The worms crawl in and the worms crawl out
May 8, 2015 11:12 AM   Subscribe

I am having a weird symptom lately that I don't know whether to attribute to depression, anxiety, or aging. Namely, I can't stop thinking about death and dying. I'm 26 and I am constantly thinking about how I could die at any moment and time is running out for me (and my loved ones).

Of course, these things are true-- time is ticking by and I could die at any moment. But it seems unhealthy to think about it every day and kind of all the time.

It's not like a panicked thought, it's more like every time something good happens to me, I think, "well, I could die at any moment." Or I'm just sitting around with a sense of low-level dread because it's always on the back of my mind. This has been happening for about three months now, since I had an IUD inserted in January. I visualize myself suddenly dying a lot-- being hit by a car, being shot. Watching a horror movie used to be a scary/fun experience for me and now it's like inviting in weeks of morbid dread. I also think about my loved ones getting old and it makes me very sad, like tears-in-my-eyes-at-work sad.

I used to have these thoughts a lot as a teen (and was also an insomniac), but they stopped in my 20s. In my 20s I also basically completely stopped being an insomniac. Once, when I was like 22, I had a big iced coffee that sent my anxiety through the roof and I spent the rest of the evening in a haunted haze of doomy rumination, and I realized for the first time that the general dread/generalized anxiety was probably just that, anxiety related. I have no idea about the incidence of heightened anxiety with an IUD, but since having it installed, I've also had insomnia again. It's pretty easy to treat-- waking up earlier or taking a little melatonin from time to time helps. But the doomy thoughts don't go away. I asked my doctor and she said there was no correlation that she knows of (though to be honest, I don't particularly like her approach to woman care/health care, which is kind of just "put up with it" when it comes to birth control).

I started taking an SSRI (Zoloft) to see if that would help, and it did for awhile, but it seems like maybe a certain time in my menstrual cycle is also triggering it? I haven't pinned it down yet. It happens when I am drinking caffeine and when I haven't had caffeine in months, so I don't think there is an important correlation (caffeine could make it worse but quitting doesn't make it stop).

I'm not really depressive in any other sense. I don't hate myself-- I actually like myself more than ever. I've been accomplishing a lot in my life lately and feel good about it. I noticed that a lot of the intrusiveness went away when I visited family-- I think a lot of it is related to feeling lonely and like no one is around to be my witness, or to experience milestones with me, so my life just passes meaninglessly. But on the other hand, I've been living this life for awhile now and the thoughts haven't been consistent.

I will talk to my doctor about this, but I'm a little concerned that these problems are being brought back by the hormones from the Mirena IUD, because I don't really want it taken out to check-- but I also don't want these symptoms for the next five years. Is this normal? Should I try a higher dose of SSRIs? (I'm on a low dose now, 25mgs, which took the edge of my anxiety for the most part.)

The really weird thing is that I'm kind of at peace with death. I don't want to die, but I have gone through periods of "holy shit holy shit death how do I function" and this is not that. I am sad that it will happen to me and my loved ones, but I know that in likelihood it won't happen for awhile, and that you take life one step at a time, and I take comfort in my little nephews and nieces who will (hopefully) outlive us. I want to have my own children one day too. But I just... don't want to dwell on this all the time in such a "gotcha" way. It's like I keep thinking I'll be taken unawares and want to be on guard-- which is ridiculous.
posted by easter queen to Health & Fitness (10 answers total) 4 users marked this as a favorite
 
This is what I'd call an "intrusive" thought. CBT is great for quelling them, as is EMDR.
posted by Hermione Granger at 11:45 AM on May 8, 2015 [2 favorites]


Best answer: This happened to me sort of when I was on the pill, and Mirena actually made that stuff go away. But any hormones can do ridiculous things to you. Have it checked out.
posted by roomthreeseventeen at 11:53 AM on May 8, 2015 [1 favorite]


If you are really averse to having your IUD removed in case hormones are the culprit, you can try therapy for a couple of months and see if there starts to be improvement.

I'm about your age and I also have been constantly thinking about death and how I can die at any moment. In my case it was directly related to this. Therapy might help you uncover other causes for these thoughts if it's not actually hormonal.

Good luck.
posted by Librarypt at 11:55 AM on May 8, 2015


Response by poster: I should also note that the Mirena is definitely having SOME effect on me-- my sex drive has been nil since it was inserted. I'm being a good little patient and waiting 6 months to see if symptoms resolve themselves, however.
posted by easter queen at 12:27 PM on May 8, 2015


I think this is a normal part of being a 20-something. I began feeling this way a year and a half ago when I lost a parent, but I have been assured by Mental Health Professionals and Other Adults of Authority In My Life that everyone comes to realize their own mortality at some point.

As far as the IUD -- were using an oral contraceptive (or shot/patch/ring) before having the IUD put in? If so, more likely the symptoms you've been experiencing are due to stopping that (high-dose) method, not starting your new (low-dose) method.
posted by i_am_a_fiesta at 1:10 PM on May 8, 2015


Best answer: Oh god, yes, this is me. Or it was me a couple years ago, less so now. Hermione Granger is right; they're known as intrusive thoughts, and often a symptom of OCD. Finding a therapist who specializes in OCD or anxiety can help, and you may want to look into ACT specifically.

For me, it seems to come and go, sometimes flaring up if I'm under a lot of stress, have recently seen or read something similar to my intrusive thoughts, or if my life has a lot of... restlessness, I guess I'd call it? When there's nothing specific in my life that's worrying me or getting me down, but there isn't anything good or satisfying for me to focus on, either. It's like intrusive thoughts are my mind's busywork when my mental inbox is empty. So it helps me to give my brain something benign to do, like reading a good book or cleaning the house. Exercise helps me a lot, too: it tends to get my brain's excess energy out and leaves me feeling relaxed.
posted by Metroid Baby at 1:20 PM on May 8, 2015 [3 favorites]


Best answer: The Mirena made my emotional health go completely haywire (including vicious intrusive thoughts), it is totally possible that this might be related. Talk to your gynecologist ASAP. I went back to baseline within two months of having it removed.
posted by lydhre at 1:38 PM on May 8, 2015 [1 favorite]


Hey, I took Zoloft for six weeks once, I had death dreams all the time, wierd ones. So turning 25 was my least favorite birthday. It might just be a benchmark time, and dark thoughts are your less heard self trying to access the complaint department. Think more about your day to day happiness and make sure you are serving it.
posted by Oyéah at 3:22 PM on May 8, 2015


You might want to read Staring at the Sun, by Dr. Irvin Yalom. It's precisely about fear of mortality, and how to deal with it. I found it strangely inspirational as well as moving.
posted by artemisia at 4:35 PM on May 8, 2015 [1 favorite]


I am not sure what the causes could be, but I know seratonin and dopamine are precious, and when they get too low, my fears incapacitate me. It's great to appreciate how fragile life is, but it robs quality of life when it gets you down. I hope the best for you.
posted by Shylo at 6:12 PM on May 14, 2015


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