Intrusive thoughts about horrible things

[Emma_student]

[LEFT][LEFT]Hey, ive been diagnosed with health anxiety disorder recently but before that i saw a councellor for feeling depressed. Now, im not depressed to the point of staying in bed all day and constantly feeling low, i have periods of happiness when im distracted (i know people who have experienced this and wouldnt wish it on my worst enemy) I can carry on as normal, but inside i feel like i cant feel truly happy (i'd describe it as melancholy, a really old fashioned word i know but it like im neither truly happy nor truly sad, just bordering the line between sad and happy) Ill get points when ill feel really happy and positive and then ill just sink back down. Ive had intrusive thoughts for years; relating to death, sickness, etc (i have been getting panic attacks which have eased) . More recently my worst thought and fear is that im going to sink lower and lower and become suicidal. Ive never EVER attempted it, and never EVER want to as i have too much to live for. its just a very scary image/thought that comes into my mind and distractions work only temporarily. I have CBT every week and a wonderful support system around me and wonderful life at university. Does anyone else get these horrible thoughts. I know there are a lot of people on here who are so low and i feel like im being a bit of a burden here. I'd just like to know:
1) Does anyone get these thoughts, how do you cope with them, how do you stop them
2)Ive been prescribed citalopram but i dont want to take it due to the fact that im not in dire need of it, should i start taking it?
3) Does depression cause anxiety and vice versa? Is there any way i can prevent 'going under' as it were

[Flat Stanley]

Hi Emma,

Seems we are very similar, so don't feel alone.

To answer your questions in order:

1) Yes I do. For many years I have survived on "distractions", basically those things in my life that keep my mind away from what seems to be its natural state, that is to say a state of anxiety and depression. Distractions can be anything from a good book, to telly, to my work, to writing music. I do anything and everything I can to find happiness in my distractions as I find my natural state of mind (to which I all to often return) to be unbearable at times. When I do catch myself disappearing down my rabbit hole into a world of worry I distract myself from my negative thoughts by simply reminding myself of the type of thoughts I am having. Don't get me wrong, I don't try to actively stop my negative thoughts (that can be very difficult to do), I simply distract myself by actively analysing the type of thoughts that I am having. By acknowledging to myself that I am ruminating I find that I can help to curtail my ruminations.

2) I have been on 10mg Escitalopram (basically the same as Citalopram) since 2006. It has done me a world of good, although the first 4 weeks can be hell as you will first go through a dip before you pick up again. The best way to start on any SSRI type drug (such as Citalopram) is to ramp up your dosage slowly. Take a 1/4 dose in week 1, a 1/2 dose in week 2, 3/4 dose in week 3, and finally a full dose in week 4. Wait at least two months, however, before you decide if it is or isn't doing you any good and consult your GP if you feel you need to stop taking them or maybe up the dosage beyond what you were initially prescribed. Only downside to ramping up like this is that you'll need to break your tablets into smaller bits. I used to nibble mine in the beginning

3) Depression and anxiety are comorbid, and they regularly occur together. In my personal case I am convinced that my depression came about as a result of my anxiety and not vice versa, although that is not to say that depression cannot bring about anxiety. Filling my head with constant worry, as I often do, and it was inevitable that I would become depressed. Even I get sick and tired of listening to my own moaning, so I blame myself for causing my own depression The good news, however, is that SSRI type drugs are great for treating both anxiety AND depression. That's not to say that I don't have ups and downs, but taking Escitalopram has made my life a whole lot more bearable.

All the best to you, and remember, you are not alone in feeling the way you do.

Regards
FS

[Emma_student]

Thanks for your reply Flat Stanley,

Its just very disturbing that i cant seem to control my thoughts or my mood. Im a young adult and i should be enjoying life but instead i'm going through everyday under a cloud. The past couple of months i barely remember, i just know that ive been anxious all the time. Some days are good some are bad but it seems that my neutral state is more negative than neutral. It seems that the anxiety has quietened down and has now been replaced with these horrid, scary thoughts (its not just the fear ill hurt myself; things like, if im in the kitchen ill imagine someone lurking in the garden waiting to attack me)

Did you go on medication immediately or did it take you some time to start taking them?

[harasgenster]

1) Does anyone get these thoughts, how do you cope with them, how do you stop them

I used to believe that I would commit suicide when I really didn't want to. I thought I'd just lose control in an instant of despair and do it without thinking. I even went as far as telling my Mam to hide all the knives from me! It came from me suddenly having the thought that I had nothing to live for because I felt so empty inside, and then I thought I was going to do something about it in a moment of madness. I also had it when I was standing next to train tracks or a road. I was afraid I would throw myself under a car or train.

These thoughts are very common. I also thought I'd lose control and kill children and puppies/kittens etc. because I'd see an image in my mind of me doing it and I'd think I would lose control. My therapist at the time told me there isn't a day that goes by that she doesn't hear someone say exactly the same thing. It takes a bit of practice but to remove the power from these thoughts you have to recognise them for what they are - thoughts, not reality. Just because you think it, it doesn't mean it will happen. Once the power is taken from these thoughts, they slip away.

2)Ive been prescribed citalopram but i dont want to take it due to the fact that im not in dire need of it, should i start taking it?

Taking antidepressants is not necessary to recover, but some people find it helpful. If you don't feel in dire need and you don't want to take them, then there's no reason why you should. However, if you're just not taking them because you're afraid they'll change you or because you feel guilty about needing them, those are not good reasons If you're already in therapy and able to engage with that therapy without taking antidepressants then perhaps you just don't need to take them. Basically, there's no right or wrong - it's completely your decision.

3) Does depression cause anxiety and vice versa? Is there any way i can prevent 'going under' as it were

First question on depression/anxiety - I think of them as two sides of the same coin to be honest. I don't think I ever had a time when I didn't to some extent suffer from both. They're not really like 'disease entities' as such, they exist on a spectrum between 'dysfunctional' to 'totally healthy' back to 'dysfunctional'. Basically, you wouldn't want to feel no anxiety or depression because that would be a problem, but you also don't want to feel them so much that you become ill. You want to be somewhere in the middle where you are able to feel anxious about the things that it's worth feeling anxious about but cope with it fine.

As for preventing yourself from 'going under' - one of the first steps might be to stop worrying about 'going under'? If you're telling yourself you're not able to cope with the way you feel, well that's a self-fulfilling prophesy. Ask yourself what frightens you so much about going under. What is it you don't think you can cope with?

As well as that, the way to prevent relapses is to work out why you feel the way you do in the first place. You can then decide if there are some things about yourself you want to change - maybe there's some beliefs you have that you'd like to change. You're behind the steering wheel on this one and with guidance from your therapist you'll be able to decide exactly how you want to be, and how you want your life to be, in the future. Once you're aware of the patterns you repeat in your life (which is what causes the relapses) you'll be able to spot yourself going down a familiar path and stop and ask yourself - wait, do I want this? Then turn back around.

It takes a bit of practice but I'm sure that with the therapy you have you will get there Good luck.

[Emphyrio]

I have purely obsessive OCD where I can imagine the worse possible situation, and deciding to follow through with it. I find that these thoughts are also closely linked to anxiety - and that therefore one can make some lifestyle changes to try to challenge them. For example, keeping your central nervous system as calm as possible can help - that means chamomile tea instead of caffeine, limiting alcohol intake, etc.

CBT has been proven very effective for managing intrusive thoughts.

I think that if you feel you can cope without medication, then do not take it. Medication can have a number of benefits for those who are really struggling, but it also comes with a number of side effects not to mention the horrible withdrawals that come when you finally have to stop taking it. If you do go down the medication route, you could try a loser dose - 10 or even 5mg - which may make a difference without giving you bad side effects.

[Flat Stanley]

Did you go on medication immediately or did it take you some time to start taking them?

At the time I went on Escitalopram I was quite bad and was desperate to try anything. I'd been on other medication before to deal with specific attacks of anxiety, but without much success. Escitalopram was the first chronic medication I ever went on. I never had any trouble taking the pills, but I was anxious that they wouldn't work and that I would in some way fail the pills (rather than they fail me). In hind site it all sounds rather silly. My GP at that time was fantastic (I lost him when he emigrated) and his warnings were stern and loud, insisting that I ease my way into the medication. So yes, I did start it immediately, but I slowly ramped the dosage up to 10mg per day in an effort to avoid side effects.

[Emma_student]

Thankyou for all your help and support guys!!! The past couple of days have been bad and its nice to know that im not on my own on this. I believe i will get better but it seems a long way away.

[saab]

Most people with anxiety suffer intrusive horrible thoughts at times. One of the main ideas in cbt is that thoughts are not that important - worrying that you might hurt someone is of no more significance than thinking about a unicorn. Don't judge your thoughts or put a value on them. Thoughts are not good or bad, they are just thoughts. "THOUGHTIES NOT NAUGHTIES" is one phrase I read. Another is, " Real, but not true" - the negative thought is real, it exists, but that doesn't mean it is true.

When my anxiety was very bad I was worried I might do something like cause an accident. I think part of my brain was testing me - trying to think of the worse possible thing that could happen - to see if I could cope.

Try to see your thoughts as leaves floating down a river. Just observe them, don't get pulled in. Acknowledge the thought, then let it go. The Claire Weekes floating method helps with this too.