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survivingbp

Going back into therapy for anxiety, help!

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Long story short - I was diagnosed with bipolar I and a bunch of other things (including anxiety) a few years ago, but because the bipolar had a direct threat to my life and sanity, all of my treatment focused on that. I dropped seeing a therapist because my psychiatrist also offered therapy in our regular consults and that was more affordable for me. 

Fast forward to now, and my mood is good (yay!). However, my severe anxiety and paranoia is now more obvious to my psychiatrist, and he has advised me to see an external psychologist as well as adding on medications. I'm really scared about seeing a therapist because it's been so long. I was wondering if anyone had any advice about going back into treatment, and how to prepare for that initial consult with the psychologist.  

Something that worries me is getting across the information I want to in that first meeting. I've written down bullet points, but I don't know exactly what information is the most useful, especially as my psychiatric history is more complex than the average outpatient anxiety patient (psychosis, multiple hospitalizations, suicide attempts etc). My psychiatrist wants the psychologist to give some diagnostic feedback and I'm not sure how to get across the most importation information here. To make things a little complicated, just from observing me and some of my concerns, my psychiatrist thinks I have GAD but also maybe some other stuff too. The GP writing the referral letter wrote down possible OCD and phobias. So everyone agrees that I have very intrusive and disruptive anxiety, but they don't agree on the finer details. 

It all just feels overwhelming and I'm worried about the consult not going to plan. I don't know how to get ready for it or even calm my mind about it because every time I've discussed these things with clinicians recently it has resulted in anxiety attacks. 

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On 6/11/2018 at 3:19 AM, survivingbp said:

Long story short - I was diagnosed with bipolar I and a bunch of other things (including anxiety) a few years ago, but because the bipolar had a direct threat to my life and sanity, all of my treatment focused on that. I dropped seeing a therapist because my psychiatrist also offered therapy in our regular consults and that was more affordable for me. 

Fast forward to now, and my mood is good (yay!). However, my severe anxiety and paranoia is now more obvious to my psychiatrist, and he has advised me to see an external psychologist as well as adding on medications. I'm really scared about seeing a therapist because it's been so long. I was wondering if anyone had any advice about going back into treatment, and how to prepare for that initial consult with the psychologist.  

Something that worries me is getting across the information I want to in that first meeting. I've written down bullet points, but I don't know exactly what information is the most useful, especially as my psychiatric history is more complex than the average outpatient anxiety patient (psychosis, multiple hospitalizations, suicide attempts etc). My psychiatrist wants the psychologist to give some diagnostic feedback and I'm not sure how to get across the most importation information here. To make things a little complicated, just from observing me and some of my concerns, my psychiatrist thinks I have GAD but also maybe some other stuff too. The GP writing the referral letter wrote down possible OCD and phobias. So everyone agrees that I have very intrusive and disruptive anxiety, but they don't agree on the finer details. 

It all just feels overwhelming and I'm worried about the consult not going to plan. I don't know how to get ready for it or even calm my mind about it because every time I've discussed these things with clinicians recently it has resulted in anxiety attacks. 

I have SZA and I see a therapist regularly like at least every other week. More like every 1.5 weeks. I'm supposed to see her weekly but she books out so far ahead it's ridiculous. 

Anyway. We talk about my goals in my treatment plan, coping with my psychosis and mood issues somewhat, and mostly and honestly how to calm my beastly anxiety. Which is great because meds only work so much for my anxiety which is usually terrible and can get out of hand quite quickly and totally interferes with my life.

So I think it's great that you have a plan of what you want to work on in therapy, a goal! It's good to have a paper with bullet points. Are they about your anxiety and how it impacts your life and what it's like for you symptom wise? Like what does an anxiety attack look like for you personally? That could help your new tdoc decide on which coping skills might be best to try first to help you with your awful anxiety. 

My tdoc focuses on CBT and a tiny bit of DBT (distraction and mindfulness.) That could be a question if you'd like to find out more about your tdoc's specialty. That could possibly help ease some of the worries? It's ok to ask them appropriate questions too! It's your treatment after all!

I think you're off to a great start! I totally understand the worry about the complex history. But I'm sure he/she has worked with people of all sorts of backgrounds before. But this could be another good question for your new tdoc if you'd like to know their experience with bipolar patients and patients with suicide attempts histories. I know I'd like to know that too. I don't blame you for wondering and being worried.  

But my point is people from all walks of life seek therapy. You'd be surprised. From grieving people to people on the SZ spectrum. 

So I know it will be hard and anxiety provoking for your appointment. But hang in there. Take a PRN if you have any. That could help. Request one from your pdoc if need be. You sound prepared. That's great! Take a deep breath. You got this! :)

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Perhaps writing sub-bullets under the main bullets. 

To be sure you don’t miss a thing, in the main bullets, write psychosis. Sub-bullet, what type of psychosis, how it affects you, how long it affects you. 

Next bullet, eg, anorexia. Sub-bullet, what type, when it started, how it makes you feel? All complications, how it affects all social functions, including family..

Dunno if this will help, or if it’s too rudimentary. I really hope it can help, even if just a tiny bit!

I hope you’re having a great weekend!

Edited by DammitJanet

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