I'm in psychotherapy for my BPD - but my GAD & Depression are to much on top of my BPD symptoms. It's all too overwhelming, I developed GAD & panic attacks in the past year, I wish I was just BPD now. Everything is TOO INTENSE. Please help - my therapist only want to discuss BPD symptoms and underling causes really & we don't touch upon my anxiety.
Have you told your therapist that you want to work on your depression and anxiety? If you don’t come in asking to talk about something in particular, therapists will often choose a topic they think will be helpful. However, if you request a certain topic, it’s their professional responsibility to try to help you with that topic. Here are tips if you’re having trouble speaking up.
If you can’t tell your therapist or they’re not helping you, here are some ideas that might help you to cope with your symptoms.
- Coping with overwhelming emotions
- Know the signs. Pay close attention to what you’re feeling, physically and emotionally, as symptoms come on. Look for patterns. Making a record (eg writing it down) of what you learn is a good idea.
- When you notice the signs, start using coping skills, and/or reduce triggers/stress (eg leave the room), if possible.
- Tell the people around you how you want them to respond to your symptoms, if you’re comfortable doing so. Writing it down can help you explain it. You might like to describe how your symptoms make you feel so that they understand.
- Staying organised with mental illness
- Try to sleep (second link) and eat well, exercise enough, drink plenty of water, wash yourself regularly, and get enough fresh air and daylight. Here’s something to help (you’d better bookmark that link right away). Yes, all these things are much harder when you’re mentally ill, but the more of them you’re not doing, the worse you’ll feel, including your mental illness. You have to tend the meatsuit.
- ^ Related to the above: here’s what I’m trying myself - I set myself a minimum number of self care tasks to do in one day (right now, 3). So instead of thinking “I have to shower, but I don’t want to, I can’t, it’s not happening” endlessly and going nowhere, I think “Do I want to shower, OR do I want to validate myself? Ugh I’m not up to positivity yet I’ll shower instead”. It’s been going alright, especially when I really don’t like one of the options, haha. Procrastinate your way into productivity! (But make sure your priorities are realistic, eg I don’t let myself skip meals in this way because no other coping skill can give me nutrition.)
- On eating well: How to cope with weight gain / How to eat when you have no appetite / Bulimia recovery workbook / Recovering from a restrictive eating disorder / Recovery Record (mostly drawn from this masterpost)
- Reduce unnecessary stress and bring positive things into your life. Unfollow that person whose posts upset you and put more kittens on your dash. Buy, make or print out something (or things) that makes you happy and put it/them in places you often go, or items you take with you. You don’t have to and probably wont immediately feel better, but being surrounded by positivity normalises it, so that it doesn’t feel so uncomfortable or forced anymore.
- Try expressing your positive feelings aloud more often, if you can. I’ve found it makes a big difference if I acknowledge that I’m feeling good, or if I share any fond thoughts I have about other people with them. Try saying “I’m having fun” and “I’m happy” out loud when you are. It often makes people around you happier too.
- Tips to cope with a panic attack
- Overcoming panic attacks
- Information and further links on panic attacks, panic disorder and agoraphobia
- The TIP skill is great for when you can’t think well enough to use coping skills. They’re simple and physical activities. Here’s a great explanation of the skill and how it works from Pandora, and here’s a short summary of TIP.
- Choose and rehearse reality statements for when you’re panicking, eg “My body is upset right now but I will be okay” / “I know that this will end and I will be alright” / “I have survived every panic attack I’ve ever had and this one is the same”
- Grounding techniques (dissociation is common in panic attacks)
- Handling panic attacks for autistic adults
- This site lists three different types of panic attacks which I thought was interesting
- Anxiety and disordered eating (explains hypoglycemic shock, which can feel like or trigger a panic attack)
- Do things to reduce your anxiety before you get acutely anxious, eg do breathing and relaxation exercises regularly, gather resources, prepare affirmations, try to write down all your triggers and think about how you can manage those triggers and/or your anxious response.
- Breathing recalibration station
- Cognitive restructuring (attacking unhelpful thoughts)
- Positive statements to replace negative self talk
- Slow breathing to reduce anxiety
- Anxiety and panic masterpost
- Progressive muscle relaxation (here’s one written for parents that uses simpler language)
- Self talk to help end obsessions
- Dealing with intrusive thoughts
- The Quiet Place (guided meditation/relaxation)
- calm.com (guided meditation/relaxation)
- Save some fun non-triggering distractions as safe spaces, like Touch Pianist, or these links. Games on your phone also work - I play sudoku to distract myself.
- The “so what?” method of breaking down unhelpful/anxious thoughts
- Coping with depression
- Dealing with depression
- Teenager’s guide to depression
- How to think when you can’t think
- Choose Recovery
- Sad Ghost Club
- Six ways to be productive while depressed
- It’s okay to not be okay
- Self care
- Giving yourself time to recover
- Chronic illness and depression
- Make sure you go outside every day. It doesn’t have to be long. Try to spend at least 10 minutes outside. Going for a 30 minute walk means you get all enough sunlight, fresh air and exercise for the day in one activity. But it’s okay to start smaller. If you really can’t go outside, sit by a window (open if possible).
- Find or make affirmations that work for you. I started a tag on my personal blog for affirmations that I find helpful. If a lot of affirmations make you think “That’s not true for me though…” then writing your own might help. Again, it’s okay to start small (source). This worksheet on validation might help you to write them.
There are still more resources, many of them local (eg when I Google ‘depression’ I find a lot of Australian organisations and websites), that you can search for. You can also try the #actuallydepressed and #actuallyanxious tags, or look for blogs specifically for depression and/or anxiety.
If you are really unhappy with the treatment your therapist is giving you, you may want to think about whether seeing another therapist is an option. Here’s a post about finding the right therapist.
If you’re just not getting everything you want/need out of therapy because you have a lot going on, I sympathise and I recommend you plan to start learning and practicing coping skills (such as from the lists above) independently. When I do this, I tell my therapist what I’ve been learning, so we can discuss the skill and so my therapist can validate my self treatment.