Somebody help me, please!

Long Term Care Columnist / Guide · Jan 30, 2004

It sounds to me like you could use more talk therapy......I know what you mean about catastrophizing, but this is nothing more than negative self-talk, and what you need to do is learn how to replace those Chicken Little-type thoughts ("The sky is falling!") with more positive ones ("Aw, it's just a little sprinkle, and I've got an umbrella").

Here's an example of what I used to do when I made a mistake at work and got what we call a "nasty-gram" from the nurse-manager: my thoughts went something like "OMG, I screwed up, I'm gonna lose my job, I'm gonna lose my license, my family will end up in the food-stamp lines again because I don't know how to do anything else that pays this well" etc. etc. etc. Then I'd be so uptight that I'd make another minor error or omission, and I'd get yet another nasty-gram, and the anxiety just grew and grew until I finally quit because I couldn't deal with the stress.

But with the help of medications and some group therapy, I learned how to manage those self-defeating behaviors. Now, when I commit some procedural error or forget something and get a note from the manager, I tell myself, "OK, this is meant to be a learning experience. I am human, I make mistakes, and this one didn't kill anyone or affect the state of the nation. I will not make this same mistake again, so I will forgive myself and move on with my work today." I also have changed my approach to work so that I DON'T make very many errors......I'm very thorough, even methodical, and I'm organized. This helps a lot when the occasional patient crumps, or I get an admit, or a co-worker suddenly gets sick and I have to pick up more patients.

It's funny in a way; when I worked at this hospital before, I was terrified all the time. Now I'm known as one of the calmer nurses on the unit, and I even have had other nurses tell me that they never panic unless *I* look stressed! But again, that's the direct result of changing my thinking habits.........and while that takes time and work, it's well worth it!:)

sjoe · Jan 30, 2004

"It sounds to me like you could use more talk therapy"

Agreed.

sphinx, BSN, RN · Jan 30, 2004

I know what you are going through...I've suffered with depression for many years (not too long ago diagnosed properly as BipolarII). Catastrophizing is something I have done, and still often do all the time (even though I am in fairly good control at present).

Be sure your meds are adequate....they may be helping, but sometimes the dose needs to be tweaked a little. You might want to work specifically on this in therapy as well. One thing that helps me with catastrophizing is humor! When my husband notices I am doing it, he points it out and gently teases me......you'd think that would bother me, but knowing I do it, and how ridiculous some of the things I go on about are, can truly be kind of funny! He usually can get a giggle out of me, and many times that derails me (but not always).

I'm sorry you are going through this......support of your peers can be helpful. There's a thread in The Break Room about anxiety/depression...it's quite long, but you can skip to the last few pages to get a gist of what we're about. basically there's a bunch of us who are or have been depressed who are very supportive to one another. Also, feel free to PM me if you'd like.

chris_at_lucas_RN, RN · Jan 31, 2004

One of the highest predictors of suicidal behavior (including thoughts) is having a family member or friend who attempted or succeeded.

You are too valuable a person (even though yuo cannot see it) to just "leave."

Get a workup by a psychiatrist (especially if there is a family hx of mental illness--), get on meds and get into psychotherapy.

I can almost guarantee you that within a month you will feel better enough that you will almost (not quite) wonder how you could have ever felt so bad.

Let us know how you are--keep us posted. you can PM me if you want. I'll answer, hon.

ChicagolandRN · Jan 31, 2004

Thanks for your input, everyone. You got me over the hump of a rough day. The good news is that I've recovered enough since I was diagnosed to handle things at work, and I'm a fine nurse, I must say!! I'm just going through a difficult time with my DF (dear fiance) and lose it once in a while. Thanks for the support.

Again, I love you all. :kiss :kiss :kiss :kiss :kiss :kiss

Dave ARNP · Jan 31, 2004

I can honestly say I KNOW what you're going through.

It's not been that long since my psychiatrist came off the speed dial

If you ever need to talk. I'm here.

I would also make sure you keep up with the psychotherapy. It is SOO important!

Dave