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CBT - Carers UK Forum

CBT

For issues specific to caring for someone with mental ill health.

CBT

Hello, just hoping for some reassurance.
My wife was diagnosed with depression and anxiety in February 2015, since that time she has been as low as you could be, has been placed on several different medications and spent 5 weeks in psychiatric unit.
Since last August she has been under a consultant at nhs mental unit who has stabilised her with medication, she now sleeps properly at night and is able to eat properly.
BUT she is still far from being well, although I realise 18 months in mental health terms is a relatively short time and 18 months in 63 years is a very small part of life, she is still saying several times daily that she wants to be in heaven and can I help her go there, which I explain that because of my love for her I cannot do this.
Her consultant has now said that he feels the time is right for my wife to start doing some gentle CBT exercises, what I would like reassurance about is does it really work and can it help, as meds seem to have got her to a point but no further.
Recently I managed to get her away for initially a few days, but after 3/4 days she suggested staying for two weeks which was brilliant, and she actually said that she enjoyed herself, but as soon as we got home she again seemed to go backwards.
Just one other thing, I enjoy fishing, should I carry on going maybe once a week for 4 or 5 hours bearing in mind her wanting to "be in heaven" or should I stay at home just in case, I do go out occasionally but only perhaps to the shop.
We are both retired and this is not how we planned things but I will do anything to get the person I love so dearly back.
Thanks for looking at this
Dave
Hi Dave,

Sorry to hear about your wife's situation and her comments about going to heaven, which must be worrying for you.

I personally did find CBT helpful as it helped me to focus my mind on smaller, more practical things and not to blow things up in my head. For example, something relatively minor, such as burning the dinner or forgetting to buy something in the supermarket, could send me into a whole whirlwind of doubt and anger at myself for not getting everything right. CBT helped me to refocus that and make it more realistic; one meal was burnt but I could just do beans on toast instead so no-one went hungry and it wasn't the end of the world, that sort of thing. Obviously it is different things for different people and there's never a guarantee that anything will work for everybody but it probably is worth at least giving it a try and seeing how she gets on with it.

I'd definitely keep up the fishing; you need some time and space to yourself and it's important to have that. I suffered from depression years ago and at the time there was a sort of outpatients therapy service where you could go along and do art classes, a bit of gardening, a drama group, that sort of thing. I just wondered if there might be anything like that your wife could access, even just for an afternoon? I found it very helpful because it meant I was occupied but not by anything demanding or stressful. The other people there were all suffering from depression as well so it was a very understanding place and we swoped tips on coping. It might be worth asking the GP if anything like that is available (although sadly funding has been so heavily cut it might not be).

The other thing I wondered about as I read your post was whether your wife likes animals and, if so, whether some sort of voluntary work might help? There are a couple of organisations that need dog walkers, for example, for people who are too ill to walk their pets or are in hospital or something like that. Rescue centres are always looking for people to provide foster care to small pets, kittens and puppies, so you have them at your home until they're able to re-home them (they pay for all their food, bedding, vet bills and so on). And then of course rescue centres themselves always need people to help out. I just thought I'd mention it as animals can be very therapeutic; they're very loving and a lot easier to cope with than people! And if your wife's anxiety means she couldn't cope with going out too much perhaps some cute fluffy kittens to socialise at home might give her a focus. Of course none of this would be any good if she can't stand animals or has allergies!

Does she say why she wants to go to heaven? Was there anything in particular that happened prior to the depression starting or did it come out of the blue (as these things often seem to?). I just wondered if there's anything in particular that she's finding very difficult to cope with or if it's the depression in general?

Hope something in there helps a bit.
Dave, hi, it's very sad that at a time of life when you should both be relaxing and enjoying yourselves, your wife is succumbing to mental illness. Were there any signs of this 'building up' in her before, and do you have any idea why it happened? (MH is a mysterious business, that said....)

From what I have heard of CBT it can be very successful. It isn't 'deep analysis' of the 'So, what were the traumas in your childhood that are surfacing now?' sort of thing, but it's very 'practical'. It aims, so I understand, to 'retain' the mind, to make 'happiness a habit', rather than unhappiness.

So I would definitely suggest giving it a go!

That said, DO you have any idea what is 'causing' your wife's MH? Is there any trauma 'way back when' that is now 'resurfacing' (or even 'surfacing' for the first time)? Why does she say she wants to die? Does she give any reasons?

Now, I'm only speaking here as ENTIRELY a lay person, but, from what I understand, there are, broadly speaking, two overall 'causes' of MH.

The first is 'nature' if you life - a genetic 'predisposition' perhaps (very poorly understood, still, and very controversial!) and/or a 'brain chemistry malfunction' (where parts of the brain responsible for 'mood' can be adversely affected by an imbalance of the chemicals that determine our brain's behaviour).

The second is 'nurture' if you life - ie, a 'what happened to someone in their life' cause. So, someone who had 'bad experiences' may develop MH as a result of such trauma, or stress, or unhappiness.

or, of course, the two causes may 'overlap' etc.

Personally, I would say that to find out 'which' is the cause in any person with MH, first of all one has to understand whether one can 'rule out' the second (nurture) cause. If there are no 'particular stresses', no obvious trauma etc, all the 'deep' stuff that counsellors probe into (were you neglected by your mother, etc etc etc), THEN one can move on to whether or not the cause is completely 'outwith' the personality/character of the sufferer, and is merely an 'adventitious' result of something like brainchemistry.

One thing is for sure though, it's a complex area! And poorly understood overall. To my mind, I'd say in terms of treatment 'whatever works is justified'. Because MH is so poorly understaood, in a way, even if we don't know WHY something works, if it does, we should grab it and go with it!

I would say, myself, there is one final, 'third' cause of MH - and that is that a deeply reflective mind, a philosophical mind, can think 'so deeply' about the human condition, can think about the impact of, say, being a conscious being, who has existence and desires and emotions and who yet knows that, one day, they will die, can be so 'traumatic' as to trigger of itself MH. It's not surprising in the slightest to me that so many 'philosophers' have MH, because, after all, the human condition is, essentially 'tragic' because we are destined to die, to 'stop', and that can be (inevitably) 'unbearable'.


One final 'lighter' point. If you say your wife was much happier on holiday, I'm wondering is that is worth pursuing as a 'cure in itself'.?? Now that you are retired, is it at all possible for you to move, maybe even abroad, where she will be able to 'relax'? (You might even find somewhere with fishing!)
Hello Dave,

I did a Diploma in CBT. I had become interested in CBT after using it on myself to help with my social anxiety when I was a teenager and in my early 20s. I'm soon to qualify as a mental health nurse and would like to go back into some more CBT training and perhaps specialise in it down the line. It's not for everyone, but it really helped me and continues to do so. I hope things get better for you both.

Alex