CBT: I'm being offered CBT (cognitive behavioral... - NRAS

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CBT

wilbertjellyfish profile image

I'm being offered CBT (cognitive behavioral therapy) on nhs.

Not really sure it's going to help.

Basically late last year I broke down crying with RA doctor because everything was getting to me. Things are tough now too but are tough most of time.

Here's my situation work basically full time running my own business, probably quite high pressure job (vet??) Definitely physical work. Main breadwinner.

Five children 14-8, do have child minder at home who does some house work but only recently. Oh and might be leaving.

Farmer husband who tries to do his best but still inadvertently demands a lot.

RA (sero neg) 4 1/2 years. Not under control this year got my fifth biologic and after a month developed pneumonia (only got diagnosed after 4weeks because I thought it was just a pulled muscle and soldiered on as you do) on second week abx now but joints are awful so pred back up to 20mg.

Sorry for the long winded post, sometimes it helps writing it down but wondering if anyone has any advice or experience.

Thanks

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wilbertjellyfish
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31 Replies
Kerensa56 profile image
Kerensa56

That all sounds so stressful even without RA and yours doesn’t sound like it’s controlled yet. I hope you get the support you need; the nras helpline (on their website) are very good and may have more ideas than me.

For what it’s worth I did a cbt course about a year post diagnosis (6:8 weeks group one for chronic diseases which may not be possible with Covid) and yes I did find it helpful, tools to help with anxiety, stress, depression etc. Obviously not a cure all, if only eh? but may be worth trying. Take care x

Neonkittie17 profile image
Neonkittie17

Go for it! Nothing ventured. Just to say things out loud to someone impartial and professional is going to help I’m sure. I did so when first diagnosed on a one to one organised by my rheumy and GP on the NHS. Acceptance of RA was hard as I was a competing athlete.

wilbertjellyfish profile image
wilbertjellyfish in reply to Neonkittie17

Thank you.

I think I've accepted the RA it's one of those things I was unlucky, it could be worse.

The problem I have is that it's hard and everyone seems to just think I should be able to cope the same as before. No one seems to recognize when I'm struggling and need help. I'm not good at asking for help and when I do it doesn't work, in that they do a little bit then everything goes back to me having to sort it.

I probably need assertiveness training.

I'm complaining to you and you've likely had to make much bigger adjustments, sorry.

Mmrr profile image
Mmrr in reply to wilbertjellyfish

The hardest time to say no is the first time, then it becomes easier. Two little letters, difficult to say, but have huge power if said directly....no.....

CBT should help, certainly worth trying.

Haz58 profile image
Haz58 in reply to Mmrr

Totally agree with you. I’m an independent g*t but have had to learn to say no and I can’t do that today and ask for help..if I didn’t we wouldn’t eat or it’d be microwave meals every day lol.

Neonkittie17 profile image
Neonkittie17 in reply to wilbertjellyfish

Not a complaint at all. It’s a how can I change things. (Get a day/night off!) It sounds very, very hectic and you need some rest from a busy schedule a couple of evenings or one at least a week. Can you make it so you don’t make dinner or clear up etc one night a week? It’s if you can stand the way/mess of how they do things. 😳 Or ever find anything again! (That’s my well meaning hubby putting cutlery in places I’ll never find again!! 😝) I do a slow cooker or oven casserole day and my prep is done quite easily and quickly and it frees me up standing at the cooker and watching over things. Standing still at a cooker or sink makes me ache the most. I’ll often make enough for the next day. Then less standing prepping. You must be on your feet most of the time as a vet. Very physical as you say. Hoping you can make some changes to help your busy situation.

Most Definitely you need someone to do housework. If they go, please find sometime else. I’d go to the therapy as they’ll have all sorts of useful advice and suggestions and you’ll feel better just to say it all out loud to someone who is an expert at dealing with all of this. I think maybe your hubby probably doesn’t want to acknowledge you aren’t feeling good as it upsets him? Maybe can’t accept what’s happened but you’d feel so much better if you weren’t doing the biggest part of things at home, or all of it. I hope you can find a way to let them see some help would be appreciated.

JEM95 profile image
JEM95

It can’t be easy for you.I used to feel frustrated that no-one understood how I felt. With RA you look fine on the outside. I’m a stubborn old mule and asking for help just wasn’t in my vocabulary! I pushed myself to keep up at work, I was so hard on myself.

When I thought back, my mother had RA years before me and I was exactly the same - I didn’t understand how she felt and how she was struggling.

I’m sure the CBT will help with coping strategies etc.

My biggest mindset change was to expect nothing from anyone and to ask for help when I need it. People can’t really understand RA unless they have lived it so it’s up to me to ‘guide’ them to help me when I need help. Look after number one - it’s tough but they don’t and can’t understand.

My life is much easier, I ask for help now but I no longer feel frustrated because I accept peeps don’t understand.

Take care of yourself x

Sheila_G profile image
Sheila_G

I can't give you any advise but I hope you get what you need to cope with your problems.

Scottishlad profile image
Scottishlad

So sorry to hear that your rheumatology team have not found a treatment that controls your RA.

As a retired dairy farmer you have my full sympathy. I certainly see no harm in trying CBT. I always thought our vets were such hard working people. To have RA on top of such a workload must be so difficult.

One of our vets had brucellosis, my heart went out to him after one difficult calving, twins coming together and the cow pushing like mad. Poor chap he was completely done by the time the two calves were safety delivered.

I think you really need to try to get on top of the childcare and housework situation as a priority. The stress from this will make your situation so much worse.

Perhaps CBT will help you sort out your priorities and make progress with your life.

Best wishes for the future, I hope you get relief soon from your RA and the current stressful situation you find yourself in.

Fruitandnutcase profile image
Fruitandnutcase in reply to Scottishlad

Definitely agree with Scottishlad about the childcare / housework arrangements. That’s probably the straw that’s breaking the camel’s back.

Both you and your husband are probably working flat out in really hard, challenging jobs. You’ve got the kids - although 14-8year olds ought to be pulling their weight - and now you’ve got RA on top of that. Not surprising you burst into tears - you are getting ground down with it all - you need to find yourselves a ‘Mary Poppins’ type housekeeper / treasure of your own to take some of the household stress away from you.

You sound exhausted and in pain and constant demands from every side don’t help.

My husband is really good but I understand completely when you say your husband ‘tries to do his best but still inadvertently demands a lot.’

It can be hard when your other half expects praise for something you have done for years - with no thanks, we’ll I find it is - and I don’t think unless someone has rheumatic disease they truly understand how we feel even when they try.

Probably worth giving the CBT course a try, that and learning to use the ‘no’ word more often. Once you’ve done it a few times in different circumstances you will feel liberated. (((Big hugs))) to you, hope you find the answer soon.

14bubbles profile image
14bubbles

Hi

Sorry to hear your struggling, it's not easy with so much on. I had a couple of courses of CBT a couple of years ago. It was to do with something else that had happened so not RA related, but I did find it useful. It helped me just to have someone tell me that I was justified in how I was feeling and also gave me lots of strategies for coping when things get too much so I'd say it's definitely worth a try.

Regarding people understanding what you're feeling and asking for help...I get you, I really do. I'm the same, I don't like admitting when I'm struggling and asking for help and am only now recognising that I do need to tell the people around me when I'm struggling because otherwise they just don't know...I'm still working on this!

As for worrying about moaning when you know others are worse off, again, I get you but a friend recently told me, just because other people are struggling, doesn't make your struggle any less important or justified, and at least here you know the people you are moaning to understand.

Hope this is helpful

Charlie

springcross profile image
springcross

You have a such a lot to cope with so anything that can possibly help is good and certainly worth trying. I really hope it works for you. x

janmary profile image
janmary

It must be so hard coping with full time work when feeling ill and in pain. I think I might give CBT a go - a chance to have a rest for half an hour and concentrate on yourself for a change ! And perhaps get your family and staff to read a leaflet explaining what RD is (from NRAS) .

Hope you feel better soon

vonniesims profile image
vonniesims

My daughter in law did a course a few years ago when she got to the point of having suicidal thoughts. It really helped her and she's been fine since, It involved quite a few sessions though. Go for it !

You must be absolutely shattered, as Scottishlad mentioned the stress won't help your RA and until this is tampered down i imagine you are facing a struggle getting your arthritis under control.

I would say yes to the therapy and I would also seriously think about making it clear to your nearest and dearest you cannot maintain doing all the things you did pre RA. I know it sounds easier said then done but you do alot, even without arthritis alot of people would be permanently knackered.

Hope things change for you and don't forget you are awesome xx

Nessa28 profile image
Nessa28

I had CBT training about 15 years ago . I’m like you zero negative . I also had 5 kids , stressful job and a husband that worked nights .

I had 6 sessions and I can only say they ground you . They give you coping mechanisms , an ability to breathe , take stock and move forward . I had a really bad fall prior to this and I just couldn’t get up . I was in the road with cars coming at me and no one helped me . I was totally mortified and at the time I was being tested for MS . This one event took my confidence and my ability to go out . I was given a second chance through the Therapy and I highly rate it . It also stops them telling you you’re depressed and that’s why you’re not coping . Go in open minded and do the exercises they set you . I promise it’s time we’ll spent 🤗🌷

Gilliancheche profile image
Gilliancheche

Definitely give it a go. Well worth trying. Approach it with an open mind.

oldtimer2 profile image
oldtimer2

There are two things to consider - firstly if you turn down treatment offers your medical team may feel you are not co-operating with them and secondly - it might actually help with other problems if not the Rheumatoid Disease. It is a way of thinking that often helps people who have stressful lives, so it might help you and you need to go into it with an open mind.

Perhaps you feel that you are being 'fobbed off' rather than taken seriously, but it is clear from research that stressful situations make pain and inflammation worse.

Haz58 profile image
Haz58

I had CBT and highly recommend it! It helped me see and think through things differently. It’s not magic and I still sometimes get very down but I can get myself out of it faster with the training I received. I had all mine over the phone due to COVID. Go for it, nothing to loose. Good luck. Xx

Mmrr profile image
Mmrr

The first thing is don't do everything and don't try too. I hope what I am about to write does not sound 'preachy' is isn't meant too, but things sound different when written down.

You are the main breadwinner, that is a big role.

Everything else involved in running a family household needs to be shared out, including your husband's contrubutions. Lets just say it straight, working full time, simply isn't enough from him.

Modern young families expect people to be able to pull their weight, irrespective of being a man or woman. Childhood is the time to skill people up for successful partnerships /marriages later on. And, you cannot do it all , you should not be expected too...no one should...but particularly so with RA.

I used a number of what would now be called 'life hacks' to assist with running a big household as a single mother, with a full time job and 3 children.

The first was to give up ironing, completely. Over the last 35 years I could count on my fingers the number of items I have ironed, if I remember correctly my partner looked out my iron and ironed my dress for my daughters wedding 7 years ago. I look smart, no one has ever noticed I don't iron.

Buy all the children black identical socks, when washed put them all, unpaired, in one big bag convienantly placed, and they size and choose their own each morning. If they don't want black socks that's fine, I gave them choice, then it was then up to them to wash and look after them. Choices have consequences, a great life skill to learn young.

(They all opted for the black socks, other than special occasions...lol)

Each child stripped their bed and brought the linen with their towel to the washing machine. I put the downie cover back on the downie after washing for the wee ones, otherwise they made their own bed with the fresh linen. Your husband could do the same for your bed, bed making is a big problem for us folks with RA, lots of posts here on the forum about it.

After each meal, everyone put their used dishes into the dishwasher and replaced a few other items either in the cupboard , dishwasher ...whatever. All I had to do was wipe the surfaces and the kitchen was tidy. Your husband could do this, save you. A benefit of everyone tidying up was that everyone knew were things were in the kitchen.

Cutlery went from the dishwasher to a container on the kitchen table (like you see in some restaurants) that way there is no table setting or cutlery in and out of drawers.

My children were all taught to cook, just by being in the kitchen with me chatting, chopping up food, peeling the garlic (a favourite task of my sons) ....whatever. Two of them are now great cooks as adults, my son hosts the most amazing dinner parties. Skills learned at my knee without direct 'chores' being involved, it was fun.

(As an aside, my 6 ft 4 in rugby playing son in law makes a mean tray bake and fabulous cakes...all learned at his mothers knee too. He made all the favours at his and my daughters wedding)

Undertaking a course of CBT may help you come to terms with RA and help you on your road to not over stretching yourself and being clear of what you expect from other household members.

If you become very unwell, everything and everyone else suffers, so by highlighting your own needs you are putting the needs of others first.

I wish you well.

Fruitandnutcase profile image
Fruitandnutcase in reply to Mmrr

Like your style Mmrr- the men in my family all wore black socks for exactly the same reason. I operated the way you did and they are now grown up fully functioning adults too. 😉

Biofreak profile image
Biofreak in reply to Mmrr

Excellent advice there Mmrr!😊

wilbertjellyfish profile image
wilbertjellyfish in reply to Mmrr

Lol. I haven't ironed in years either. I only wear black socks and the children are getting trained. The older ones are learning to cook. I think we're women after each other's hearts. Thanks for the support and taking the time to reply.

Live hacks are the key. I have a robot hoover now it's impressive.

Mmrr profile image
Mmrr in reply to wilbertjellyfish

👍 I fancy one of the robot hovers.

Happy5 profile image
Happy5

Hmmm well you're fortunate to be offered it lots struggle to get access to it, so try it, won't harm eh? Mental health issues are a definate part of this condition, so some support is a good idea.

As well as child minder are you able to afford housework help apart from your child minder's assistance?

You sound to have a lot of spinning plates to keep going, any way to find a way of spinning fewer? Agree with Mmrr learning to say no is hard at first but those being said no to find alternatives to their requests.

I too was super independent, in fact the one most turned to for support, well now it's my turn for support, which the treasured few provide.

Your OH as a farmer will be magga busy, & not sure they ever realise the extra pressure they inadvertently add.

All the best :)

wilbertjellyfish profile image
wilbertjellyfish in reply to Happy5

😂 hubby has no idea half the time but I'm definitely getting better at letting him do it himself more.The childminder is supposed to do cleaning twice a week but at times I'm not convinced it's done and then you get annoyed.

Need to learn to say No....I'm getting better 🙈 thanks

Jimminey profile image
Jimminey

I had anxiety and depression for 3 years before the RA 'presented itself', as they say, though blood tests had shown a high rheumatoid factor. I have since discovered that anxiety and depression can be a direct result of RA - that the inflammation itself produces those effects in the mind. I found a course of CBT helpful, but what really pulled me round mentally was a group course of Compassion Focused Therapy - that and, I suspect, drugs that got my RA under some control (reducing the inflammation and its direct affect on my mind?).

All the best.

Flor1rence profile image
Flor1rence

Hello, if it wasn't for CBT I wouldn't be here today! I would say give it a try, good luck🍀

smilelines profile image
smilelines

This is an interesting thread. I just looked up the difference between the CBT and the Compassion Focused therapy. I am not sure if the program you were offered is structured with just the CBT or if you will have a therapist that can do a bit of whatever you need. You could always try it for a while to see what it is like. Having inflammatory arthritis is terrible and so if CBT was offered to me I would try.

Chockyuk profile image
Chockyuk

Hello 👋 I’m sorry to hear you feel like this, but it’s quite understandable in your situation.

About 6 years ago I separated from my husband, I was in my late 50’s at the time, he was the main breadwinner. To cut a very long story short, having money issues, stress, having the threat of having to sell the house, move etc....then within a few months, my son went off to Uni, I fell and broke my arm, then I was diagnosed with RA.

I actually stoically soldiered on for a while, then one day I woke up and felt so overwhelmed I didn’t go into work for 2 weeks.

My GP referred me to CBT, and I’m sorry to say for me, it didn’t work. But I do think it’s worth a go, I did meet some nice people there, it was a F2F group, and it was good to chat problems through with them (mainly after the group).

I eventually received F2F 1:1 counselling, which I found much better, I had I think 14 sessions, which brought me right up to lockdown. 🤦‍♀️

I think it’s all down to the individual and what works for you.

I hope things get better for you.

Big hugs

wilbertjellyfish profile image
wilbertjellyfish

This is the thing horses for courses. I think my biggest hurdle is that I get the impression that I should just be in pain and get on with it. Like it's wrong to be upset that I'm sore all the time and not able to do stuff. I hope your life is on the up now. Take care.

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