Are intrusive thoughts a regular symptom of high anxiety?

[LiveAboveIt]

I was diagnosed with GAD as a kid, but recently Ive been recently experiencing my worst bout of anxiety ever. My worst symptom is the inability to control my thoughts or whats on my mind. I used to feel like I had control of my thoughts in the past, but now I have this strange awareness of how I feel and my thoughts.. Ive noticed the more I dont want to think about something, the more my mind forces a barrage of them at me. Simply thinking about my anxiety bothers me, and it bothers me that it bothers me that Im thinking about it, if that makes any sense. It has even progressed to my mind screwing with me during times of high anxiety, especially in the morning.. For example, .. When a thought that I dont like pops into my head, I think "No, Im not going to think about this." And then I have this thought, "What if I cant stop or help it?" I feel my mind immediately think "Yes you are going to think about it," which seems almost involuntary and really freaks me out. Its almost like I have a voice in my head that is an embodiment of my fear and subconscious. I immediately start to panic and think something is wrong with me or that Im going crazy or have something else that I havent been diagnosed with. Its almost like Im fighting with my own thoughts and I cant control where my mind goes and it decides to think the very thoughts that I try not to think about, and it scares me. Am I going crazy? Is this the onset of some other mental disorder that has been missed?

Ive also been sleeping with absolute crap, due to dealing with pretty bad insomnia. Only get 3-4 hours a night, and Im not sure if this has been a contributing factor.. Ive been assessed by multiple Psychiatrists and nothing but GAD has ever been diagnosed, but I cant help but feel frightened by the intrusive thoughts and the fact that they seem to have a mind of their own, its a very new symptom for me and I dont understand it. I just want reassurance that this is normal, so I can learn to not be afraid of it.

[Xtrastrongbint]

Oh gosh - this is very normal! I was at my worst with intrusive thoughts when I had panic attacks...you can have a look at panic and anxiety on youtube or wherever and it's definitely a side effect of anxiety - I promise you're not mad x

[wantpeace]

You're suffering from metacognition. All part and parcel of severe anxiety. It does get better with treatment.

[LiveAboveIt]

Phew. Thank you for the replies, I thought it was schizophrenia or maybe something even worse. Honestly, I think just not knowing what it was or why it was happening was why it was so scary. Should I just do my best to ignore it and not be afraid of it?

What type of treatment is recommended? Im taking 20mg of Citalopram and trying to find a therapist.

[Xtrastrongbint]

How long have you been on the cit? If you're in the first 4-6 weeks it will get worse before it gets better but you will get better. There's quite a lot of advice when it comes to intrusive thought and how to deal with it...claire weekes is a good one - she says to float through it, some say acknowledge the thought and let it pass but don't concentrate on it (hard!), distract yourself, do some mindful meditation etc etc...I was reading that actually everyone has intrusive thoughts it's just anxiety makes you focus on them - the umbrella term is Pure O and people have some scary intrusive thoughts but therapy and meds will definitely help x

[LilGsMama]

I've had unpleasant thoughts during this anxiety/depression/HA etc.. mostly about death. I first read Claire Weekes' methods back in 2003 and although I find them hard to implement when I'm in a downward spiral, they do help. I ended up replacing one of my books as it fell to bits! definitely worth a read :yesyes:

[LiveAboveIt]

Ive been on 20mg for 22 days, was on 10mg for 4 days before that. I feel like Ive fallen so far down in my anxiety that every little thing is a fear, I walk around pretty much all day with intense fear for no reason until my anxiety catches a particularly scary thought to throw at me.. it feels so easy to fall into panic, even when i know that the thoughts are illogical, the fear seems to be a habit. Been going on about 2 months now and I feel like my morale is incredibly low and I have no faith or confidence in myself, constantly seeking reassurance about even my own thoughts, from others.

Hoping the Citalopram will help once Ive been on it a little longer.

[Xtrastrongbint]

Live - it will get better - you gotta hang on in there for 4 to 6 weeks - coming on here is a great relief. I would also google as much as you can for anxiety help. There are so many free and helpful things on the internet. My panic disorder started before the internet and I was terrified and had no-one to talk to...it was hard. Hopefully coming on here will make you feel better - let us know how you get on :hugs:

[LiveAboveIt]

See, I tried to follow the ****** ****** and all it did was make me afraid to take medications and it made me worried to seek reassurance from therapists and other sources.. In the end I decided that it wasnt for me, but there is still residual information left over that causes me to feel unsure.

[LiveAboveIt]

Can it really increase anxiety for 4-6 weeks? I was under the impression that most side effects are gone within the first 1-2 weeks, or at least that's what I've read. Being on week 3, this idea actually worried me that the pills weren't actually going to work if they aren't already. I can't imagine going through something like this when you have no one else to talk to, that would be incredibly difficult.

[MyNameIsTerry]

I think people who suffered side effects for 1-2 weeks were lucky.

If you look at the SSRI class alone there are differences in which other receptors & neurotransmitters they work on but predominantly it is Serotonin. However, the half life dictates how fast you reach "steady-state" (the same amount going in as going out i.e. a stable dose) in your blood plasma. For instance, Citalopram takes over a week, Escitalopram is quicker than this, Sertraline takes just under a week and Fluoxetine takes just over 30 days! Fluoxetine is really the exception as it has a far longer half life than any of the other SSRI's so it is known to take beyond 5 weeks until levels in the brain are stable.

Now add in SNRI's. Ven reaches stable dose within 3 days because it's such a short half life drug. Duloxetine isn't much longer either.

I had Citalopram the first time and I found it took until week 3 until the started reducing and by week 5 they had gone. The second time around I went on Duloxetine which has a much shorter half life. You have to taper up on Duloxetine (first 30mg and then to 60mg) and at the 60mg it crosses over the threshold into being a SNRI otherwise before this it is really working as a SSRI. On this med the 30mg hit me with the usual nausea of the SSRI's for a couple of days but soon it was ok but the day after starting the 60mg I was suffering badly and this got progressively worse until about 4 days and then it stayed at an atrocious level of agitation until about day 8-10 and then it suddenly reduced. As I came to understand this med later on I worked out how it would have reached it's steady-state and found it was close to that day 4.

I have observed in some people that they seem to suffer a worse week two on Citalopram. I can't remember how mine went, it was so long ago now. I've seen some people struggle with the 5th week on Fluoxetine. So, I wonder whether once you reach that steady-state where you are getting a stable daily dose of the med, whether your body has adjust from there hence why many people suffer more then than at the very beginning when it is ramping up.

We also have to remember that SSRI/SNRI's work in two stages. Stage one happens very quickly by increasing the volume of the neurotransmitter circulating in the space between two nerve cells, known as a synapse. It isn't creating more, it's just flooding that gap because it's preventing reuptake (in the sending nerve cell) and allowing more stimulation of the receiving nerve cell. The second stage takes longer and this is the down regulation part which is basically the plugging of the holes in the sending nerve cell, a bit like a shower head getting furred up so less water comes through the holes until some hols are blocked except it just means that more is sent out but less is reabsorbed into the sending nerve cell. This is the real effect needed. I've seen some studies where this has been quoted at 30 days but I can't remember which SSRI it was. Fluoxetine will obviously take much longer due to the issue with it taking 5 weeks to achieve what other SSRI's do within a week or so.

[LiveAboveIt]

You've done some serious analytical research when it comes to meds, Terry! It makes a lot of sense, I suppose. It seems like my first week was pretty bad, second week slowly started to improve, and now my third week seems worse than the first week. I imagine it's difficult to tell from person to person, as everyone is different, but it certainly seems like my body is going through phases when it comes to adjusting to the med.

So I guess I have two things to look forward to, the side effects decreasing as my body adjusts more to the med, and hopefully the med will start to improve my anxiety/depression once my body adjusts to it, as well.

Thanks for the response, I was worried about still having issues after having been on the med for 3 weeks. Seems like all I could find were posts about people saying the first week or so is the worst, but week three seems to be pretty bad for me in ways, especially increased anxiety in the morning.

[MyNameIsTerry]

The curse of OCD for me there :winks: I knew nothing a few years ago and suffered for that lack of knowledge but joining this place got me on the path to finding these things out from others and reading the medical sites. It helps me knowing how things work as I can use that as positive evidence in some way when dealing with symptoms.

I would think the first week is rocky because of all the upheaval in steady dosage but then the second week would be tough as it's consistently high. (this is considering Citalopram) But then there is this down regulation part going on towards week 4 so perhaps some find that hits them more? I don't know why, but in your case it seems less like what I was thinking when I looked at my experience.

Meds are just a minefield! Since the scientists still haven't proved how they help us other than "it is thought", we can only try to work with it.

We always say 4-6 weeks on here. I think that is also because people become frustrated with taken a med that not only doesn't seem to be helping but is making us worse. It's the opposite of what many of us would experience with the meds we were prescribed growing up like antibiotics. Those who have had more serious physical problems may be more used to the "gets worse before it's better" issue.

It's just so annoying though because you go to see your doctor saying you can't cope and don't think you take any more and what do they do? Make you worse for a few weeks first. It's like going to A&E with a broken nose and asking the doctor if he can deal with it for him to reply 'yes sir, but first let me punch you on the nose'!

[LiveAboveIt]

The curse of OCD for me there :winks:

I would think the first week is rocky because of all the upheaval in steady dosage but then the second week would be tough as it's consistently high. (this is considering Citalopram) But then there is this down regulation part going on towards week 4 so perhaps some find that hits them more? I don't know why, but in your case it seems less like what I was thinking when I looked at my experience.

Meds are just a minefield! Since the scientists still haven't proved how they help us other than "it is thought", we can only try to work with it.

We always say 4-6 weeks on here. I think that is also because people become frustrated with taken a med that not only doesn't seem to be helping but is making us worse. It's the opposite of what many of us would experience with the meds we were prescribed growing up like antibiotics. Those who have had more serious physical problems may be more used to the "gets worse before it's better" issue.

It's just so annoying though because you go to see your doctor saying you can't cope and don't think you take any more and what do they do? Make you worse for a few weeks first. It's like going to A&E with a broken nose and asking the doctor if he can deal with it for him to reply 'yes sir, but first let me punch you on the nose'!

That's exactly what it feels like! I can totally relate to that idea. Honestly with anxiety sometimes it's so difficult to tell apart the pattern of AD side effects and just random anxiety bad days.

It's difficult because I've always had a very obsessive mind, OCD tendencies I guess they call it? I'm normally jumping between different obsessions with severe analytical research not unlike yourself, but it seems to have taken course to only obsess over anxiety and it's symptoms. It seems like I get stuck on one thought or worry and can't get my mind on anything else and once I conquer a fear, my anxiety just jumps to a new symptom or something else irrational to be afraid of. It's like an endless maze of mental exhaustion.

Thought I could do it without meds/therapy because I was doing so well, and it's just been a downward spiral from there. I've always jumped on and off meds because I can't seem to accept that I need them. But I'm finally ready and willing to stick with the Citalopram, just a waiting game at this point.

After reading a certain anxiety "method" that I won't name, I've been afraid of using AD's, as avoiding them was one of the main pillars in the program, which also included not speaking about the anxiety or seeking out therapy. I decided that this wasn't for me, but I certainly have leftover anxiety and confusion about whats right or harmful now. It did more harm than good in my case. :\

[MyNameIsTerry]

My worst symptom is the inability to control my thoughts or whats on my mind. I used to feel like I had control of my thoughts in the past, but now I have this strange awareness of how I feel and my thoughts.. Ive noticed the more I dont want to think about something, the more my mind forces a barrage of them at me. Simply thinking about my anxiety bothers me, and it bothers me that it bothers me that Im thinking about it, if that makes any sense. It has even progressed to my mind screwing with me during times of high anxiety, especially in the morning.. For example, .. When a thought that I dont like pops into my head, I think "No, Im not going to think about this." And then I have this thought, "What if I cant stop or help it?" I feel my mind immediately think "Yes you are going to think about it," which seems almost involuntary and really freaks me out. Its almost like I have a voice in my head that is an embodiment of my fear and subconscious. I immediately start to panic and think something is wrong with me or that Im going crazy or have something else that I havent been diagnosed with. Its almost like Im fighting with my own thoughts and I cant control where my mind goes and it decides to think the very thoughts that I try not to think about, and it scares me. Am I going crazy? Is this the onset of some other mental disorder that has been missed?

Forcing intrusive thoughts away is actually a way to reinforce them, as some studies have shown. It's like the polar bear exercise - try to not think about a polar bear. The result is, you think about a polar bear. It's because rather than not care about a thought, you tell your mind to spend time thinking about not thinking about it. This means it has to do something. Acknowledging a thought and accepting it works better because it diffuses it. It's a lot harder than that though! Accepting thoughts takes time because of all the fear side and the symptoms they can come with. The other way is the CBT way to challenge them in a positive/neutral manner.

What you have to remember with intrusive thoughts is that they are classified as "ego dystonic", the opposite of true character and beliefs. The true character and beliefs are what guide your actions and that's why these thoughts are coming to your conscious mind. It's as simple as the subconscious saying 'ok, I've checked this thought against what is allowed and it's not an allowed one, so here is all the data conscious mind - tell me what to do with it!'.

Another thing to remember is that the area of the brain on the lookout for the response only looks for a negative response, the stronger the better. It's a process set up to get feedback about whether to run from that bear or attack it. But with intrusive thoughts, it's neither. So, you can starve it by doing neither, by accepting a thought is just a thought and means nothing, or by challenging it with a positive/neutral process because it won't send back the negative feedback it requires. The negative feedback literally ticks a box to say this process is "valid". Notice the use of the word "valid" and not "correct". This is why we are taught in CBT to change how we view our thoughts, not to rise to the panic.

---------- Post added at 08:10 ---------- Previous post was at 08:06 ----------


After reading a certain anxiety "method" that I won't name, I've been afraid of using AD's, as avoiding them was one of the main pillars in the program, which also included not speaking about the anxiety or seeking out therapy. I decided that this wasn't for me, but I certainly have leftover anxiety and confusion about whats right or harmful now. It did more harm than good in my case. :\

I know which you mean and it has a lot of contradictions in it. I've tried it too, didn't work for me. After doing my research, and reading a lot of the authors claims online, I know it's a load of BS. Some of it is correct, the bits that came from Dr Claire Weekes and modern psychology, but the whole avoid meds and don't talk to doctors is not necessarily what people think it is. Besides if you carefully read the story in there, you will see the author was on meds anyway and didn't use the method either. I guess I should leave it there, we are not allowed to talk about it on this forum anymore but please don't let that colour your view of anything.

[wantpeace]

Your experience is not unusual at all LiveAboveIt. It's taken me up to 5-6 weeks at the final dose to start feeling better. Increases in dose seem to cause the same symptoms in me.

[LiveAboveIt]

Forcing intrusive thoughts away is actually a way to reinforce them, as some studies have shown. It's like the polar bear exercise - try to not think about a polar bear. The result is, you think about a polar bear. It's because rather than not care about a thought, you tell your mind to spend time thinking about not thinking about it. This means it has to do something. Acknowledging a thought and accepting it works better because it diffuses it. It's a lot harder than that though! Accepting thoughts takes time because of all the fear side and the symptoms they can come with. The other way is the CBT way to challenge them in a positive/neutral manner.

What you have to remember with intrusive thoughts is that they are classified as "ego dystonic", the opposite of true character and beliefs. The true character and beliefs are what guide your actions and that's why these thoughts are coming to your conscious mind. It's as simple as the subconscious saying 'ok, I've checked this thought against what is allowed and it's not an allowed one, so here is all the data conscious mind - tell me what to do with it!'.

Another thing to remember is that the area of the brain on the lookout for the response only looks for a negative response, the stronger the better. It's a process set up to get feedback about whether to run from that bear or attack it. But with intrusive thoughts, it's neither. So, you can starve it by doing neither, by accepting a thought is just a thought and means nothing, or by challenging it with a positive/neutral process because it won't send back the negative feedback it requires. The negative feedback literally ticks a box to say this process is "valid". Notice the use of the word "valid" and not "correct". This is why we are taught in CBT to change how we view our thoughts, not to rise to the panic.

---------- Post added at 08:10 ---------- Previous post was at 08:06 ----------



I know which you mean and it has a lot of contradictions in it. I've tried it too, didn't work for me. After doing my research, and reading a lot of the authors claims online, I know it's a load of BS. Some of it is correct, the bits that came from Dr Claire Weekes and modern psychology, but the whole avoid meds and don't talk to doctors is not necessarily what people think it is. Besides if you carefully read the story in there, you will see the author was on meds anyway and didn't use the method either. I guess I should leave it there, we are not allowed to talk about it on this forum anymore but please don't let that colour your view of anything.

I just want to thank you, Terry. Yesterday I was terrified of intrusive thoughts, but after your explanation of how the brain works I feel much more confident and much less afraid. Knowledge really is power. You should be a therapist.

The only thing Im struggling with now is accepting the passive feeling of fear and discomfort and trying not to worry too much about it or associate it with anything.

Can anxiety just cause a random feeling of fear and discomfort when everything else seems okay other than your apprehension? Maybe Im still early on the process.

And I find myself still thinking and analyzing the anxiety, even though I dont want to, but Im trying my best not to struggle against it.

And thank you, Peace. Im happy to hear that it still gets better from here. Nice to know that Im not alone.