I have a family history of mental illness. I've been in therapy for four years without incident, but lately my anxiety and sadness seem out of control. What do I do now?
I started therapy with an LCSW four years ago in the aftermath of my first (and to date only) serious break-up. At the time, though I had a family history of mental health issues (mom is borderline [undiagnosed] and her mom was bipolar), I did not enter therapy because I thought I had any diagnosable mental health problems. I did it because I had a thoroughly difficult childhood that had a lot of long-term effects on my adult behavior, had just been through a very tough break-up, and was still dealing with my mom's behavior. I had had "low points" as a teenager, but those never felt like more than typical teenage angst.
Fast forward to today. I'm still with the same therapist, but over the last few months, I've noticed some serious changes in my behavior that are starting to really upset and terrify me. I'm quicker to anger. I feel like a lot of the work that I've done on my self-confidence, which was nil when I started seeing her, is starting to crumble. My childhood, which I do talk about with her, has become more and more upsetting to me in the last few months - I recently spent the weekend with a friend's family and came back really depressed that I didn't have a "normal" mom and dad. I haven't been in a serious relationship since the ex that I started going to my therapist about, and I get into self-defeating cycles of thought about my loneliness that almost always end with what seems like a panic attack. For the first time in awhile, every one of my close friends is in a happy relationship, and I've been spending a lot of time around couples, which leads me to resent everyone, say things that are probably a bit too cutting, and make me want to cry all the time. I've always been anxious, but now my anxiety overwhelms me more quickly. I feel like my emotions tend to snowball a lot faster. For example, last night, I was lying in bed and remembered something about my ex, which led to me thinking that I'm going to die alone, which led to me crying to the point where I could barely breathe. I got up to close my blinds and go to bed and the blinds broke. It was kind of a straw that broke the camel's back - I simply could not deal with the simple problem of figuring out how to fix the stupid blinds, and I lost it even more. Then for the first time in.. well, ever, I started thinking about going to work tomorrow and thinking that I literally could not do it. I could not imagine myself getting out of bed and sitting at the computer and doing my job. I imagined staying in bed for days instead and cancelling everything I was supposed to be doing. I thought about turning off my phone for days on end. My brain just completely shut down.
And it scared the hell out of me. I have never, ever had those thoughts. Today, of course, I got up and took a shower and came to work and I feel okay. I've always dealt with anxiety and I've always been a cryer, but I've never had an "episode" escalate to that point, with the gasping for air and the never wanting to leave the bed. It seems kind of silly now, but it scares me to think it could happen again. And of course, given my family history, I am petrified that I am starting to exhibit any behaviors that were like my mom's.
I guess I'm looking for people who have experienced anything similar and what their next steps were. I want to be proactive about this. I'm beginning to think that after years of trying to deal with my anxiety or whatever else is going on with just therapy, medication might be useful. What do I do now? My therapist is great, but I don't know how to even tell her about this stuff. We mostly talk about annoyances that I have at work or with my mom, not anything as deep as this. I just know that I was and am petrified of being swallowed whole by any sort of mental illness.
posted by anotheraccount to human relations (27 answers total) 12 users marked this as a favorite
TALK TO YOUR THERAPIST. She can help, especially since (yay!) you seem to have a good relationship with her. She will not say you're "crazy" in any sense of the word; she's there to help you navigate your feelings and figure out how to manage them.
Yes, it might be time to check into the possibility of medication. Your LCSW therapist can help you figure out what route to take with that, whether it goes through a psychiatrist or your GP.
You also might benefit from some more targeted therapy such as CBT (Cognitive Behavioral Therapy) that works to help you understand, for example, the patterns that get you into obsessive spirals. If you can head some of those things off at the pass, you'll have a good start at not letting them take over your life. There are many CBT techniques you can look into on your own, whether you explore them with your therapist, use them while you're on medication or just read a book. AskMe favorite Feeling Good and its associated workbook are good starts.
For some more personal experience: I've had a very similar situation to you, though my family situation has leaned more toward depression. I've been on and off medication in cycles, but it looks like I'll be on it for a good long time now, and that's no big deal. When I'm on it things are at a nice, manageable level. When I'm not -- at least the most recent time -- I've found it much easier to fall into these same kinds of patterns that distort my thinking and make me question the people and situations around me. Being on medication, however, has helped me get a better gauge on those things and recognize the signs of feeling off-kilter.
I've had sudden episodes like you describe, and of course they suck. But the more you get to know your own tendencies, the more you can manage them and their effects.
About your family mental illness, though: What's the worst that could happen if you DO have some sort of weird condition that could theoretically swallow you whole? It sounds to me like you're just reacting to some tough times and experiences, but if you did have something more going on, wouldn't it be worse to let it go unchecked? Not knowing always feels so much worse than knowing, because the more you know, the more you can do (proactively or reactively).
Feel free to MeMail me if you like.
I think you'll be okay :)
posted by Madamina at 12:25 PM on August 15, 2011