Am I on the right track?

[kel12347]

Okay, this is what I've learned from therapy thus far. 100% of my anxiety about vomiting(and many other situations)comes from my fear of vomiting. When I do get anxious, 80% of the time, it is caused by my thoughts, i.e., what if I get sick, I'm going to vomit, is today the day, and 20% is caused by external stimuli, like hearing about others vomit, etc. So one of the things I need to work on is the thoughts. I've learned two techniques, and am wondering if these are both appropriate.


1. Challenging the thoughts....asking where is the evidence for this, has it happened before, what would I do if the worst happened. I've noticed this seems to work well when the thoughts are just starting, and I'm not very anxious. Then, when I ask myself, "Well, what if the worst happened?" I say to myself, "Who cares? I would just vomit and get it over with."


2. The stop technique. When my anxiety is high, challenging the thoughts and saying "what if the worst happens?" just increases my anxiety. When I'm more anxious, I say "Stop! I am choosing not to participate in these thoughts! I am safe, and I am not in danger." Is this way as effective as challenging the thoughts? Hopefully it at least has some benefit, because when I'm more anxious, I can't challenge the thoughts.


How long will it take for this stuff to start working? I've been doing it consistently for about a week, and have noticed the "Stop" response start up automatically once or twice.


I'm doing a little better than I had been the last couple of weeks. I was actually able to drive to Chicago to meet my new hypnotherapist (supplement to CBT) yesterday with only moderate anxiety (even with being stuck in traffic for two hours). Of course, I had a huge panic when I got home, but I really liked the hypnotherapist, he seemed to have a lot of insight into my issues. Exposure therapy is currently on hold, due to the fact that I am barely holding it together anxiety wise. We will probably start up again this week or the following week, using Sage's hierarchy.


The anxiety is still very rough, but I'm having more good hours in a day than bad hours on most days, so that's an improvement. The possibility of an SSRI is still there, but we're kind of taking it on a wait and see basis. I think maybe things are finally calming down because my stress levels are decreasing.


Sage, when you did your first round of CBT which cured the fear of yourself vomiting, what exposure hierarchy did you use? Was is the same as the one posted on the "treatment info sheet"? If not, could you post it here for us? I'd like to have as many ideas as possible for exposure.

[sage]

Hi Kel,


Yes, it's the same one. It's the easiest stuff to look at, moving toward more difficult stuff.


You're doing great. Really. Questioning yourself and your treatment program constantly is just another form of anxiety. Keep that in mind! You won't notice results in a week. It may take up to a year before you even realize that you're better. But you MUST hang in there. You ARE on the right track. You're doing all the right things. Just keep it up!


Someone's signature on this site is: when the going gets tough...keep going! That's your motto, hun.


All the best to you.

[harmonygirl72]

Hey, kel!


That sounds awesome! I just wanted to tell you that I live in the Chicago suburbs, so if you ever want to talk or just know there is a fellow emet in the area, I'm here!


Mary

[kel12347]

I'm trying to hang in there, but it's just so damn hard!! I have constant anxiety all day long, just at varying levels. Trying to stop the thoughts just seems to cause more of them. I just need to know if this is going to go on forever or if I will get a little bit of relief, just enough so that I can function. Anxiety SUCKS!! I know that this is going to be a slow process, but all I'm asking for at this point is one or two hours a day when I don't have the negative thoughts. GRRR! I read about Sage's notecard idea here, and I'm going to buy some notecards today. I've been doing my affirmations and stuff in my head, and it might help to have it already written out.


My latest negative thought is really annoying also: What if I vomit before I'm cured? Same old crap, I guess, just a different form of question.

[kel12347]

Same old anxiety yesterday and today. I actually managed almost 4 hours with anxiety under 20 today. My notecards I made are already gettinga workout. I have an appointment with a psychiatrist, I think I'm going to go on a low dose of SSRI (if I can get the courage to take it). I want a dose just enough to allow me to function (which I can't right now), but still leave a bit of anxiety for me to work on.

[sage]

Kel,


I don't give medical advice on this forum, and don't advise people to take medical advice fromthe internet...but generally speaking...someone who says they have anxiety all day long, or even 4 hours with it under 20, could probably do very well with an SSRI. Just trust the prescribing physician for your dosage - don't diagnose and prescribe yourself. With SSRIs it's not like tranquilizers where you can have a little bit for a little bit of anxiety. The dosage (and type of drug)must work for your body weight and metabolism...or else it won't do anything at all. You can't just add a little seratonin to your brain - you have to take enough that you'll stop making the new receptors and that will make a huge difference.


You can still work on your therapy while on the drugs, and it will benefit you greatly - probably more than now.


Keep us informed and good luck!

[kel12347]

Thanks Sage. I went to see the psychiatrist today, and she prescribed Prozac, Reglan, Klonopin and Ambien (because I haven't been sleeping well at all lately). She seemed understanding of my problem, even though she hadn't heard of it before. She was so nice that I was actually crying in her office because it was so nice to have someone understanding. She is starting me on a low dose of Prozac, and then will increase it. I was supposed to take 5 mg tonight, but only took 2.5 mg. If things are okay tonight, I will go up to 5 mg tomorrow. The psychiatrist was of the same opinion....that I need to get myself stabilized before moving on to exposure therapy. I did take .25 mg of Lorazepam today, so hopefully that will stop any nausea I may get from the Prozac. I did eat with the Prozac, so hopefully I will be okay (I'm pretty worried, can you tell?).


I'm also worried that I may have a problem stopping Lorazepam. When I'm doing okay, I take a max of .25 mg per week. With my anxiety so bad the last couple of weeks, I've been taking .25 - .5 mg per day. I'm supposed to change over to Klonopin tomorrow, and I'm worried that I may have Lorazepam withdrawal.


I'm just hoping to get stable, and back to eating and sleeping normally, so I can really go to work on this phobia!