Cognative Behavioural Therapy

I've seen my doctor today as I am suffering with depression. The last four months I have been a totally different person, withdrawn, miserable, a pale version of my former self. I am currently taking 600mgs of Carbamazepine daily and an small evening dose of Amitriptyline (30mg). The carbamazepine is not totally keeping the pain at bay so I have been increasing the dosage slowly.

I explained to her that I am not sleeping, am lethargric and depressed. I was so miserable last week that I could barely utter two words to my team at work, which as a manager is completely rubbish. My family are convinced that I have changed because of the Carbamazepine which I have been on for the last 6-7 months. I expected her to suggest that I should try another medicine but instead she wants to check my throid (I am tired, not sleeping and have gained weight which is more than likely because I have stopped my contraceptive pill) by having some blood tests. She stated that she expects everything to be fine but she also suggested a course of Cognative Behaviour Therapy. She seems quite keen on this. She also seems to think that taking my Amitriptyline up to 75mg may also help Although having a doctor that want to investigate thoroughly is great I was also a bit miffed that she didn't want to switch to something else. Has anyone else tried Cognative Behavioural therapy? I must admit that stress is a trigger for me in the past where my TN is concerned. I have type 2 TN on both sides.

Thanks, your input is greatly appreciated!

Cognitive Behavior Therapy and Rational Cognitive Therapy (an earlier variant from the 1970s) have a track record of demonstrated effectiveness as supportive therapies for people dealing with Post Traumatic Stress Disorder. Both are focused upon behavior change tools of self-management for mood, thought, stress and relationship interactions -- NOT "insight" into any presumed damage that may have been done to the client by early childhood experience (even when present coping mechanisms for such past trauma might be addressed in passing). The focus is on improving present conditions, not explaining forever, how we "got this way". I've talked to a number of pain patients over the past 16 years who have gotten considerable benefit from these types of counseling and learning.

Both frameworks are also intended to be used over shorter time periods (generally a few weeks to months), at lower expense than classic psychotherapy (which by the way has NOT demonstrated a record of success in improving personal life conditions for moderately to severely depressed people).

A book out of the 1970s may be useful for anyone considering the strengths and weaknesses of various schools of therapy and counseling: Martin L. Gross "The Psychological Society: the impact -- and failure -- of pshchiatry, psyychotherapy, psychoanalysis and the psychological revolution. " [Random House, 1978]. It's no longer in print, but available through used book stores and worth the read.

Go in Peace and Power


I have just started CBT but this was because my doctor thought I have anxiety brought on by TN.
Only had two appointments so far so can’t comment on how good it is yet. The counsellor tries to get you to look at a different point of view instead of a negative way. Well this is what he started with me so far. Hopefully you’ll find it useful.

Think I'll have a go then. Stess really does make things worse and I have never been very good with stress. I tend to bury the problem until I have to face it which has never been good. Thanks for the info guys!

I work within a team where there is a CBT therapist and those whe are referred to her usually find it a really helpful approach and appear to get a lot out of it. It helps you to re-think how we look at and handle various aspects of our lives. Within our team, the therapist meets with the person for a few sessions and then a decision is made at that point between the two parties as to whether it would be seen as being beneficial for a longer period of time - this is done as some people are so traumatised that it may not be right for them at that point in their lives......So, I feel that you have nothing to lose and possibly everything to gain!

Good luck and I hope all works out well for you.

Thanks Mandy, warming up to the idea!

I have tried CBT therapy in the past and found it works wonderfully. There is also a fairly decent one on the internet called MoodGym that I have done in the past. If you walk away with nothing more than some different thought patterns I consider that success. I'd suggest giving it a try ... you've got nothing to lose :)

About your weight gain ... now sure how high of a dose it would take but I believe weight gain is one of the side effects of Amitriptyline.