Hello Drew,

Mindfulness DOES HELP with self-control.

How long have you practiced mindfulness? Have you had any troubles while trying to be mindful in your everyday life?

You need to go deeper into your problems. The results won’t come in a few days. Changes take time. If you feel like sharing more, we are here to help. But bear in mind that you must be open to discussion and advice.

Hi Drew

I wanted to add that my conditions are C-PTSD, Autism and Dyspraxia. Different people with different conditions are going to have different struggles.

But Jana is correct in that it won’t be fixed overnight. There is no one fix, but over time and with practice everything adds up bit by bit. It took me years to get a better handle on things and I am only able to manage with medication when things are really stressful. When things are less stressful I can manage without.

I did find meditation helpful, but only in very limited circumstances. For example, it is a good technique for self-care. It didn’t stop things on its own. I don’t think anything one thing would.

It sounds like you’re doing your best to manage your condition. Please be gentle with yourself! These things are not your fault. Just keep trying your best and that is good enough, even if mistakes happen. ❤️

Dear DREW:

“I continually find myself vocalizing my own thoughts (unintentionally), mostly noticing sometime through doing so, but also after I’ve finished saying them aloud!… Think of it: how often have you started scratching an itch BEFORE you’re aware that you’re doing so?”-

– It’s possible that you could be experiencing vocal tics, which can be a symptom of Tourette Syndrome (from which I suffer) or other tic disorders. Vocal tics are involuntary sounds or words that a person makes, and they can range from simple sounds like grunting or throat clearing to more complex vocalizations, including speaking words or phrases.

Many individuals with Tourette Syndrome report that their tics are preceded by uncomfortable sensations, often likened to an itch that needs to be scratched. From a UCLA study (escholarship.org): “Tourette syndrome (TS) and chronic tic disorder (CTD) are characterized by sudden, rapid, recurrent motor and/or vocal tics… In addition to these observable symptoms, many individuals with TS or CTD also experience frequent, uncomfortable sensory phenomena that immediately precede the tics… These sensory phenomena have been variously described as an itch, pressure, tension, urge, or ache that is temporarily relieved by the completion of the tic.”

“A few years ago I was temporarily prescribed a medicine by a specialist, and while on it a problem began which persists even now”- tic disorders, including Tourette Syndrome, can sometimes be triggered or exacerbated by certain medications. This phenomenon is known as “medication-induced tics.”

Medications such as methylphenidate (Ritalin) and dextroamphetamine (Adderall), commonly used to treat ADHD, have been reported to cause or worsen tics in some individuals. Certain antipsychotic medications, such as haloperidol (Haldol) and risperidone (Risperdal), can also lead to the development of tics as a side effect. Other medications, including some antidepressants and antiseizure medications, have been associated with the onset of tics in some cases.

There are several other potential explanations for your experience of unintentionally vocalizing your thoughts, aside from tics, or in combination with tics. Here are a few possibilities: (1) High levels of anxiety and stress can sometimes lead to involuntary vocalizations. This can be a way for the mind to release tension or cope with overwhelming emotions, (2) Obsessive-Compulsive Disorder (OCD) can involve intrusive thoughts and compulsions, which might include vocalizing thoughts out loud, (3) Attention Deficit Hyperactivity Disorder (ADHD): Individuals with ADHD may have difficulty with impulse control, which can lead to speaking thoughts out loud without realizing it. This can be part of the impulsivity associated with ADHD, (4) Medication side effects as mentioned above.

If in your evaluation, Drew, any of the above is a possibility, it might be helpful for you to seek an evaluation by a neurologist who can conduct a thorough evaluation and provide an accurate diagnosis and potential treatment options.

Personally, I have suffered since childhood from high levels of anxiety and stress, ADHD symptoms, and I was eventually diagnosed with Tourette Syndrome (TS) and Obsessive Compulsive Disorder (OCD). SELF CONTROL (in capital letters) has been indeed a core problem for me: I couldn’t control the motor and vocal tics, couldn’t control the OCD compulsions, couldn’t react to people and situations the way I wanted to.

“Have any of you managed this? If so, how? If not – PLEASE DON’T RESPOND!”- I did manage the OCD so well that I no longer fit the diagnosis, and my impulsivity problem had greatly improved! I am still working on reducing the frequency of the motor tics.

“This one is lifelong: something will happen to me, and I can’t / don’t respond in the way I want to. E.g. a person will ask me something, say something to me, or DO something to me, and instead of responding in a way I’d like, I just react, often in a way I’d prefer not to. I’ll either have done it before I know it, or find myself in the process of doing it and feel it’s too late to stop. Either way, I always regret it… 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.”-

– I can relate to this big-time as it’s been a lifelong problem for me until recently. I managed my impulsivity with what I call the NPARR method, which I’ve been practicing every day for years: first, I Notice stress within me, a disquiet. Next I Pause (before I act, before I say or do something that I may later regret). Next, I Address the situation. I ask myself: is there a situational problem that needs to be solved? What is the problem (define it)? Can I provide all of the required solution or pat of it? If I react mindlessly, automatically, will I be adding to the problem or creating a new problem? Etc. Next, I Respond, or not: I say or do something, or not. Finally, I Redirect my attention elsewhere. There is more to my method, and if you would like it, we can talk about it further.

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:

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