Help with fixated/repetitive thoughts
 

Hello all

Early on after my injury I had very obsessive, fixated and racing thoughts. It seemed to reduce later in my recovery, perhaps because of the SSRI I started taking, or perhaps because of brain healing.

Now 1.5 years later, I have had several big life changes happen recently including having to move and losing my job. My doctor and I decided it was time to taper off the SSRI slowly before these events happened. I am on the last dosage of tapering off the SSRI.

I seem to be having more trouble with the repetitive thoughts. It is like my brain fixates on something that happened, can't let it go, and just repeats it over and over. It is troublesome at night as I can't sleep. Right now my brain is fixating on getting fired and what happened in the meeting.

Is this common for TBI because I don't remember this happening before my injury? Is there a specific type of therapy that can help me deal with this? Are there any supplements that might help with this? I have heard of EMDR therapy - might that be helpful?

Thank you for your help.

RRC,

I get me too and it is what wakes me up...usually work related.

Bud

Hi RRC,

I too have had and continue to have issues with this. After seeing a counsellor about this in the first recovery year, the term they give this obsessive thought/though racing is "rumination". I was told by a separate counsellor that rumination and uncontrollable thought focus was something very common to people who have experienced a head injury. As like you, I had never had trouble with this prior to the accident and therefore took comfort in knowing that it is normal for this type of injury.

For me, rumination occurs following too much over-stimulation and/or mental flooding occurs. These "triggering events", as I call them, lead to a recovery typically lasting 4-7 days in which rumination occurs almost exclusively in Days 1-3; outside of these days, it simply doesn't occur.

For treatment, my counsellor said that there's really no way control them other than avoiding triggers. When they do occur, the best solution is to use breathing exercises, alternate focus points (i.e. focus on a cup and think about it's color, function, etc.), and distraction (do something that takes your mind off of what you're ruminating). For me, distraction has been the best approach. Note, I've had numerous people suggest walks, showers, and meditation. In my case, these are utterly useless and counter-productive during rumination periods... they just give me more time for thought-racing:(

One thing I have noticed is that my rumination has overall decreased in the second year of recovery when compared to the first. Like you, I'm on an antidepressant and it is very possible that it is helping, but I'm not sure either way. In looking at what you're currently ruminating about (meeting in which you were fired), I can tell you that this would be a major problem for me. I would relentlessly obsess on this following any triggering event for months on end. I still ruminate about an issue with my benefits provider from this past February!

Hopefully others will be able to chime in. All my solutions are short-term in nature, though I think the passage of time is significant in learning to deal with rumination. I know Bud has commented on thought-racing in a number of threads... hopefully he'll offer his thoughts.

lol... evidently Bud beat me to it:wink:

"For treatment, my counsellor said that there's really no way control them other than avoiding triggers."

This is terrible advice. Avoiding triggers only feeds obsessive thoughts and reinforces the mistaken notion that they (or what you fear) are dangerous. In the short-term, avoidance can provide temporary relief, but in the long run, it makes the problem worse.

Feared situations and anxiety more generally must be faced rather than avoided to make progress with anxiety disorders. This is obviously difficult, takes time, and must be done gradually--preferably with the guidance of a knowledgeable therapist.

Even if your feared situation is some wild hypothetical that can't be created as a means of "exposure," and even if it is something that is extremely unlikely (as I'm guessing it is), the way forward is to start working on accepting your feared situation, accepting the uncertainty you have, and working on being okay with that uncertainty. A good therapist who specializes in anxiety disorders should know all this and more. S/he can guide you through the necessary steps involved in exposing yourself (even if only mentally) to feared situations and correcting distorted thought processes through Cognitive Behavioral Therapy (CBT).

This book is good:

http://www.amazon.com/Freedom-Obsess...nathan+grayson

Great suggestion Xanadu.

For me personally, I think my situation might be slightly different than others. I don't fear nor am I anxious about situations that lead to rumination; they're simply a fact of life... I do too much, I know this will occur. The key for me is to increase my tolerance to stimuli (i.e. reduce mental flooding) such that the extended recovery doesn't occur... this is going to take some time, however, and a therapist will absolutely need to be part of it : )

RRC,

I struggles with this severely. But, I was getting stuck 'looping' on mundane things. The spelling of a work, a license plate number on a car that drove by, a stanza of a song, etc.

I was put on max dose Paxil/paroxetine. It stopped this looping except when I has hit by a trigger (repetitive song on the radio)

Lower doses of the paroxetine brought the looping back but not so extreme. i could find distractions to over-ride the looping.

My psychiatrist wanted me to wean off the SSRI and start taking L-Tryptophan to increase serotonin. I did this over a few months. The looping was much better with the L-Tryptophan but not fully resolved. I added 100 mgs of 5-HTP and 200 mgs of L-Theanine and I am doing great.

If the looping starts, I can distract my thoughts successfully.

I suggest trying L-Tryptophan, maybe 500 mgs 2 times a day. If you do not get enough relief, substitute the 5-HTP for one dose of L-Tryp. And, you can add L-Theanine.

They work to increase neurotransmitter production.

L-Tryp become 5-HTP which becomes serotonin. You can not overdose on L-Tryp but you can on 5-HTP. Excessive sweating is a sign of overdosing on 5-HTP.

You can increase your 5-HTP dose and see if there is a best dose.

I would loop so badly that I would crash from the mental exhaustion. Imagine playing the same though for a day or even two.

It will help to learn ways to define the issues around these anxious thoughts. Good neurotransmitter levels will make this thought effort easier.

My best to you.

I had a lot of trouble with this for a while and found that Risperdal in combination with my SSRI was quite effective.

OMG!! I have this. :eek: It got worse after my stroke. It has gotten better in the past year though. My triggers are word games and scrabble. Well, they were anyway, it's much better now.

I thought I was just obsessing too much over silly things. But when I couldn't stop it I sensed something was wrong.

Thank you MicroMan and Bud. It is comforting to know that others (unfortunately ;) have the same issue. I will try some of your advice and look for Bud's threads.

Thanks Mark for your suggestions on supplements. My one concern is that I am not sure additional serotonin is what I need. I did the Neuroscience neurotransmitter testing and it came back that I have elevated serotonin, glycine, glutamate, PEA and dopamine with very low epinephrine.

According to this then, should I be weary about increasing serotonin levels with more supplements?