Dear Tom:

It’s great to hear from you, and I hope you’re doing well too.

I’m glad to see you’re taking proactive steps by looking into a career coach and reaching out to recruiters. Balancing your current role with self-care through fresh air, exercise, and reading sounds like a healthy approach.

Exploring self-employment and new job opportunities can provide you with valuable insights into what might be the best path forward.

If you need someone to talk to or if there’s any way I can support you during this transition, feel free to reach out. Wishing you all the best as you navigate these decisions.

Take care and stay in touch.

anita

Dear Peter:

Thank you for your kind words. I’m glad my example resonated with you and helped illustrate the concept. The “infinite loop divided by 0” is such an apt metaphor for the trap we fall into with compounded negative emotions.

Your reference to Buddha’s concept of Maya is deeply insightful. It does seem like one of the ways we create our own illusions and suffering. Recognizing these patterns is the first step toward breaking free from them.

I appreciate your reflections and the wisdom you bring to our conversations.

anita

Dear Drew:

You’re very welcome! I’m glad to read that you found my reply comprehensive and helpful. It’s great that you have a plan of approach and are ready to go back to your GP’s practice. I understand that the initial dismissal was frustrating, but it’s encouraging to read that you usually have good experiences with them.

With a well-thought-out strategy, I’m hopeful they’ll consider investigating further this time. If you ever need additional support or have more questions along the way, don’t hesitate to reach out.

Best of luck with everything, and take care! Bye for now,

anita

Dear Drew:

After submitting my last post to you, I realized that I focused primarily on the unintentional vocalization of your thoughts and neglected the second part of your post. Based on what you shared about your lifelong struggle with controlling your responses, there are potential conditions that might be relevant. While only a qualified healthcare professional can provide a definitive diagnosis, here are some conditions you might consider:

Impulse Control Disorders (ICDs): These are mental health conditions characterized by difficulties in controlling impulses and behaviors that can cause harm to oneself or others. These disorders often involve actions that are aggressive, destructive, or socially inappropriate. Here are two types that might be relevant:

Intermittent Explosive Disorder (IED): This involves sudden episodes of unwarranted anger and aggression. Individuals with IED may have outbursts that are disproportionate to the situation.

Oppositional Defiant Disorder (ODD): Although more common in children, ODD can persist into adulthood. It involves a pattern of uncooperative, defiant, and hostile behavior toward authority figures.

Your thread title, “SELF CONTROL,” aligns with the challenges posed by impulse control disorders. You mentioned reacting impulsively to situations in ways you regret, which fits well with characteristics of these disorders. Your desire to respond in a controlled and deliberate manner indicates self-awareness and a wish for better impulse control.

Towards the end of your post, you wrote:

“What I WANT to do in all such situations is be fully aware of what’s going on, be fully aware of what I’m doing, and RESPOND in a deliberate, controlled, assertive way; and ideally be calm too. Have any of you managed this? If so, how? If not – PLEASE DON’T RESPOND!”-

Your use of uppercase letters and strong language indicates intense emotional responses, which align with IED. People with IED often experience sudden outbursts of anger and frustration. Your frustration with not being able to control your responses reflects a key aspect of IED, where individuals wish for better control over their impulses and reactions.

Your emphatic instruction to not receive unsolicited advice (“PLEASE DON’T RESPOND!”) and your frustration with well-meaning people fit the defiant and oppositional behavior seen in ODD.

While your posts exhibit behaviors and feelings that may align with these disorders, it’s essential to remember that a comprehensive evaluation by a mental health professional is necessary for an accurate diagnosis. Your unique symptoms and experiences need to be assessed in the context of your overall mental health and history.

Cognitive-Behavioral Therapy (CBT) is a recommended treatment for impulse control disorders. It starts with a comprehensive assessment to understand your specific symptoms, triggers, and the situations in which you struggle the most. Together, you and your therapist would set clear, achievable goals for therapy, which might include learning to control your vocalizations and managing your impulsive reactions.

CBT involves cognitive restructuring, which helps identify and challenge negative or irrational thoughts contributing to impulsive behaviors. For example, if you think, “I can’t control myself,” a therapist would help you reframe this thought to something more positive and empowering, like “I can learn strategies to manage my impulses.”

Skills training is also a key component of CBT, where you can learn specific skills to help control your impulses and vocalizations. This includes developing strategies to handle difficult situations more effectively, allowing you to respond rather than react.

I suffered from impulse control issues myself and had CBT therapy for two years (2011-13), achieving great success with impulse control, and will gladly share more about it with you, if you are interested.

You’re not alone in this journey, Drew, and I believe in your strength to overcome these challenges.

anita

Dear Drew (or do you prefer DREW?):

Thank you for your thoughtful response and for sharing more about your situation. I understand that finding the right diagnosis and treatment can be challenging, especially with the added difficulty of accessing specialists and not being able to afford private treatment.

“I dismissed Tourette’s outright as I believed it’s always congenital, but if you’re right that it can be brought on throughout life, and even triggered by some medicines, then that fits with my suspicion that my involuntary vocalizations may have been caused by the pill I was taking when mine started.”

Tourette Syndrome (TS) is generally considered congenital, meaning it is present from birth and often manifests in early childhood, with the average onset occurring between the ages of 5 and 7 years old. It is strongly influenced by genetic factors, and it often runs in families.

While rare, there are documented cases of TS developing in adulthood. These cases may be triggered by factors such as stress, neurological injuries, infections, or certain medications.

“I don’t know about other tic disorders though – I’d need to research that.”

Tic disorders that include involuntary vocalizations, such as voicing thoughts out loud, include the following:

Tourette Syndrome (TS): Multiple motor tics and at least one vocal tic present for more than one year.

Persistent (Chronic) Motor or Vocal Tic Disorder: Either motor tics or vocal tics (but not both) present for more than one year.

Provisional Tic Disorder: Motor and/or vocal tics present for at least four weeks but less than one year.

Other Specified Tic Disorder: Tics that do not meet the criteria for the above disorders but still cause significant distress or impairment. The duration and presentation can vary.

Unspecified Tic Disorder: Tics present, but there is not enough information to make a more specific diagnosis. The duration varies.

Medication-induced tics are not classified as a separate tic disorder. Instead, they are considered a type of movement disorder caused by the side effects of certain medications. These tics can resemble those seen in tic disorders but are specifically triggered by medication use.

“I also don’t recognize the medicines you list, but perhaps mine is a culprit.”

The medications I mentioned, which can lead to the development of tics as a side effect, have different brand names. Here are some examples:

Methylphenidate: Ritalin, Concerta, Equasym XL, Medikinet, and Delmosart.

Dextroamphetamine: Dexedrine, Amfexa.

Haloperidol: Haldol, Serenace.

Risperidone: Risperdal, Consta.

There are several other medications that can result in tics or tic-like symptoms. These include medications that treat psychiatric symptoms, nausea and other gastroenterological issues (examples: Metoclopramide, promethazine, prochlorperazine, levosulpiride), allergies (examples: Hydroxyzine, promethazine), and antiepileptics.

“I have wondered about ADHD but only regarding impulse control: I’d never heard of it linked to vocalizing thoughts. But I thought that unlikely as I generally don’t have trouble concentrating; certainly not to the extent that I’ve heard described as typical for ADHD.”

It is possible to be diagnosed with ADHD even if not all of the symptoms apply. ADHD is a spectrum disorder, and different individuals present different combinations of symptoms with differing severity, often without all the listed symptoms being present.

If there’s anything more I can do to support you or if you have any further questions, please don’t hesitate to reach out. Wishing you all the best. Take care and stay strong 💪!

anita

Dear Drew: You are welcome and no worries about when you respond. I want to thoroughly read and reply to you Wed morning (it’s Tues afternoon here).

anita

Dear Zenith:

And how are you feeling about it, about the manager talking you out of applying to the internal job and about you changing your mind about it?

anita

Dear Aj:

Thank you for your thoughtful response. I’m glad to read that you’ve started recognizing the patterns of reassurance-seeking and how it affects you. This awareness is an important step towards managing your OCD.

It’s great that you’ve taken your sister’s advice to give into the uncertainty and stop your compulsions, even if it’s challenging, and that you deleted the internet for now and feel better for it. The “Maybe, maybe not” technique can be difficult at first, but it’s encouraging to read that you’re starting to feel clearer-minded.

Remember, you’re not alone in this journey. Seeking professional support from a therapist who specializes in OCD can provide you with the tools and strategies to manage these thoughts effectively.

Wishing you strength and clarity as you navigate these challenges.

anita