My therapy experience: CBT for extreme mood swings, depression and mania

Natasha, 20, shares how cognitive behavioural therapy (CBT) has helped her cope with extreme mood swings, depression and mania.

I’ve struggled with my mental health for much of my teen years and now into my early 20s, but over the last year - and especially as we headed into lockdown - I noticed that my previous coping techniques and ways of understanding my mental health didn’t seem to be working or fitting with what I was experiencing anymore.

I wanted to find help, but in the midst of lockdown, I wasn’t sure how to go about finding it or what would be available to me. After some searching, I found the online NHS self-referral system - which meant I wouldn’t have to worry about going to my GP surgery in person - and found an online cognitive behavioural therapy (CBT) service that I was eligible for. I filled in a handful of questionnaires and referral forms, and before long I was assigned a therapist and a date for my first session.

I had tried other talking therapies before at different points, but I’d never had CBT and I wasn’t sure what to expect. During my first session, my therapist explained to me that the purpose of CBT was to identify, challenge and change unhelpful, negative or distortive patterns of behaviour and thinking to improve overall mental health and help develop personal coping strategies.

This appealed to me - I experience intense mood swings between depressive and manic states, so being able to interrupt negative behaviours or thinking patterns that might trigger a dip in mood, or stop an unhelpful train of thought that might end badly while I’m feeling manic, seemed like a great approach for managing my issues.

I had also never had online therapy or really used many online resources for mental health before, so that was a new experience for me.

The way my specific therapy was organised was in a typed live chat with my therapist at our set times each week, with weekly questionnaires to track my moods and goals as well as a messaging portal, so my therapist could send me more resources between our appointments.

At first I was unsure whether I would like online therapy as I worried it might feel impersonal or I’d feel distanced from my therapist because it wasn’t face-to-face. But in the end, I didn’t struggle to connect with or trust my therapist; she made me feel just as comfortable and safe as if I was sat in her office. Being able to attend my appointments remotely also made being in therapy feel a lot less daunting and scary, particularly when I was feeling low and had little energy.

In total I worked with my CBT therapist online for nine weeks. At the end of my sessions, she referred me to a specialist to continue therapy. Although in the end we came to the conclusion that I needed to work with someone else, being introduced to CBT practices has helped me develop some new coping techniques, and I feel better prepared to cope with shifts in my mental health. It has also helped me identify and understand the patterns of thought that some of the issues I’m dealing with stem from, which gives me a good starting spot to work from in further therapy.

Overall, I found CBT therapy helpful and a good place to start for me. Also, particularly with lockdown and all the anxiety that has come with the Covid-19 pandemic, being able to use online therapy services is amazing; even as things are starting to slowly open back up, being able to access these services from home cuts out the need for any travel or exposure, which is invaluable if you are considered high-risk for coronavirus or have high anxiety over the virus.