CBT, The Unseen Battle: Coming to Terms with Mental Health

CBT, The Unseen Battle: Coming to Terms with Mental Health

I have had a horrible time of it of late, to the point where two months ago I finally made the jump to get help. Being the product of generations of stoic Scottish farming stock meant that it was never going to be an easy jump to admit that I needed help. The old adage of bury it deep was strong in me, but with my old job killing me physically and mentally and almost destroying my family life. It took my partner leaving me for a few weeks to finally smash it into my thick, stubborn head that this couldn’t go on.

Mental health struggles often begin as silent wars waged in the most intimate spaces of our being, a gradual erosion of peace that many fail to recognise until crisis strikes. So if I can do it, and trust me, there aren’t many people out there as stubborn or pig-headed as me. That old phrase, like a Pitbull with a bone, that’s me. So I have decided to write what I hope is an article that might help some of you make the jump to get help before you reach complete crisis mode.

Note, I am no professional, this is all from what I have learned from my own journey. If I have got anything wrong, please let me know.

The Crisis of Recognition

Coming to terms with mental health problems begins with an internal earthquake that shatters fundamental self-perceptions. What starts as persistent sadness, unexplained anxiety, or overwhelming stress often clashes with societal narratives that equate mental strength with invulnerability. As Mental Health UK notes, mental health problems are “difficult experiences that make it harder for us to get on with our lives”, typical responses to life’s challenges rather than personal weaknesses. Yet this rational understanding provides little comfort when confronting one’s own mind in turmoil.

The recognition phase is often marked by:

• Self-Stigma: Internalising societal prejudices leads to toxic self-criticism (“Why can’t I just snap out of this?”).
• Misattribution: Physical symptoms, insomnia, fatigue, gastrointestinal issues, masquerade as purely physical problems 10.
• Diagnosis Ambivalence: The medicalisation of distress through labels like “depression” or “anxiety” brings relief to some (“It’s not my fault”) while others feel reduced to a diagnostic category 1.

“Mental health problems are not a weakness, they are just responses to what is happening, and what has happened, to us and around us.” 

The Weight of Stigma and Denial

Before treatment can begin, you first must navigate those powerful external barriers that exist to stop you from getting help. Mental illness remains shrouded in misconceptions, with many fearing discrimination in workplaces, social circles, and even healthcare settings.

I had never felt so alone when he said that. All it would have taken was a simple, “Go home, Jim. You’ve put in enough hours; we can manage.” But instead, he saw me as weak and pathetic. I made sure to express this in my resignation letter, which I sent to the CEO of the company.

That was my last day at work. I got signed off and found a new job, so I haven’t spoken to him face to face since then. But it’s coming—I plan to go into my old store, and he’s going to hear everything I have to say. I’ll show him just how strong I am now that I’m no longer being ground into the dirt by toxic, backstabbing managers like him, who held the threat of losing my job over my head every day, despite being 150 hours short each week to do the job properly. You can stick your “you need to write better schedules” right up your arse, Dinal.

But back on topic.

The Mayo Clinic emphasises that stigma manifests in subtle ways—avoidance by friends, assumptions about instability, or internalised shame that silences suffering. This social dimension compounds personal struggles, creating isolation that reinforces destructive thought patterns.

Cultural narratives further complicate acceptance. The myth of the “nervous breakdown”—an outdated yet persistent concept, reflects society’s tendency to frame mental health crises as catastrophic collapses rather than understandable responses to overwhelming stress. In reality, these crises represent the culmination of prolonged suffering where coping mechanisms finally fracture under accumulated strain.

The Breaking Point: When Denial Falters

Reaching for help often follows what Cleveland Clinic describes as a “mental health crisis”—the point where functioning deteriorates beyond self-management. Key indicators include:

• Inability to perform basic self-care (showering, eating regularly)
• Withdrawal from social and professional obligations
• Physical symptoms like panic attacks, uncontrollable trembling, or insomnia
• Intrusive thoughts of hopelessness or self-harm
• Comfort eating.

This crisis moment contains paradoxical power: the devastation that finally breaks denial also creates openness to change. As one’s world contracts “losing jobs, friends, children, housing” as Mental Health UK starkly notes, the once unthinkable step of seeking therapy becomes a lifeline.

I went through all of the above, showering, brushing my teeth, and even changing my clothes, became an impossible task for me. There was always a voice in the back of my head, saying it takes minutes to shower, just go and do it. But it would feel like I had to climb Mount Everest with a ten-tonne weight on my back when I had to do these simple tasks.

The idea of doing anything other than what needed to be done, like work, felt crippling to me, and I often tried to find a way to avoid it. I even almost skipped seeing one of my favorite bands because of these intrusive thoughts. Thankfully, my partner practically dragged me out by my ears to go see them.

The CBT Journey Begins: Structure Meets Vulnerability

Entering Cognitive Behavioural Therapy represents a profound shift from suffering to agency. Unlike open-ended therapies exploring childhood roots, CBT offers immediate, practical engagement with current struggles. The American Psychological Association defines CBT as “problem-oriented” and focused on “changing thinking patterns and behavioural patterns”, creating a collaborative partnership between therapist and client.

Initial sessions involve building what positivepsychology.com calls a “strong therapeutic alliance” while developing psychoeducation about the cognitive model. Patients learn the revolutionary concept that thoughts—not situations—directly create emotions and behaviours. A foundational framework emerges:

This mapping creates both discomfort and hope, recognising one’s role in perpetuating suffering also reveals paths to change.

Confronting the Inner Landscape: Tools for Transformation

CBT’s transformative work occurs through structured techniques that challenge deeply ingrained cognitive distortions. Aaron Beck’s pioneering work identified these “automatic thoughts” as biased interpretations reinforcing distress 5. Patients learn to identify patterns like:

• Catastrophizing: “My heart is racing—I’m having a heart attack!”
• Personalization: “My boss didn’t smile—she hates me”
• Black-and-White Thinking: “If I’m not perfect, I’m a failure”

The Courage of Exposure and Homework

One of the most challenging yet transformative aspects of cognitive-behavioral therapy (CBT) is exposure therapy. This approach is particularly effective for anxiety disorders, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). It involves systematically confronting feared situations, ranging from crowded spaces to traumatic memories, without resorting to avoidance behaviors. This process teaches the nervous system that the perceived threats are unlikely to materialize. As MyLife Psychologists explain, graded exposure means gradually facing your fears instead of avoiding them, which allows the fear to diminish over time through habituation.

Crucially, CBT extends beyond the therapist’s office through skill-building homework:

• Practicing mindfulness during anxiety spikes
• Scheduling pleasurable activities to counter depression’s inertia
• Using relaxation techniques like controlled breathing
• Tracking automatic thoughts in real-time

This work demands immense courage, engaging directly with pain rather than numbing or avoiding it. The process isn’t linear; setbacks occur when old patterns resurface under stress. Yet each small victory builds what positivepsychology.com terms “self-efficacy”, the belief in one’s capacity to cope.

Reclaiming the Self: The Transformative Horizon

With consistent practice, CBT’s benefits compound into profound personal reclamation:

• Cognitive Liberation: Recognizing thoughts as mental events rather than truths creates psychological distance 
• Behavioral Activation: Incremental changes (a short walk, reaching out to a friend) rebuild engagement with life 
• Relapse Prevention: Skills become lifelong tools for navigating future distress

The UK’s Improving Access to Psychological Therapies (IAPT) program demonstrates CBT’s real-world impact: 67% of treated individuals show substantial symptom reduction, with 51% achieving full recovery 5. Beyond statistics lie human transformations: the depressed parent regaining capacity for joy with their children, the trauma survivor reclaiming safety in their body, the anxious employee presenting confidently at meetings.

Ultimately, the journey through mental health struggles into CBT represents more than symptom management; it’s a reclamation of agency. By courageously confronting distorted thoughts and avoidance behaviours, individuals rewrite their relationship with suffering. They discover, as Aaron Beck’s century of work revealed, that changing one’s thinking changes one’s world.

The path demands immense courage, but each step forward validates a fundamental truth: though mental illness may be part of one’s story, it need not define one’s destiny. It has not been easy for me. It has made me look at myself in ways I never thought possible. And it is not always a journey into the light, sometimes you unearth thoughts and feelings that were buried so deep you never knew you had them.

This weekend at Cymera was a fantastic experience. I found myself surrounded by amazing authors, many of whom held PhDs, and all of them were far more talented than I am. As I sat there, I couldn’t help but wonder what I was doing there and what I could possibly contribute. My stories, filled with my silly mishaps and my uncanny ability to almost get myself killed yet somehow always survive, felt insignificant in comparison.

I felt like an outsider, as if I didn’t belong. I questioned the value of what I had written; I doubted anyone would regard my work the same way they would a published book. My contribution felt ephemeral, at best.This is what Cognitive Behavioral Therapy (CBT) can do—it makes you assess your life more critically than you ever have before. Sometimes, you may not like what you uncover, but it is essential to face these truths.I have just begun my journey with CBT, taking the first few steps on this marathon towards better mental health.

I know there will be more challenging truths to confront in the coming months, but addressing these issues is something that needs to be done.If, after reading this, you feel the need to talk about it further, please reach out to me. My DMs on social media are always open for anyone in need of support.Just remember, you don’t have to suffer alone. I almost took the darkest of paths when I felt there was no way out. It pains me to think that someone else might consider that option, believing there was no shoulder to lean on.

Further Reading

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