Unsure of what to do next.

[Nerdyfiance]

Hi Everyone,

I'm not overly good at writing things down, so bear with me.

I am currently the primary carer for my fiance who is struggling through a combination of emetophobia (fear of vomit/vomitting), anxiety, depression and mild agoraphobia.

This all began two years ago when a suspected bad reaction to a birth control pill resulted in a prolonged period of random nausea and vomiting. After stopping the pill under her doctors advice the nausea remained, being compounded by her fear of vomiting. This resulted in her constantly being anxious that she will get nauseous at all times.

The constant fear of getting sick has added extra fears of doing things she could easily do before, such as driving and going shopping due to her getting randomly nauseous doing these things in the past.

After about 6 months of this nausea and plenty of doctors visits yielding no answers about the cause she started to become very depressed. At this time her doctor prescribed her medication and drew up a mental health plan. The medication had a violent negative reaction to her system and she was taken off it after two days, and the psychologist she saw refused treatment without medication.

It took 6 more months of encouragement to help encourage her to try again with a different psychologist and medication. This time she tried different medication and got along with the new psychologist.

Around her 4th psychologist visit she was referred to a psychiatrist to re-evaluate her medication since she had been prescribed a "blanket anti-anxiety medication" and needed something more specialized. As much as I would like to say this went well, it didn't, she was brushed off by the psychiatrist who reported an "all clear" back to her gp and due to financial difficulties we have been unable to continue psychology.

Through this whole process I have been researching everything I can about anxiety, depression and emetophobia in an effort to support her through this as best as I can. I've taught myself everything from massage to guided grounding techniques. Lately these things have started to feel less effective and it's seeming like, despite both of our best efforts, she has been going backwards lately.

I know that our next step is to resume psychology with and try again to have her medication re-evaluated. But in the mean time, does anybody know anything else we might be able to try in order to help her move forward because I'm really feeling like I'm bashing my head against a wall at times.

[Zeal]

Hi Nerdyfiance,

Welcome to the forum!

Being the primary carer for anyone is tough, let alone when you're caring for a loved one with multiple mental health conditions. Like your fiancé, I have emetophobia. I also have OCD/anxiety. Often a vomit phobia is triggered by an event (or series of events). For me, this event was in my very early childhood, and I was very distressed when throwing up from the flu at 14. This reaction to the birth control bill was the trigger (or one of the triggers) for your fiance.

Does your fiancé avoid eating certain foods for fear of getting sick? Or avoid eating altogether? Emetophobia can lead to eating disorders (not saying this will be the case for your fiancé), so that's why I ask. Also, a low body weight/lack of nutrition has physiological and psychological effects that can worsen symptoms of anxiety and depression. It's sad that the unexplained nausea triggered depression in your fiancé. The fact that the last medication she tried led to a severe reaction must have been frightening, and confirmed her health anxiety fears.

It is clear that you and your fiancé have been persistent with seeking professional help, which is great. Financially, continued psychological/medical help can be challenging, but hopefully more treatment is viable. It's good that your fiancé has a mental health care plan. I am touched by how dedicated you are to your fiancé's mental health, with the independent research and learning techniques to help her. Massage, even if it doesn't have a huge effect, is lovely and relaxing. My partner sometimes does this for me, and I always appreciate it.

In the meantime, continue being supportive and encouraging of your fiancé. While emotional support won't directly improve your fiancé's mental health concerns, it will provide stability and is sometimes a buffer against further decline. Take care of yourself too, as your wellbeing is crucial, not only for you personally, but also in caring for your fiancé.

If you'd like to have access to mental health resources (not as a replacement for professional advice though), I highly recommend this site which I was directed to years ago by a mental health nurse: http://www.cci.health.wa.gov.au/resources/consumers.cfm There are resources here on conditions/topics such as general anxiety, social anxiety/agoraphobia, depression and tolerating distress. This Beyondblue site also has useful fact sheets.

It would be great to hear back from you 🙂

Best wishes,

Zeal

[Nerdyfiance]

Hi Zeal

[Nerdyfiance]

Hi Zeal

Thanks for the reply, I'm sure you understand all too well how much it helps knowing there are people understand.

Thank you for the link, I've read through some of it already and I think there could be some really useful information in there.

With food, she does avoid spicy food as it does bring on her nausea. But other than that not much has changed, cooking is another thing I have learnt over the course of her treatment.

I guess the main reason I posted in the first place was to try find advice on how to help her stay motivated to continue at her pace, without making her feel like I'm pushing her.

Given her past set backs she has almost lost all confidence in psychology and medicine, I really am lost for ideas on how to keep her going on.

Any advice is appreciated.

[CJs_mum]

CBT?