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Cognitive Behaviour Therapy



Oct 9, 2006
I did not have many problems going to the dentist until I was about 26 and needed to have a wisdom tooth out. I had been having a fairly tough time in general, and my anxiety about having such a procedure got completely out of control. This coincided with my anxiety levels in general getting very high indeed.

I managed to have the extraction done a few months down the line, but I suffered high anxiety levels at every stage of the process, from booking the appointment, although I was slightly better when I actually had the work done.

I kept up my appointments afterward, although sometimes I would let the gaps between them go a little longer than the dentist would recommend. I was suffering a little less, but booking and keeping an appointment was still an event, and I would tend to cry by the time I had to go in.

Shortly before my 30th birthday I got sick and was urinating blood, necessitating dreaded trips to the doctors, and worst of all, the hospital. I was lucky that although it had looked quite bad and had been advised to prepare for the worst, it turned out that there was no terrible cause for the bleeding. However along the way a doctor had commented that my levels of anxiety when I was in the hospital were causing my heart rate to elevate to dangerous levels, and that I really needed to look into ways of calming that down as I was running the risk of having a heart attack.

This was the first time where I though maybe I did need to make some general changes in my life. A few months when passed and I went with my girlfriend to see the GP. I told him that I felt I had a problem with anxiety and I would like to look into practical ways of resolving it. At first he offered the pills, as they always do. I always turn them down. I did not spend billions of years evolving from a single cell protozoa to be told that the bit I am missing is what some California bio-chemist came up with one lunchtime. So after that he said "Maybe some cognitive behaviour therapy would help you". That sounded better, so I got a referral to the local mental health team and after a fairly fraught assessment, they put me on an 'Anxiety Education Course'.

The course was quite straightforward. It was a two hour class, once a week for six weeks. There were about 25 to 30 people on the course. There were slightly more women than men, but men were certainly not under-represented. The course went systematically through understanding the biological causes for anxiety and some of the practical and evolutionary reasons we have it. I felt a lot of the things they taught were things I had come to realise myself over the years, but there were three key things that really struck with me. The first was the concept of focusing on the anxiety. That is about instead of trying to avoid anxious feelings, trying to hold them and examine how they feel, and take come time to get comfortable with them.

The second thing was the concept of 'Ladders', where on your way to achieve your goal, you do lots of little things to get there. So one of the things I tried while the course was on was to visit a sick friend in hospital. The first day I only made it to the reception door. The second day I met my other friend in the reception and we went up to the ward together. The next day I went up to the ward by myself. After a couple of weeks I was able to go in without being distracted by the anxiety much.

The third thing, which I have only really fully appreciated as time goes on, is to not let yourself get too upset about little setbacks. I think that is quite relevant in dental phobia cases where it can be very easy to get frustrated and upset if you miss an appointment or get more upset in the appointment than you would like.

After this course I found I could develop strategies to manage the levels of anxiety much more effectively and I could even go to the dentist, the doctors and go for other medical tests and procedures by myself, although I may get a little upset sometimes. However, the levels of anxiety in general still seemed very high, even though things were so much better now I was managing them better.

A major change happened last August when I was finally diagnosed with a major vitamin D deficiency (for the doctors on here, it was below 12 undetectable) which has since been shown to necessitate that I remain on a maintenance dose forever. Even though most doctors I speak to were convinced that vitamin D has no relation to anxiety, since I have been on a maintenance dose my anxiety levels have plummeted to vastly more manageable levels.

So today I arranged for a wisdom tooth extraction. I am still a little apprehensive about it, I have warned the receptionist I may be upset by the time I arrive, but my thoughts are not dominated by it and I am not counting every second until I am due to go in. Things are much better. In fact they are more than tolerable.

In short, I would recommend a anxiety education class like the one I took, and if you do suffer problems with anxiety in general, I think it is worth asking your GP about getting a full set of blood tests done, including vitamin D.


Nov 21, 2007
Interesting story, sounds like that's really worked out for you. I've never heard of Vitamin D and anxiety being linked, probably just coincidence but interesting, I have general anxiety and am prone to Vitamin D deficiency (along with iron deficiency anemia). I've been taking a weekly supplement for a few months, though, and haven't really noticed any changes. Not even more energy, which I was really hoping for.