How to stop my life's blooper reel constantly playing in my head?
October 23, 2011 3:00 PM Subscribe
[Depression/medication filter] Recommendations for constant negative thoughts about myself? Unfortunately medication/treatment-resistant so far.
As a teenager, I was severely depressed and tried a long series of medications, none of which worked and/or gave me severe side effects (seizures, panic attacks). Eventually I was hospitalized and put on Effexor (venlafaxine), which worked! I'm now 34 and am able to live on my own, have a full-time job and keep up with basic hygiene matters.
One thing the Effexor hasn't helped with is the constant thoughts of stupid things that I have said or done in the past, or negative things that have happened to me. Several years ago I started going to a therapist to get help with this. Despite trying CBT, exercise, volunteering, yoga, meditation and staying on a healthy diet, my brain still insists on replaying my life's blooper reel over and over again. I have a terrible self/body image and the obsessive thoughts are making it worse. I never date and have a very hard time socializing with the few friends that I have.
My therapist has finally concluded that it might be time for me to start trying a different medication along with Effexor (I am already on the highest recommended dose). I am terrified to try another medication because of how badly I reacted to them in the past. However, I'm even more terrified of what will happen if I don't try and things continue to worsen.
Has anyone out there successfully treated obsessive negative thoughts with medication, and if so, which one has worked? The meds that were unsuccessful for me were: Paxil, Prozac, Xanax, Cylert, Zoloft, Nardil, Celexa, trazodone. (I was also misdiagnosed with borderline schizophrenia and put on Stelazine, that was fun!) Or if you were successful without medication, what did you do?
(throwaway email: anon2695@gmail.com)
As a teenager, I was severely depressed and tried a long series of medications, none of which worked and/or gave me severe side effects (seizures, panic attacks). Eventually I was hospitalized and put on Effexor (venlafaxine), which worked! I'm now 34 and am able to live on my own, have a full-time job and keep up with basic hygiene matters.
One thing the Effexor hasn't helped with is the constant thoughts of stupid things that I have said or done in the past, or negative things that have happened to me. Several years ago I started going to a therapist to get help with this. Despite trying CBT, exercise, volunteering, yoga, meditation and staying on a healthy diet, my brain still insists on replaying my life's blooper reel over and over again. I have a terrible self/body image and the obsessive thoughts are making it worse. I never date and have a very hard time socializing with the few friends that I have.
My therapist has finally concluded that it might be time for me to start trying a different medication along with Effexor (I am already on the highest recommended dose). I am terrified to try another medication because of how badly I reacted to them in the past. However, I'm even more terrified of what will happen if I don't try and things continue to worsen.
Has anyone out there successfully treated obsessive negative thoughts with medication, and if so, which one has worked? The meds that were unsuccessful for me were: Paxil, Prozac, Xanax, Cylert, Zoloft, Nardil, Celexa, trazodone. (I was also misdiagnosed with borderline schizophrenia and put on Stelazine, that was fun!) Or if you were successful without medication, what did you do?
(throwaway email: anon2695@gmail.com)
IANAD. IANYD. One thing you might talk about with your therapist is the possibility that you may need to treat a borderline Obsessive Compulsive Disorder? Nothing that makes you wash your hands compulsively, but one that won't let your brain shut down useless thought patterns? That might help your doctor to narrow down the range of pharmaceuticals that you might try.
posted by pickypicky at 3:10 PM on October 23, 2011
posted by pickypicky at 3:10 PM on October 23, 2011
I don't have any experience with medication. But for some reason, reading about ways to help myself and how to change my dialogue with myself really helped. Maybe it's because it was such a different approach to how I usually handled things. It made a difference to get a different perspective on things and ways to change my dialogue. I'm not one for a lot of self-help books, they typically bore me, but I thought it was worth a shot. I'm not perfect, but it gave me some things to work on and think about.
The Power of Self-Coaching, while not a cure-all or even the most amazing book ever written, gave me pause and helped me try a different approach to tackling my anxiety and depression. Perhaps it's just one more piece to the puzzle in helping you get better.
posted by Sassyfras at 3:14 PM on October 23, 2011
The Power of Self-Coaching, while not a cure-all or even the most amazing book ever written, gave me pause and helped me try a different approach to tackling my anxiety and depression. Perhaps it's just one more piece to the puzzle in helping you get better.
posted by Sassyfras at 3:14 PM on October 23, 2011
As insectosaurus said, this is a question for a psychiatrist who is well-versed in medication-resistant depression.
Maybe even try a different therapist with that specialty, as well? I'm guessing you've discussed this stuck point with your therapist already--if so, it is not likely to be helpful to go to your therapist and tell him/her what diagnosis you "may need to treat" as suggested above. If you haven't already discussed it with your therapist (can't imagine you wouldn't have said something about it already, though), then definitely give that a try, describing your symptoms in as much detail as you can.
posted by so_gracefully at 3:21 PM on October 23, 2011
Maybe even try a different therapist with that specialty, as well? I'm guessing you've discussed this stuck point with your therapist already--if so, it is not likely to be helpful to go to your therapist and tell him/her what diagnosis you "may need to treat" as suggested above. If you haven't already discussed it with your therapist (can't imagine you wouldn't have said something about it already, though), then definitely give that a try, describing your symptoms in as much detail as you can.
posted by so_gracefully at 3:21 PM on October 23, 2011
You might talk with your therapist about doing some thought restructuring exercises, if you haven't done those already. You need to do them a lot, like every day all day for awhile. You know, when you have a negative thought, you literally have to go to your diary and write it down and then restructure it on the spot. It takes months of practice.
You can also make it fun, if that helps. For awhile -- this story is almost embarrassing, but everyone else seems to think it's awesome -- I used to imagine my brain as a court room. There was a judge, which if you've done DBT is in the wise mind role. There was a prosecutor, who just kept the ANTs marching in incessantly. And then there was me, in the role of defense attorney.
Having that little game helped me to identify the negative thoughts, do the "how much do I believe this?" thing, and then the, "what do I really believe?" thing, all without nearly as much effort as it had taken in the past. It was like making a story in my head.
For what it's worth, I've struggled with ANTs all my life. I struggle somewhat less now, after combining the DBT and CBT. But it used to be all, "Ten years ago I told a guy that his legs were so skinny it was gross. I can't believe I said such a thing to a person, especially a person I really liked. He was really offended. No -- he was hurt! I bet he still hates me," and "OMG remember that time I punched a guy? Who does that??? I must be evil."
So: thought restructuring! Do it constantly. Create your own story, and have that story be about being kind to yourself. Recently I was sporting a fairy godmother in the form of an angelic LM Montgomery, who would talk reasonably to me about the crazy stuff in my head. And right now I've got a campaign going called, "Do it for The Grey Lady!" (aka, Lady Jane Grey, my newly adopted cat). Doing homework has never been so much fun.
Medication-wise, have you talked with your psychiatrist about benzodiazepines? I'm not saying that's the right thing -- having never studied medicine or therapizing in any way, I am not qualified to say what is the right thing. But you might ask your doctor about the effects of a small dose of a longer-acting benzo to take at bedtime. (If you're like me, you probably lie awake nights thinking over all the terrible things you said that day.) You could also talk about a minuscule dose for when you're having a serious obsessive negative thought session.
If you live in a medical marijuana state you might consider talking about that with your doctor. I'm not sure if cannabis + Effexor would be a good combination, so please be sure you're in the hands of a good psychiatrist before you start in on the sativa.
Also, if you have impulsivity difficulties, you might not want to start in on either benzos or cannabis. So, you know ... ask your doctor!
If you are in NYC and want recommendations for good DBT folks, psychiatrists or the like, please feel free to MeFiMail me.
posted by brina at 3:51 PM on October 23, 2011 [4 favorites]
You can also make it fun, if that helps. For awhile -- this story is almost embarrassing, but everyone else seems to think it's awesome -- I used to imagine my brain as a court room. There was a judge, which if you've done DBT is in the wise mind role. There was a prosecutor, who just kept the ANTs marching in incessantly. And then there was me, in the role of defense attorney.
Having that little game helped me to identify the negative thoughts, do the "how much do I believe this?" thing, and then the, "what do I really believe?" thing, all without nearly as much effort as it had taken in the past. It was like making a story in my head.
For what it's worth, I've struggled with ANTs all my life. I struggle somewhat less now, after combining the DBT and CBT. But it used to be all, "Ten years ago I told a guy that his legs were so skinny it was gross. I can't believe I said such a thing to a person, especially a person I really liked. He was really offended. No -- he was hurt! I bet he still hates me," and "OMG remember that time I punched a guy? Who does that??? I must be evil."
So: thought restructuring! Do it constantly. Create your own story, and have that story be about being kind to yourself. Recently I was sporting a fairy godmother in the form of an angelic LM Montgomery, who would talk reasonably to me about the crazy stuff in my head. And right now I've got a campaign going called, "Do it for The Grey Lady!" (aka, Lady Jane Grey, my newly adopted cat). Doing homework has never been so much fun.
Medication-wise, have you talked with your psychiatrist about benzodiazepines? I'm not saying that's the right thing -- having never studied medicine or therapizing in any way, I am not qualified to say what is the right thing. But you might ask your doctor about the effects of a small dose of a longer-acting benzo to take at bedtime. (If you're like me, you probably lie awake nights thinking over all the terrible things you said that day.) You could also talk about a minuscule dose for when you're having a serious obsessive negative thought session.
If you live in a medical marijuana state you might consider talking about that with your doctor. I'm not sure if cannabis + Effexor would be a good combination, so please be sure you're in the hands of a good psychiatrist before you start in on the sativa.
Also, if you have impulsivity difficulties, you might not want to start in on either benzos or cannabis. So, you know ... ask your doctor!
If you are in NYC and want recommendations for good DBT folks, psychiatrists or the like, please feel free to MeFiMail me.
posted by brina at 3:51 PM on October 23, 2011 [4 favorites]
One of the things that has been helpful for me specifically for recurring negative thoughts is writing the whole thing out and then picking it apart. Like, say I did X and I keep thinking about it and what a loser I am. I write out the whole entire situation surrounding X ("it was a bright sunny day, I was about nine years old, my parents were busy in the living room...") and exactly how I feel about it and the situations that tend to make me think of it ("it seems like I think about X the most when I'm doing something sort of mindless like cooking, and my thoughts begin to drift... the litany of fail is really persistent at these times and I usually end out burning my dinner as I weep in despair.") Then I try to write out all the things that indicate that it wasn't such an epic failure ("I was only nine years old and didn't really understand what was going on, I was under a lot of stress with dad recently getting remarried, I did X out of instinct, I haven't ever done X again because I learned my lesson.")
My therapist also had me do some exercises involving my inner critic which I have found helpful (I'll email you examples.)
And this is something that could come from what some people call "pure-o" OCD as well as from other anxiety disorders, depression, and even other stuff. I have been blessed with several diagnoses, each of which has intrusive thoughts as a symptom. At the moment I am on a very low dose of Lexapro which isn't helping much; a moderate dose of Wellbutrin helped more. The Wikipedia link lists some drugs that are found helpful for specific types of intrusive thoughts.
You have my sympathies, by the way, on the drug changes thing.
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 4:15 PM on October 23, 2011 [1 favorite]
My therapist also had me do some exercises involving my inner critic which I have found helpful (I'll email you examples.)
And this is something that could come from what some people call "pure-o" OCD as well as from other anxiety disorders, depression, and even other stuff. I have been blessed with several diagnoses, each of which has intrusive thoughts as a symptom. At the moment I am on a very low dose of Lexapro which isn't helping much; a moderate dose of Wellbutrin helped more. The Wikipedia link lists some drugs that are found helpful for specific types of intrusive thoughts.
You have my sympathies, by the way, on the drug changes thing.
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 4:15 PM on October 23, 2011 [1 favorite]
Hope you find a medication regimen that works better.
Meanwhile, try cognitive-behavioral strategies as suggested by others already. Try "Feeling Good" by Dr. David Burns ( http://www.amazon.com/Feeling-Good-New-Mood-Therapy/dp/0380810336 ). Although his theory that negative thoughts create depression is bunk, IMO, his strategies are good. If you have trouble getting yourself to do them, get a friend or your therapist to hold you to a schedule or other framework of commitment, sitting with you if necessary.
You may like to read "Triumph Over Fear" by Jerilyn Ross, as it has a lot of success stories of people with horrible anxieties getting over them. Not quite the same as constant intrusive thoughts, but there's a lot of overlap.
posted by r0w at 6:32 PM on October 23, 2011
Meanwhile, try cognitive-behavioral strategies as suggested by others already. Try "Feeling Good" by Dr. David Burns ( http://www.amazon.com/Feeling-Good-New-Mood-Therapy/dp/0380810336 ). Although his theory that negative thoughts create depression is bunk, IMO, his strategies are good. If you have trouble getting yourself to do them, get a friend or your therapist to hold you to a schedule or other framework of commitment, sitting with you if necessary.
You may like to read "Triumph Over Fear" by Jerilyn Ross, as it has a lot of success stories of people with horrible anxieties getting over them. Not quite the same as constant intrusive thoughts, but there's a lot of overlap.
posted by r0w at 6:32 PM on October 23, 2011
I'm in a similar situation. I'm keeping a log of every little thing I accomplish. If it doesn't make me happy with myself, it at least sets a lower bound: I can accomplish at least this much.
posted by LogicalDash at 7:20 PM on October 23, 2011
posted by LogicalDash at 7:20 PM on October 23, 2011
Recently, I was driving in the car listening to the radio and I heard this program
from a guy who leads guided meditations. He talked about having a respectful inner dialogue with yourself and something just clicked for me. I realized that I hadn't been having a respectful inner dialogue and that I at least deserved to treat myself as respectfully as I treat others.
posted by bananafish at 10:10 PM on October 23, 2011 [1 favorite]
from a guy who leads guided meditations. He talked about having a respectful inner dialogue with yourself and something just clicked for me. I realized that I hadn't been having a respectful inner dialogue and that I at least deserved to treat myself as respectfully as I treat others.
posted by bananafish at 10:10 PM on October 23, 2011 [1 favorite]
I have/had this exact same problem. Honestly, medication never seemed to nip this particular problem for me, although I tried quite a few. I know you said you tried CBT and it didn't work, but that was what helped me. I learned some mechanisms to cope and they work pretty well most of the time. Part of it is just being mindful and noticing that you are doing it and that it's affecting your mood. Also visualizations/thought experiments have helped me a lot with this problem. For instance, if I notice that I'm replaying every stupid thing I've ever done, I'll try to actively imagine something else, like building a magnificent garden in my head and working out every detail like which flowers go where, etc. You have to interrupt your brain's negative thought process. At first it's really hard, and you'll find yourself unable to do it, but with practice, it gets much easier. Now I can only get about 5 minutes of brain blooper reel before my mindful brain kicks in and says, "Hey! Let's think about how to take apart a car/make a garden/recite the preamble to the constitution instead!". It's weird, but it works.
posted by katyggls at 11:38 PM on October 23, 2011
posted by katyggls at 11:38 PM on October 23, 2011
My brother had mild OCD, and possibly whatever might be a mild case of bipolar disorder. he was greatly helped by Learned Optimism, Martin Seligman. I have been helped a lot by Playing Ball on Running Water, David K. Reynolds. Both have strategies for changing behavior, and dealing with negative thoughts.
posted by theora55 at 7:17 AM on October 24, 2011
posted by theora55 at 7:17 AM on October 24, 2011
What you are asking is how do you learn to love yourself. Drugs can dull the pain of lacking self-love but I doubt any drug can give you that love. And therapists are rarely very helpful, other than to offer more drugs. So where to find this love of self from which all other love springs? Despite it's poverty, filth and general bad world image, I doubt that there is any other country on earth that has given so much time and effort to understanding the nature of mind as India. And that is what you need to discover - the nature of your mind. If you do that, self-love (not self-ishness) will follow quite naturally.
There are many places you can go that are sheltered, comfortable, secure and offering what you need. If you want to message me I can recommend (I'm not associated with any of them in any way, but I know their work and many who have been to them).
posted by nickji at 4:42 AM on October 25, 2011 [1 favorite]
There are many places you can go that are sheltered, comfortable, secure and offering what you need. If you want to message me I can recommend (I'm not associated with any of them in any way, but I know their work and many who have been to them).
posted by nickji at 4:42 AM on October 25, 2011 [1 favorite]
Caution: stay away from the pot. It plus the Effexor will not be kind to you.
I have something similar, and my psych suspected I may have bipolar disorder, so besides the Effexor I also am on sodium valproate. I do feel that I can focus more, but the blooper reel thing hasn't always gone away (it comes and goes).
What helps for me is external validation - just hearing someone say something nice about me helps me get out of my head a bit. Sometimes it can be hard to believe, buta different perspective is useful.
posted by divabat at 7:17 AM on October 25, 2011
I have something similar, and my psych suspected I may have bipolar disorder, so besides the Effexor I also am on sodium valproate. I do feel that I can focus more, but the blooper reel thing hasn't always gone away (it comes and goes).
What helps for me is external validation - just hearing someone say something nice about me helps me get out of my head a bit. Sometimes it can be hard to believe, buta different perspective is useful.
posted by divabat at 7:17 AM on October 25, 2011
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I have struggled with serious depression and an eating disorder (including very poor self and body image) and obsessive thoughts as well.
I am not familiar with all of the meds you have tried, but it sounds like you have tried a lot of SSRIs. Have you tried a mood stabilizer to "boost" the effect of the SSRI? I take a low dose of abilify, and it really helps boost the effect of my celexa. I also tried lamictal - which is supposed to do the same thing - but it had zero effect on me (nothing good or bad, no side effects).
CBT works for me, but it worked slowly. I'd say it took about 6-7 months of very intensive work (some inpatient) to see any improvement. So, if it's been less than a year, keep at it - it might still prove very helpful.
I might come back to this after I think about it a little.
posted by insectosaurus at 3:09 PM on October 23, 2011 [4 favorites]