![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 20 of 20. This is the beginning of the thread.
Posted by Phidippus on October 25, 2009, at 22:52:34
Alright, so I have ADHD and OCD and have some mood instability. I'm also being evaluated for Epilepsy-TLE type. I take Dexedrine, Lexapro, Geodon, Lithium and Zonegran.
Here's my symptom: I have developed an anxiety about my inner voice. Why it sounds the way it does, why its there, will it go?
P
Posted by rjlockhart04-08 on October 26, 2009, at 0:14:06
In reply to You tell me how to treat this., posted by Phidippus on October 25, 2009, at 23:52:34
Like a intuition voice? i would just say try to ignore it, yet what is it trying to say to help you on in life?
Posted by Phillipa on October 26, 2009, at 12:10:29
In reply to You tell me how to treat this., posted by Phidippus on October 25, 2009, at 23:52:34
I don't know what does your doc say have you had EEG's? P
Posted by zzzz7 on October 26, 2009, at 22:21:47
In reply to You tell me how to treat this., posted by Phidippus on October 25, 2009, at 23:52:34
What do you mean by your inner voice? Do you hear it in a way similar to the way in which you her other people's voices?
Posted by cactus on October 26, 2009, at 22:39:14
In reply to You tell me how to treat this., posted by Phidippus on October 25, 2009, at 23:52:34
Have you tried CBT, it can really help if you get a good psychologist. Sometimes I refer to it as spin cycle, as in a washing machine, no matter what you do it just won't go away. In conjunction with meds, sometimes you can shut it off, it's great when you can, but you have to practice very hard. C
Posted by Phidippus on October 27, 2009, at 19:13:46
In reply to Re: You tell me how to treat this. » Phidippus, posted by Phillipa on October 26, 2009, at 12:10:29
EEGs have been negative so far, but Keppra makes the voices go away...hmmmm.
Posted by Phidippus on October 27, 2009, at 19:15:08
In reply to Re: You tell me how to treat this., posted by rjlockhart04-08 on October 26, 2009, at 0:14:06
> Like a intuition voice? i would just say try to ignore it, yet what is it trying to say to help you on in life?
My inner voice. I'm either finding it intrusive, obtrusive, locked in thought about it or it seems not my own.
P
Posted by Phidippus on October 27, 2009, at 19:16:24
In reply to Re: You tell me how to treat this. » Phidippus, posted by cactus on October 26, 2009, at 22:39:14
> Have you tried CBT?
I'm doing exposure :)
P
Posted by cactus on October 27, 2009, at 19:38:39
In reply to Re: You tell me how to treat this., posted by Phidippus on October 27, 2009, at 19:16:24
Cool, it's like CBT, but in the field. I have to practice mine more. It's hard work, keep it up. C
Posted by zzzz7 on October 29, 2009, at 0:33:38
In reply to Re: You tell me how to treat this. » Phidippus, posted by cactus on October 27, 2009, at 19:38:39
I think it's worth talking to your psychiatrist about the voice you mentioned to see what s/he thinks.
Posted by ace on October 31, 2009, at 0:18:47
In reply to You tell me how to treat this., posted by Phidippus on October 25, 2009, at 23:52:34
> Alright, so I have ADHD and OCD and have some mood instability. I'm also being evaluated for Epilepsy-TLE type. I take Dexedrine, Lexapro, Geodon, Lithium and Zonegran.
>
> Here's my symptom: I have developed an anxiety about my inner voice. Why it sounds the way it does, why its there, will it go?
>
> PI would suggest a trial of Carbamazepine or Lamicatal. Strongly urge Anafranil (Clomipramine)
I could be wrong but this new anxiety disorder could well be the product of an interaction between your other meds.
Posted by ace on October 31, 2009, at 0:21:02
In reply to Re: You tell me how to treat this., posted by Phidippus on October 27, 2009, at 19:15:08
> > Like a intuition voice? i would just say try to ignore it, yet what is it trying to say to help you on in life?
>
> My inner voice. I'm either finding it intrusive, obtrusive, locked in thought about it or it seems not my own.
>
Hmmm....this causes you distress/irritation?
Are you focusing on it greatly each and every day....?
Sounds like a possible OCD symptom.How long has this been around for?
Posted by g_g_g_unit on October 31, 2009, at 0:45:14
In reply to Re: You tell me how to treat this. » Phidippus, posted by ace on October 31, 2009, at 0:21:02
have you ever tried Anafranil Ace? my pdoc wants me on it but it sounds really dirty
Posted by bulldog2 on October 31, 2009, at 13:14:54
In reply to Re: You tell me how to treat this. » ace, posted by g_g_g_unit on October 31, 2009, at 0:45:14
> have you ever tried Anafranil Ace? my pdoc wants me on it but it sounds really dirty
Dirty but good. Ranks up with maois in effectiveness. You need high doses to get serotonin and norepinephrine. This drug is the first one that has been used as a dog OCD drug. Marketed under clomicalm. So if you have any OCD it good for that to.
Posted by ace on October 31, 2009, at 23:24:46
In reply to Re: You tell me how to treat this. » ace, posted by g_g_g_unit on October 31, 2009, at 0:45:14
> have you ever tried Anafranil Ace? my pdoc wants me on it but it sounds really dirty
Hi mate!
Yes I have, on two occassions. The first time it made my derealization syndrome worse, with pronounced sedation. The second time I switched after 2 weeks of Nardil washout- I suffered 5HT syndrome.
Essentially i did not give it a long enough trial.My sister went on Anafranil with good results, and side effects were not so pronounced.
Anafranil typically has to prescribed at a high dose- 200mg+. It usually does produce a myriad of s/effects, however these can be managed and do abate with time (usually).
I have a lot of literature on Anafranil, and it certainly is a great medication for OCD, depression and anxiety. I have read many anectodes on it (and clinical trials) which certainly substantiate the efficacy of Anafranil.
I would certainly try it before any SSRI.
But I would urge a slow taper, paying close attention to unwanted effetcs.
Let me know your decision!
Ace:)
Posted by ace on October 31, 2009, at 23:25:50
In reply to Re: You tell me how to treat this., posted by bulldog2 on October 31, 2009, at 13:14:54
> > have you ever tried Anafranil Ace? my pdoc wants me on it but it sounds really dirty
>
You need high doses to get serotonin and norepinephrine.Very true....
Posted by floatingbridge on November 1, 2009, at 19:05:07
In reply to You tell me how to treat this., posted by Phidippus on October 25, 2009, at 23:52:34
> Alright, so I have ADHD and OCD and have some mood instability. I'm also being evaluated for Epilepsy-TLE type. I take Dexedrine, Lexapro, Geodon, Lithium and Zonegran.
>
> Here's my symptom: I have developed an anxiety about my inner voice. Why it sounds the way it does, why its there, will it go?
>
> PO.K. So you're in exposure therapy--may I ask for what issues?--or feel free to take a pass on that personal info. Does that work with inner thoughts as part of it? Like CBT?
I have also borrowed from DBT--especially distress tolerance. Right now, mindfulness based cognitive therapy (meditation focused on the breath and acceptance of thoughts, feelings and sensations). I'm working on affirmations, talking back (kindly). This is all helping me--plus psyhcotherapy. D-amp makes them shush to a tolerable level as well.
Sometimes the inner voice (what I'm calling it may not be what you are referring to) is quite loud and pins me to the mat and seems more than I can bear.
When I first started AD's they remitted a bit--but not for long.
Good luck, really. Are you finding anything helpful in these board responses?
I'm sorry to read you are having this difficulty. Does it say anything to you in particular? (Not that you need to share that here.)
You can always babblemail me.
fb
Posted by Phidippus on November 1, 2009, at 22:32:58
In reply to Re: You tell me how to treat this. » Phidippus, posted by floatingbridge on November 1, 2009, at 19:05:07
> O.K. So you're in exposure therapy--may I ask for what issues?
I have participated in DBT therapy in the past, and have had plenty of CBT. Right now I concentrate on distress tolerance, mindfulness and exposures to help with the OCD symptoms.
>Does that work with inner thoughts as part of it? Like CBT?
Well, what I've done is structured it in my head that when I am speaking to myself in my head I imagine speaking to someone else. I think I was feeling very lonely just talking about the same thing over and over in my head to myself. I hate it though when I feel like I'm examining my inner voice, then it feels like not my own and that is very deporsonalizing.
> I have also borrowed from DBT--especially distress tolerance.
Its been a life saver for me.
>acceptance of thoughts, feelings and sensations).
This is where I get kind of washed out. Sometimes there's such a rumble all I can do is shut it out and just feel this blank, restless, depressed, dreadful feeling. Its like a peaceful terror, if that makes sense.
>D-amp makes them shush to a tolerable level as well.
Same here, but my Keppra hushes them even more and then I just have three voices, mine, which feels not my own at times, the depressed, I am nothing voice and the OCD voice which tells me I'm going crazy, going to kill myself, dying or about to kill.
> Sometimes the inner voice (what I'm calling it may not be what you are referring to) is quite loud and pins me to the mat and seems more than I can bear.
Oh, I get this terrible voice that beats my brain down until I can't think a single thing or panic.
> Good luck, really. Are you finding anything helpful in these board responses?
Yes, I am. Your's is a helpful response.
P
Posted by floatingbridge on November 3, 2009, at 9:44:55
In reply to Re: You tell me how to treat this. » floatingbridge, posted by Phidippus on November 1, 2009, at 22:32:58
Hi Phidippus
>
> Well, what I've done is structured it in my head that when I am speaking to myself in my head I imagine speaking to someone else. I think I was feeling very lonely just talking about the same thing over and over in my head to myself. I hate it though when I feel like I'm examining my inner voice, then it feels like not my own and that is very depersonalizing.I have a workbook, ( I forget the name, but still have it), about speaking to inner voices, and it recommended for some speaking to one's self in the second person. Ultimately, this did not work for me--though sometimes I do address myself by my name. I find your comments interesting re: depersonalization
>
> >acceptance of thoughts, feelings and sensations).
>
> This is where I get kind of washed out. Sometimes there's such a rumble all I can do is shut it out and just feel this blank, restless, depressed, dreadful feeling. Its like a peaceful terror, if that makes sense.Yes, it does. Mindfulness meditation helps me, but I'm only beginning. I focus on the breath (most successful for me) and sensations, thoughts and feelings, always returning to the breath, esp. when disstressing 'thoughts' or images arise. I also like the body scan meditation. I listen to a cd under earphones--and I like my teachers' voices and calm, intermittent, unobtrusive assurance. How do you use mindfulness?
>
> Oh, I get this terrible voice that beats my brain down until I can't think a single thing or panic.I'm sorry--me too, in my own way and degree.
>
> > Good luck, really. Are you finding anything helpful in these board responses?
>
> Yes, I am. Yours is a helpful response.
>
I'm so happy to hear this!warmly,
fb
Posted by g_g_g_unit on November 6, 2009, at 21:30:36
In reply to Re: You tell me how to treat this. » floatingbridge, posted by Phidippus on November 1, 2009, at 22:32:58
wow Phiddipus. if i can't add anything useful to this thread, then it at least feels really comforting to find someone finally describe an experience i've been going through, and struggling to get a grip on.
i kind of wondered why there were times when i felt like i was going completely crazy with anxiety, and others (hours, days apart) where i entered, as you say, a kind of terror-filled calm. the idea that it's based on the "ratio" of these voices seems interesting. for example, small parnate doses (10, 20mg) fed the OCD voice, which overrode everything else and pushed me into an intense panic, because those looping thoughts were given enough fuel to feel more present. the depersonalization goes away to some extent, but that's because i'm so consumed with dealing with the OCD.
but off medication, when depressed, or on SSRI monotherapy, i feel like i experience more just this broken-record ADHD kind of voice which can't really stay pinned on any topic long enough for me to feel present. i just have to let the thoughts (fractured ruminations) exist. sometimes the OCD voice comes into play and tries to control my inner monologue and put it back on track, but i get nowhere, because there isn't enough fuel for the OCD fire. i experience no physical anxiety, but i feel completely alienated from myself.
i can relate to what you say about feeling lonely. i was saying to my therapist that it's so sad when i can't even rely on my own company any longer. i just have to feed myself constant stimulation - music, TV, games - to feel like i exist.
i've been wondering how i'm meant to realign those voices, pharmalogically-speaking, so i can feel more like a human being. i've also been wondering how i'm even going to begin explaining the problem to a psych. my only idea is a detailed record of what meds i've been on and how each influenced (or brought on) each state.
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.