How can I stop the endless negative chatter that stops me focusing?

May 21, 2017 11:40 PM

I know lots of people have an inner monologue of negative thoughts, I believe the Buddhists call it the "monkey mind" but I'm not sure. But I seem to have it to a ridiculous extent, to where it's impeding my ability to focus and do back to work activities, and I think my bipolar brain chemistry is a big reason it's so bad. What can be done about and what sort of specialist help could I seek (it's something I'd be willing to pay privately for help/ classes with if there was a good chance of success).

I have Type 1 Bipolar Disorder and haven't worked since 2005, partly because for many years I was a caregiver in an unhealthy relationship and unable to access much treatment for myself or engage with the help on offer.

I now have no personal commitments and plenty of time to try to find "work that works for me", indeed there's a charity helping me do just that, but I am finding one thing a major hurdle.

I need to study to refresh my skills after so long out the workforce and the big hurdle is not being being able to focus for very long because of the constant negative chatter that plagues me all day long. I paid £200 to have access to an online computer training course but whenever I sit down to try to study after a few minutes I can't concentrate because of these thoughts, all very common for people with bipolar disorder, but which just depress me and exhaust me. I will give you some examples. "No one cares about me" "I just can not get things going" "I am worthless and everything I do is worthless" "I am a failure and have always been a failure" "I can not take care of things around the house" "I do not have any hope for the future" "I have no friends and will never have friends" "What am I doing wrong - why don't I have any friends?" [that is not strictly true I have a very small number of friends I just rarely see them] "Life has left me behind" "All of the past was a mess and pointless and my future is bleak and I will never be happy again and have never really been happy in the past" "I'm plagued by this illness" "How many hours until I can sleep again and escape my problems?" "I might have a good IQ but I have no common sense"
"I'm ugly" [I have an ebook with symptomatic thoughts of bipolar people when they are depressed and these were the ones from the list that come up for me most often, there are lots of others]

For whatever reason these thoughts have come up a lot more frequently and intrusively lately. I don't know if part of the reason was, ironically, being assessed by the UK benefits agency as being "severely disabled" (I say ironically because this assessment came with additional financial support included a backdated payment most people would be delighted about) and feeling very discouraged by it, but my psychiatrist was only able to say my illness had become more "labile" and increased my mood stabiliser, but that will have side effects if the dose stays high long-term (mainly weight gain and fatigue). It is possible that the easiest help to access would be getting my Community Psychiatric Nurse to do some CBT exercises with me since I already am registered with them, but I am skeptical how much help that would be as it's very time limited. It's a huge obstacle between me and my goals, and I'd pay a lot either in specialist help or buying books or attending classes or just time if there was something which would get rid of this issue. Has anyone overcome this problem and if so how did you do it? (replies from people with bipolar especially welcome since these thoughts often come with the wonky brain chemistry of bipolar and aren't necessarily related to reality of my life, but anyone who can relate is very welcome to reply!)

posted by AuroraSky to Work & Money (14 answers total)

Have you ever read about the "Pure Obsessional" variation of OCD? Some of what you describe sounds consistent with it, and since its identification is slightly new/obscure, many therapists aren't familiar with how it manifests. Perhaps you could look into it, and re-target your treatment accordingly if it fits?

Pure Obsessional OCD Test

Pure Obsessional OCD (Pure O) is a term for a type of OCD in which an individual reports experiencing obsessions without observable compulsions. These obsessions often manifest as intrusive, unwanted, inappropriate thoughts, impulses or “mental images”. While it may seem that the individual has obsessions without compulsions, a review of his/her symptoms almost always reveals various compulsive behaviors, avoidant behaviors, reassurance-seeking behaviors, and “mental compulsions” which are not at first as easily observed as other, more obvious OCD compulsions.
posted by prosopagnosia at 11:54 PM on May 21, 2017 [1 favorite]

I have Pure O OCD and the intrusive thoughts you describe sound exactly like what I suffer with. IANAD, however, I do think other diagnoses have similar symptoms. In any case, if I were in your shoes, I would do the CBT with the nurse. It might only be short appointments, but you will likely have homework or practice throughout the week. And if she doesn't give you any homework, you can ask for it. Just give it a shot and see how it goes, and try not to write CBT off just yet.
I would do this because when my health takes a dive, I try to do whatever is easiest within my reach, otherwise I might not bother doing anything--this sounds doable.
Another thing that has helped with me is medication, so if you think you might need your psychiatrist to tweak your meds, then talk with them.
The mind chatter is still there for me but these things greatly, greatly reduce it to where I can at least function! YMMV.
You deserve to feel proud that you have identified what this problem is so that you can takes steps to tackle it. Good luck.
posted by shalom at 12:18 AM on May 22, 2017 [1 favorite]

Try this: Headspace
posted by bergnotburg at 12:20 AM on May 22, 2017 [2 favorites]

One last thing, it sounds like you are going through a transition time, and that ALWAYS spiked my anxiety. So feeling more anxiety when job searching is totally normal. I bet the vast majority of people have some amount of anxiety while job searching.
Also, being labled disabled can be very distressing. Yes, getting a little extra money is good, but disability payments never made anyone rich. Having a disability, being unable to work, is so stigmatized in our societies. We are fed this story that "falling" disabled is a huge tragedy, but that isn't always the case. I know many disabled people who lead awesome lives. I know Disabled artists, editors, dancers, therapists, performers, one who leads a prominent non profit. I know that being impaired is a pain in the ass. But there are all these weird myths surrounding disability that we are spoonfed and they are worth deconstructing, because disability is not a death sentence.
posted by shalom at 12:32 AM on May 22, 2017 [1 favorite]

i have gad and sa. a mindfulness meditation is great over a medium to long term. many beginners are filled with fear and increased anxiety - paradoxically - because now they have space to pay attention to the thoughts and feelings. the practice is, loosen the hold on them, let go.

- the meditation section in 'when things fall apart' is simple and useful.
- thict nhat hanh has a great beginner's guide
- call a buddhist center and ask about guided mindfulness meditation

and, as always, follow your md's advice starting and stopping any psych meds.

cheers - memail if you need to.
posted by j_curiouser at 12:51 AM on May 22, 2017

What you described sounds very similar to what my sister has been experiencing the majority of her life (though she likely has Bipolar 2 with major depression). She has reported, and based on her observable behaviour changes I agree, that taking an antipsychotic medication along with her depression treatment was a HUGE help. In her case it was Paxil + Seroquel. The Seroquel was the only thing that has ever quieted her Intrusive Thoughts. When she went off this combination to get pregnant the Thoughs returned :(

Good luck.
posted by saradarlin at 12:52 AM on May 22, 2017 [2 favorites]

It is possible that the easiest help to access would be getting my Community Psychiatric Nurse to do some CBT exercises with me since I already am registered with them, but I am skeptical how much help that would be as it's very time limited.

Why not begin with the free resource that's readily available to you (if your CPN has CBT training) and see if it helps at all? If it does, you can use some of your funds to seek out more CBT. CBT is generally the most effective treatment for the symptoms you describe. I agree that medication, and also The Feeling Good Handbook (which you can get delivered via Book Depository), are good steps to take.
posted by DarlingBri at 12:56 AM on May 22, 2017

I can give you some pointers from experience.

1. With respect to negative thoughts, I've found (a) acceptance and (b) a plan and (c) execution of the plan helps a lot. Accept where you are without blame or pity, plan to get out of there with a timeframe and (c) execute. Check your progress against your plan regularly. It helps.

2. With respect to chatter: Medication (SSRIs) and therapy has helped me more than anything.
posted by gadha at 3:07 AM on May 22, 2017

High level of negative chatter describes me perfectly, in fact everything you noted as things that grind your progress to a halt are the things I hear on the constant in the background of my mind.. What has helped to some success has been acts of kindness towards myself, monitoring the thoughts through arguing with them, and having a personal cheerleader. My personal cheerleader is my mentor, who knows of my history as a isolated caregiver who had given up on life.

What you can do for yourself: Start hyping yourself up over tasks you know you are doing well. I mean, celebrate it. Write it down. "Today, I was amazing at getting these things done." When a negative thought pops up, I argue it internally. "Oh, I'm ugly and alone and will never be hired? Well, how do you explain being told I was pretty, having a boyfriend and having a few successful positions with companies recently?" I browbeat my negative mind into submission most of the time and challenge each negative thought to prove itself. When depression and anxiety try to drown me, that's when I lean on my personal cheerleader. "Hey, I know this sounds irrational but my brain is being a bastard. Can you remind me why I'm going to ace this class I'm scared of failing?"

Your personal cheerleader could be a therapist, a person you respect, or an online friend. Seriously, it's not a burden to them and it's not going to poison the relationship.

Next up: at one time in my life I was diagnosed a thing and told I would likely not see my 30th birthday because of how ill I was and that killed a lot of my confidence in the future. I felt defective. I felt betrayed by my brain. Instead of making me fight the diagnosis and prove people wrong, I excused myself from living. I say this because it is very important how we are categorized as people and if we're told we can't be a thing or we're too unwell - it can trigger that "Why bother" mentality and prevent us from a lot of positive things, like having a damn life. It can also help feed the negative thought beastie and... well, it follows us around even when we're doing quite well.

I get that you've been assessed as "severely disabled" but how about rejecting the notion that this is your final status in life? Believing you can lead a happy productive life is a good part of leading a happy productive life. When we're written off as unable to do something because of brain chemistry, it can defeat us before we're out of the gate! Doesn't mean the underlying medical issue isn't there but it does take the power away from it.

Therapy will be an important part of the solution. Even time-limited therapy will give you some framework of tools in coping with what you have pinpointed as the issue. The bulk of the work in therapy isn't in the clinician's office but in our own time outside of the office.

Your online training course, does it have a study group locally? Are there groups locally that meet up for the topic you're getting into? Sometimes I find it harder for a negative thought to take control if I'm actively outside my bubble - because I'm having to interact with someone face to face and my brain can't multitask, funnily enough.
posted by missh at 5:21 AM on May 22, 2017 [1 favorite]

Have you tried noise in headphones? I use noisli (80% rain, 80% train tracks, and 20% brown noise for me, but you should try the coffee shop too). I think maybe the noise interrupts circular thoughts in the same way a CBT rubber-band does. YMMV, but you'll know if it works or not after half an hour or so, so at least it's quick to test.
posted by Leon at 5:24 AM on May 22, 2017 [3 favorites]

ADD meds helped me with this - immensely.
posted by bunderful at 5:31 AM on May 22, 2017 [2 favorites]

The best thing for me for negative chatter has been a combination of meds and CBT. Just basic self-taught CBT from a book (honestly, I think it was a "CBT for dummies" book or something close to it. Only some of the standard CBT exercises seem helpful for me, so I pick and choose the ones that do help.

Having said that, my family member with bipolar feels and strongly recommends to others that the best thing for many bipolar brains is a combination of DBT and CBT, each applied to different sorts of brainweasels. I don't know much about DBT myself except as he's explained it to me, but I wonder if it might be useful for you to pick up a book and at least look at whether it seems like a helpful tool for you.
posted by Stacey at 5:36 AM on May 22, 2017 [1 favorite]

In addition to mindfulness meditation, you might look into self-compassion: Kristin Neff's TED talk is a good introduction and her website has exercises and guided meditations.

You can learn these practices on your own, but I would suggest a class (even an online class) because you'll inevitably have questions or feel stuck in your practice and it's a huge help to have a teacher. Try googling "MBSR" (stands for Mindfulness-Based Stress Reduction) and your location.

Mindfulness and CBT can help you to be more skillful in dealing with your negative thoughts, but if you are just bombarded with them constantly, it can be really challenging to keep practicing the skills. I suspect the solution will be a combination of medication change and learning new ways to deal with negative thoughts, rather than just one or the other.
posted by tuesdayschild at 6:54 AM on May 22, 2017

I'm with bunderful. Consider ADHD therapy. ADHD can actually masquerade as other disorders, including Bipolar (which I suspected I had for ages), as well as be co-morbid.

Adderall really helps me silence the chatter in my brain, and keeps me from flying off the handle.
posted by SansPoint at 7:56 AM on May 22, 2017 [1 favorite]