well. It does either make me very anxious, or very angry, and people don't tend to understand that.
As well as irritability, I found the following symptoms had been either very strong or very frequent recently:
- Always tired: I believe this could be a mixture of fatigue due to mental health problems, as well as the fatigue I experience with my Fibromyalgia. The weather tends to make my Fibro flare up too. Either way, I struggled with my energy levels and felt relieved on any occasion I could get into bed and nap. I found it hard to do much else really.
- Think other people don't like me: I think I've mentioned this before, but I find it difficult to reassure myself that my friends still like me. I look for clues that they are drifting away from me, or simply don't like me anymore. It could range from someone cutting off contact online (unfriending on Facebook for instance) to something as silly as not being one of the friends tagged in a post I can relate to. I keep having recurring dreams about a friend who cut contact with me around 8 years ago. In the dream, I am asking her why but never getting a clear answer. I believe some of this paranoia around friends stems from the times I was bullied. Part of the tactics they used were to pretend to be my friend, then leave me out of things. It made it hard to trust who was my real friend, and whether they actually liked me
- Down on myself: My homework for this session was to play some music on one of my instruments, or to sing. It was supposed to be an "antidepressant activity" that I could enjoy and feel a sense of achievement from. When I struggled to do this more than once or twice in a week, I felt very down on myself. I enjoyed it when I did do it, even though I was quite rusty, but I was very self critical afterwards. When I didn't do it, I felt guilty, as if I was letting myself and my therapist down by not trying hard enough to ease my Depression.
- Worrying: Although my Generalised Anxiety score on the GAD questionnaire was lower than my Depression score on the PHQ, I still found I worried a lot about things in that week. Various things got to me, and I was apprehensive about when I would get my Gastroenterology appointment through, when I would get my PIP decision, would my therapist be annoyed at me for not doing my homework "enough" etc.
Resources
What Is Misophonia?: https://www.webmd.com/mental-health/what-is-misophonia#1
Fight or Flight Response: https://www.psychologytools.com/resource/fight-or-flight-response/
Patient Health Questionnaire 9: https://www.mdcalc.com/phq-9-patient-health-questionnaire-9
GAD 7 Anxiety Test Questionnaire: https://patient.info/doctor/generalised-anxiety-disorder-assessment-gad-7
Fibromyalgia - NHS: https://www.nhs.uk/conditions/fibromyalgia/
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