[tk421a]

I don't have any experience myself. However someone close to me does. I had not noticed any of it until a time of particularly high stress for them. Similar things to you such as the repeated hand washing. I can't comment on therapy / medication, but just wanted to say that they're doing much better now and that it can and does improve.

[shark]

Been chatting to Lagerstarfish and we are starting a weekly zoom session/support group tomorrow at 9pm full details here: https://ukbouldering.com/board/index.php/topic,31079.0.html

[JamieG]

Thanks for resurrecting this thread, I have been meaning to post for a while but have kept putting it off.

Around 2-3 years I started to develop obsessive compulsive disorder, I am not sure exactly when as I didn't realise that it was happening at first. Initially I just attributed it to stress in the third year of my PhD but it has continued long after. I had a pretty low ebb around 18 months ago and found myself retracing my steps everywhere I went incase something had happened (like what?) and washing my hands repeatedly incase I'd done it wrong. I managed to get a lot better on my own by October or November last year but still not 100%.

Unfortunately I've got a lot worse again since then. I mainly have a contamination type OCD, I worry about infecting other people with undiagnosed illnesses that I don't realise I have (eg if I cut myself when out bouldering and get blood on a hold I worry that the next person might touch it), or transferring dangerous substances to friends, family, and stangers. Covid has definitely not helped with this but my main problem is with chemicals. At work I am doing research on tissue clearing and microscopy, and this involves using a range of chemicals in a lab environment. I have struggled with this intermittently since I started last year but recently it has become unbearable. I become completely anxious and have to go home and thoroughly 'decontaminate' myself and anything I have touched since being in the lab. I'm pretty gutted that this has happened to me and I'm also pissed off about the major concern it is causing for my girlfriend and family.

I am currently seeing a psychotherapist weekly. At first this was really useful and allowed me to tackle a lot of the smaller problems. The way it works is that you put yourself in a triggering situation and then don't give in to washing your hands or retracing steps etc. Gradually you become less stressed in the situation until the compulsions are no longer necessary. The problem with the lab work is that the stress is absolutley intolerable and I think that is why I am struggling to deal with it.

I have not taken any medication so far but I am definitely considering it now.

Has anyone else on here experienced anything similar? I would love to hear from you if you have as I have not met anyone with similar experiences to this so far.

Sorry to hear about your OCD bigironhorse. I have had quite bad struggles with OCD, anxiety and depression for a number of years now. OCD is such a frustrating and at times debilitating condition. Mine particularly seems to focus around keeping the house and family safe. I.e. checking doors are locked, ovens off, taps off, etc etc. Not so much about germs and illness but that can flair occasionally too.

What I find particularly annoying is how arbitrary it can be. I'll check some things a ridiculous number of times and others not at all (which are in all likelihood just as "dangerous"). I am also aware that I have to be very careful not to start a habit since once it develops it is very hard to shake. I have developed quite a good and sweary inner monologue for myself when I get stuck in a loop. Amazing how brutal you can be on yourself. :-) I think it can also be hard for family since it is frustrating waiting for me to triple check everything before leaving the house, but my wife has been great about it and it does come and go a bit depending on how tired and stressed I am.

The bright (?) side is that I do take some medication which started because I had a bad depressive episode, but it also helped with my anxiety so I continued taking it. I don't think there is any shame in needing medication. I'm not particularly pleased about it, but it does help me so I continue. I have tried to come off it before and I fairly quickly relapsed into quite bad depressive episode and I don't really have any side effects so I stay on a low "maintenance" dose. I did CBT too which was helpful, but I found it hard to stick to. You need to be good at keeping the CBT up for it to be effective I think and I wasn't a good patient in this sense. The exposure part where you force yourself not to engage in the behaviour is horrible, but it does help if you can be consistent, since once I start checking something it tends to spiral quite quickly. I think the problem is it is easier and requires less energy to just quickly check than to fight the impulse at times. But is does seem to help if you can avoid the repetitive behaviour.

I'm not sure if this is particularly helpful to be honest. But I have learnt to live with and manage it. It doesn't impact my life too much I don't think. Whereas at some points the anxiety and OCD were pretty bad and I would get stuck not being able to leave the house for ages due to running back to check things. So it does get better with time. I think you just need to quite vigilant about it, get help were appropriate, and be kind to yourself. If it was a physical ailment I think it would be easier to accept, but fighting your own brain is weird and hard. Good luck with it and hope you are doing better soon.

[bigironhorse]

Thanks for the replies everyone. Just had a meeting with my boss, he was extremely understanding and is just going to let me return to the aspects of work that I find easiest first and then hopefully go back to my normal routine once things improve again. Feeling optimistic 

[JamieG]

That's good news. I'm glad your boss was so understanding. I do think awareness of mental health issues has definitely improved. Good luck and hope you are doing better soon.

[DAVETHOMAS90]

Been chatting to Lagerstarfish and we are starting a weekly zoom session/support group tomorrow at 9pm full details here: https://ukbouldering.com/board/index.php/topic,31079.0.html

Just seen this .
Bravo!
    

And Bigironhorse and everyone else 

[colin8ll]

I've been admiring from a distance the proactive approach members of this group have taken towards addressing mental health challenges   . I'm hoping to tap into the wisdom of this group for some advice in dealing with my best mate who is going through a bad patch (I hope the hijack is okay). Here's the background...

He was ill last winter with OCD issues and I think some depression too. He received counselling and medication and over time things improved. However, his issues have returned and he's now in a materially difficult situation. He recently bought his first house with his partner and the move took them away from his parents who they had previously lived with, and the rest of their support network. The recent lockdown has meant he has been unable to work which has left him with no income and he is concerned about loosing the house. Obviously, due to current circumstances friends have not been able to visit. Last month he informed our social group that he would no longer be joining our Zoom socials as he finds them too alienating. When we spoke last week he told me about how he was feeling and I gently suggested he visit his doctor which he agreed would be a good idea. He's now not taking my calls but will text later, apologising and saying he lost track of time and will call the following evening - this is not like him.

The question is what should I do to support my friend?

Thanks   

[lagerstarfish]

Tough position to be in.

Good question to ask.

Some of my ideas...

Not rocket science, nothing new  and certainly not the only things to consider...

Generally, doing something is better than doing nothing.

Keep calling, texting.

If he says outright that he doesn't want to talk, then explain that you are concerned that this is not how he usually is and would feel better if you did talk. (I mean say that you yourself would feel better for a talk)

Say that you will keep trying to contact him because you want to talk.

When stuff goes wrong for us mentally, it is common to feel that we don't have the ability or even the vocabulary to explain what is going on. This is a barrier to talking on it's own, but combined with a feeling of not wanting to drag others down or avoid feeling like we're moaning (again) makes talking really hard. Let him know that you are happy to let him rant and moan at you.

Talking about your own problems with your friend can be a good way to start talking. Thinking about other people's problems is loads easier than thinking about our own and helps get the brain and mouth working. Normal conversation is a two way thing anyway.

If communication dries up completely, tell him how concerned you are and that you now need to contact his partner (or other people) to help with your own worries. Give him a day or so to respond before going ahead with this (time frame could be different depending on the person, circumstances).

If you do talk, let him know how much better you feel for having talked.

The process of accessing appropriate support/treatment can seem painfully slow. This can be something helpful to talk about even if he doesn't want to talk about details of his symptoms.

(Possibly speculating too far, but if he's not picking up your calls, he may not be addressing other stuff like opening letters. With financial pressures, this has obvious consequences.)

You'll have a good feeling about which of these things are appropriate for your situation.

[tomtom]

That’s a hard position to be in Colin.

Lagers advice is much better than anything I could say - but having been in the position of not replying to people like your friend is (for a variety of reasons) - I ALWAYS appreciated getting a message and hearing from others. Even if I couldn’t summon the effort/courage/been too long - to reply I appreciated them.

[SA Chris]

Lagers is your guy, sound advice there.

Even if he's being uncommunicative, keep in touch. Don't get worked up of there's no response, no ARE YOU OK, REPLY PLEASE ASAP or anything like that, just touch base, share things you normally would about the world, be it amusing videos, etc, just so he knows someone from the outside world is thinking about him.

Are you guys allowed to meet up with one person for exercise in England? Assuming they are nearby you obv.  Even just going for a walk and a chat might help?

[colin8ll]

Thanks very much Lagers, Chris and Tom. I am sure this is good advice. So I texted him this morning, and he's replied apologising again for 'loosing track of time' and not calling and has suggested we have a chat at the weekend. Given it's Tuesday I feel like he's using a bit of a delay tactic. However, I feel like I should respect this and wait until the weekend to call him but in the mean time I'll try and text him over the next day or so with something along the lines of 'I saw this and thought of you' just to keep the channel open and let him know (as you guys suggest) that he's being thought about.

[slab_happy]

Public service announcement, because I just got reminded of this and am passing it along:

"Anniversary effects" are a thing -- an anniversary effect being when you "inexplicably" feel like shit around the anniversary of a traumatic event, even if you've not consciously registered the date.

As assorted psychologists have pointed out, the pandemic meets all the criteria for a traumatic event and, while it's been an ongoing one,  we are all hitting the anniversaries of our OH FUCK THIS IS GOING TO BE REALLY, REALLY BAD AND EVERYTHING IS SUDDENLY CHANGING VERY DRASTICALLY moments.

So for anyone who's found they're suddenly doing worse and don't know why, this might be one reason.

[Oldmanmatt]

Public service announcement, because I just got reminded of this and am passing it along:

"Anniversary effects" are a thing -- an anniversary effect being when you "inexplicably" feel like shit around the anniversary of a traumatic event, even if you've not consciously registered the date.

As assorted psychologists have pointed out, the pandemic meets all the criteria for a traumatic event and, while it's been an ongoing one,  we are all hitting the anniversaries of our OH FUCK THIS IS GOING TO BE REALLY, REALLY BAD AND EVERYTHING IS SUDDENLY CHANGING VERY DRASTICALLY moments.

So for anyone who's found they're suddenly doing worse and don't know why, this might be one reason.

Anniversaries suck.

But it’s funny which innocuous “Happy” days can be difficult. Tomorrow being Mothers day, gets split awkwardly around here. Starting with pressies and treats for Polly, before dropping off gifts to Grandma and then visiting the grave.
That gets repeated in a reverse family split, on Fathers day.
By the time we factor in birthdays, wedding anniversaries and death anniversaries, we don’t get a whole hell of a lot of year left. There’s always one coming or just passed.

So, we have practice and coping techniques, now, but it caused all sorts of issues in the early days.

[seankenny]

It’s coming up to the first anniversary of my father in law dying suddenly of covid, so this post really resonated with me. Later this month will be my partner’s first birthday without her dad and that’s going to be really hard too.

Luckily my in-laws are Buddhist so there is a special first anniversary ceremony that takes place, which acts as some kind of focus. But still, dreading the whole period.

[Oldmanmatt]

It’s coming up to the first anniversary of my father in law dying suddenly of covid, so this post really resonated with me. Later this month will be my partner’s first birthday without her dad and that’s going to be really hard too.

Luckily my in-laws are Buddhist so there is a special first anniversary ceremony that takes place, which acts as some kind of focus. But still, dreading the whole period.

I like these things.

The Romanian Orthodox tradition is that after death, the spirit travels the earth visiting all the people and places they visited or knew in life. The spirit returns to their close family at six months, one year and 18 months before departing. On those dates, they celebrate the departed, often as if they were there.

It helped.

[slab_happy]

Might be of interest?

https://www.mentalhealthswims.co.uk

Peer support and chucking yourself in cold water.

[Falling Down]

On October 10th 2012, ten years ago today, I started this thread with the post I’ve quoted below.  I hope it’s been a useful place for us to reach out and open up and it even led to the marvellous Black Dog club that Lagerstarfish so kindly started and led.

It’s been quite the journey for me personally, and now, a decade on, I’m in the very closing stages of a six-year training as a psychotherapist with a PGDip and (soon to be finished) MA under my belt and over 700 hours of client work gained in placements since 2018 and more recently in private practice.  By this time next year I’ll be UKCP certified and winding down the day job with a view to going into full-time private practice at the beginning of 2024. (Humblebrag over)

If anyone had told me all that back in 2012 I would thought they were in La La land.

Once I’ve got the MA out of the way in November, I’ll be gently attempting a climbing comeback of sorts so will see some of you out at the crags and blocs hopefully.

The/My Black Dog?

"My biggest fear was being found out"

"He used to wake me up with repetitive and negative thinking and remind me about how tired I would be the next day"

"Activities that previously brought me pleasure suddenly ceased to" But I'm on the road to recovery.

It doesn't matter who you are, if you're in difficulty don't be afraid to ask for help, there's no shame in doing so, the only shame is missing out on life.



At its worst, depression can be a frightening, debilitating condition. Millions of people around the world live with depression. Many of these individuals and their families are afraid to talk about their struggles, and don't know where to turn for help. However, depression is largely preventable and treatable. Recognizing depression and seeking help is the first and most critical towards recovery. In collaboration with WHO to mark

World Mental Health Day, writer and illustrator Matthew Johnstone tells the story of overcoming the "black dog of depression". For more information on World Mental Health Day, please visit: www.who.int

[SA Chris]

Good work FD, that's a lot of effort.

I think we know what your comeback route needs to be; https://www.ukclimbing.com/logbook/crags/vivian_quarry-639/psychotherapy-8710

[lagerstarfish]

If you know anyone who might benefit from this, get to it

https://twitter.com/VertebratePub/status/1579526952054329344?t=op71thIyVrtgEg0XNp9Amg&s=19

[SA Chris]

Just when I thought I couldn't like what VP do any more.

[Fiend]

A question about anti-depressants (since I couldn't find a specific thread for those). I'd like some advice about increasing / changing my medication due to having more acute / severe depression (+anxiety +moodswings +emotional lows) than previously.

I've been on 10-20mg of Citalopram for 13 years. Started at 20mg, then dropped to 10mg and mostly at that until upping it back to 20mg at the end of 2021 to cope with injury/age-derived depression. Have recently upped to 30mg to cope with more acute depression.

I've found the Citalopram to be effective at reducing anxiety and overthinking, and thus the low moods that come from that, and being generally soothing. I think it was still having an effect as the 10mg helped get me through lockdowns and the 20mg took the edge off earlier this year. Side-effects are having a bit of a "wrapped in fog" feeling, less determination, lower sex drive. I'm wary about those increased side-effects with a higher dose. And also the 30mg doesn't seem to be alleviating things as much as I'd hoped.

...

I've spoken to the GP recently who is happy for me to increase my dose but also happy for me to change to another common anti-depressant. Possibilities:

Sertraline - I know a few people on this and all have given favourable reports (alleviates anxiety whilst still feeling like themselves). I've been warned that it can have affect stomach issues (may or may not be a problem for me given my residual digestive issues are small intestine based??)

Venlaflaxine - A friend is on this, reported similar benefits as I had with Citalopram, but said it was much better ("Venlaflaxine is the real deal, when I tried other ones they were like Aldi budget anti-depressants").

Fluoxetine - an unknown quantity. I was briefly switched from Citalopram to something else when I was in hospital with DVTs, the switch over was easy but whatever I changed to was too much of an "upper", less anxiety-reducing and more mood/energy-boosting, which was completely unsuitable at the time when I needed to rest a lot. This MAY have been Fluoxetine (GP didn't have my records to check), the name sounds familiar.

...

I have a follow up appointment next Tuesday and may try a change over. But advice would be welcome (feel free to PM / Whatsapp / FB message me if you want it to be confidential). I don't mind trying to switch to something that might have slightly different effects, or have most side effects (except nausea - I'm not put off by others). But I'm wary of switching to something that doesn't have as strong an effect overall as the 30mg Citalopram - now is not the time to be risking being without that crutch. My only prior experience of switching was pretty smooth at that time though.

(P.S. Yes I am trying to do a lot of other stuff in terms of self-care, maintenance, getting support etc (which I started months previously), as much as mood allows, the anti-depressants are to try to get some stability in an acute situation to feel able to cope and then take more practical steps).

[webbo]

Fluoxetine is Prozac, which is usually prescribed for mild depression.
Sertaline or Prozac would often be tried first but if they have little effect you would try Venlafaxine or Citalopram.
I might be wrong though as my recent knowledge is 5 years old having be out of the service for that long.
There is quite a lot of medication that will help with anxiety however it is often a side effect as the medication will be for something different. You usually need to see a Psychiatrist to get these meds.

[slab_happy]

OH HEY IT'S ONE OF THE TOPICS I CAN NERD OUT ABOUT

Venlafaxine: very effective for a lot of people, it's an SNRI so can hit the parts SSRIs don't reach, but notorious for having a rough withdrawal syndrome if you need to come off it, so it has to be tapered slowly.

That's not a reason not to use it, especially if like me you're looking at being on meds for the foreseeable future, just a thing to be aware of.

Yeah fluoxetine can lean towards the "jittery" for some people; yeah sertraline is more likely than other SSRIs to cause stomach stuff/nausea in the start-up period, though often SSRI start-up effects will settle down after a few weeks so it can be worth trying to ride it out.

Query: worth asking your GP if escitalopram might be an option? It's basically a "cleaner" version of citalopram, bit more effective and lower side-effects.

So if you know citalopram works for you, you might have decent odds that escitalopram will work too, and you might be able to get a decent result with lower side-effects. Also it tends to kick in and start working faster than a lot of SSRIs.

Side-effects are having a bit of a "wrapped in fog" feeling, less determination, lower sex drive. I'm wary about those increased side-effects with a higher dose.

If you keep getting those side-effects and your GP is willing to go outside the box a bit: adding bupropion to your meds might be an option to consider.

It's only licensed for stopping smoking in the UK, not as an antidepressant, but using it off-label to cancel out SSRI side-effects (and for its own antidepressant capacity) is a fairly common thing.

I have a very small dose of bupropion in my meds cocktail and it's just because otherwise I get emotional flattening.

Downside: being on multiple meds does cement the feeling of officially being A Psychiatric Patient now.

(P.S. Yes I am trying to do a lot of other stuff in terms of self-care, maintenance, getting support etc (which I started months previously), as much as mood allows, the anti-depressants are to try to get some stability in an acute situation to feel able to cope and then take more practical steps).

Have a fist-bump of solidarity!

[joel182]

Sertraline - I know a few people on this and all have given favourable reports (alleviates anxiety whilst still feeling like themselves). I've been warned that it can have affect stomach issues (may or may not be a problem for me given my residual digestive issues are small intestine based??)

Another positive review for Sertraline from me. Generally makes me more energetic and motivated, less anxious. Have gone on and off it over the last couple of years depending on my situation.

When starting a new cycle I notice some GI tract side effects - general awareness of my gut, sometimes a bit nauseous. Makes a lot of sense to since the GI tract has a huge number of serotonin receptors.  Always fades for me after a couple of weeks.

[webbo]

The drug I was thinking of is Pregabilin, it’s an anti epilepsy drug. However it works for anxiety, we used see great results with it, not sure whether your GP would prescribe it though.