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Avatar universal

anxiety & deprassion

i have been diagnosed to have mixed anxiety & depression and undergoining behavioral therapy , my problem is that i excessivly think of death i cant stop this thinking , all the time imagine some thing bad  will happen to me or one of my family ( eg  : i ill die or my mother will die) , after that i start to cry i dont no what to do, it disrubt me alot i cant stop it

is this normal presentation of anxiety or i have something alse???
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Avatar universal
I am 20 now and extremely jealous and paranoid when in a serious relationship it affects me in a way that causes extreme self loathing and panic attacks that turn into self inflicted cuts where I'm begging myself to find the strength to commit suicide. I started having anxiety after going through an abusive relationship from age 16-19. Jealously and paranoia began before I met him. My emotions are unbelievably easily affected by my boyfriends actions and words. I can't seem to ever talk to a therapist face to face about it but have seen a couple. I really just want to feel happy and normal. Any feedback or suggestions for this would b greatly appreciated.
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Avatar universal
It's a patient's prerogative not to practice skills.  They are given to help us though.  Maybe if people understood us better before they gave us skills that would be more helpful.  More motivating.  ??
I have practiced relaxation skills for short periods but have not followed through despite getting benefit from them.  Maybe the problem is that I just haven't been able to incorporate them into my life in a way that is sustainable.

The reality is that we could die at any moment of any day.
When we are happy, healthy and well we don't focus on this though we focus on other stuff.

I'm sticking with anxiety and depression.  Maybe depression is primary??

You don't have to live with these thoughts.  When I have been unwell I have automatically skipped to untold suicidal plans, etc.  I know that this is part of me being unwell though and doesn't have to be part of my life (and perhaps shouldn't even be part of it).
When you are well you will find that these thoughts will have dissipated.

It would be a good idea to see the behavioral therapist again.
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Avatar universal
i just went two time because i were busy that period , really i were comfortable setting with him and try to apply the techniques he told me about , but i did not not practice them regularly  and he advice me to start medication but i refuse.
these thoughts trouble me alot , every day i feel i going to die and this ideas restrict my activities. in the evening i cant sleep alone.
is this presentation of depression or something else ?
sometime i say to my self that these thoughts are become as routine so i have to tolerate with but when it come i cant stopped spend half an hour or more crying.
Helpful - 0
1308134 tn?1295187619
MEDICAL PROFESSIONAL
I agree, don't take it if the bottle says external use only. One issue with all herbal medications is that there is usually less regulation of their manufacturer. An issue that can occur with St. John's Wort is contamination with cadmium... so it is important to select a good manufacturer.

It seems to me that you have been depressed for an awfully long time. This is not very good for your brain. And also, the longer you are depressed the harder it can be to emerge from that depression.

My previous attempts to help you get treatment haven't been that successful, but I would like to try again.

A few weeks ago you mentioned behavioral therapy, how is that going?
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Avatar universal
Definitely don't take the St John's wart if the bottle says for external use only.

I heard that depression was self-limiting but it would be good to talk things through with someone.  

I wonder if the liquid is some sort of aromatherapy??

Is good that the thoughts have reduced somewhat since your exams.  Try talking with your friends and family who you trust.
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Avatar universal
what i have is liquid form and writen on it for external use only ?
thoughts now become less after the exam but still i cant enjoy setting with my family or friends every time i set with them , thoughts come ( why you enjoy , what you will benefit you will die ) and then start crying , i dont talk about these ideas, i become more afraid to talk, i prefer to stay alone and cry ????
for how long this will take ??????
Helpful - 0
1308134 tn?1295187619
MEDICAL PROFESSIONAL
Usually St. John's Wort comes as a tablet.

The typical dosage of St. John's wort is 300 mg 3 times a day of an extract standardized to contain 0.3% hypericin. Some products are standardized to hyperforin content (usually 2% to 3%) instead of hypericin. These are usually taken at the same dosage. Two studies found benefits with a single daily dose of 900 mg.

If the herb bothers your stomach, take it with food.

Remember that the full effect takes 4 weeks to develop. Don't give up too soon!
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Avatar universal
i send him an email told him about the how the condition progress. and iam waiting for his reply, i hope i will be better since we will not have much pressure next weeks, try to change the routine , go with my family.

i have buy st johns wart that my doctor advice me to use , but do you know how it is used ? it is liquid formula?
Helpful - 0
Avatar universal
Congratulations on finishing your final exams.  I hope your grades turn out as you would have hoped and I hope they reflect all your hard work.
It was a good strategy to study with one of your friends, well done.

I've often had problems with negative thinking before bed.  While there are times I can manage them there are also times when I really struggle.
My doctor gave me lorazepam which he suggested I take before going to bed.  I do this when the thoughts are particularly overwhelming and when my sleep is  starting to become seriously disrupted.  I have learnt that it is best to address the problem versus not treat it.  I use to go weeks and months with limited sleep and this would really affect my health (mentally, emotionally and physically).  Taking meds, at this time, is actually the more skillful option for me.  Whilst also working towards making some long-term changes.

Since the pressure is off somewhat regarding the study are there steps you can take now to help yourself?
Could you re-visit your doctor?  Engage in regular psychotherapy sessions?
What are your thoughts and your plans?
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Avatar universal
Today i finish my final rotation exam i hope i did well in it. but unfortunately same thoughts return back immediately after i finish . last days i try to resist them by studying with one of my friends , the only trourble time was at night when i go to sleep . today i were  not able to sleep due same thinking.
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Avatar universal
It's OK to be busy but long-term it perhaps isn't the best way to deal with the problem.  Sometimes the more we try to suppress things the more they tend to affect us.

I didn't tell my parents about my thoughts and largely still don't.  My parents while I guess they care they just use what information I do give them to attack me with.  If someone is going to keep firing shots at you why would you keep giving them ammunition.  Dealing with the thoughts, etc is enough without them adding to the difficulty.

If you spoke to your parents, after your exams, then maybe they would be better able to support you.  Maybe together you could work towards finding a solution.  Maybe if your parents knew how distressed you were then perhaps their view on medication, etc would be slightly different.  ??

You spoke about behavioral therapy.  Is that not helping?  I would strongly encourage you to look into some sort of talk therapy once your exams are over.
Talking about and through your issues does help to reduce the intensity of them if they are dealt with in a caring and sensitive manner.
Due to your chosen profession I think that this may suit you best.  Understanding what is going on with you may help you most.
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Avatar universal
your words make me feel batter
usually i feel better when iam bezy with something but i need something strong to prevent me not to think.
i cant tell my parents that i think of death i dont want them to worry to much
but iam afraid these thoughts progress more and i will not be able to hide
Helpful - 0
Avatar universal
Good luck for your exams this week.
I know how difficult that can be when you feel so indecisive or ambivalent.  For me, I wanted to get well but I didn't want to take medication.  I felt very confused.  Sometimes I think that I would have been OK had someone demanded that I take it.  Maybe demanded is the wrong word but been assertive.  Shown that medication was a good choice.
I would love to tell you what to do but I think that it needs to be your decision.

That must be hard not having your parents support.  Maybe it is better to listen to your doctor though.  Family as much as they like us can sometimes hinder our recovery.  A doctor should have all your history and so should be in a better position to judge.  If a doctor only promotes one option I would be wary though.  If they are open to other suggestions that could show that they have considered other options.

Maybe you're trying too hard to stop the thoughts.  I have found that with ocd the more you try and control the thoughts often the worse they become.  Maybe giving yourself permission to have the thoughts would help??  The previous doctor on the mental health expert forum use to say that thoughts, memories, etc were only pieces of information that didn't have the ability to hurt us.

Study and stress and fatigue could be contributing.  You will have a better idea of this next week after you finish your exams and can relax a little.
I think that there are likely underlying issues though.  Things that need to be worked through with someone.

What makes a day better?  Is it because you are distracted, etc?

If I had to take something for depression I would probably look at a natural precursor for serotonin.  Or maybe just go with a medication.
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Avatar universal
i will have my final exams this week i really dont no what to do,
my parent dont encourage me to start medication.and i cant stop such ideas even i try but fail many times
my parents worried , they yhink that i study too  hard and this is the cause of the problem ,

in some days i feel better no bad thoughts but this doesnot remain for more than 1 day.
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Avatar universal
i were adviced to take st johns wart to relieve the symptoms
is it safe ?

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Avatar universal
It feels like an eternity ago now.  I was always extremely anxious so symptoms of anxiety.  I expect my mood was rather low too so depressive symptoms.  My main memory of that time now was of fear.  The fear was most extreme in the evenings.
Like I said previously I didn't want to go to sleep and then when I did I would have nightmares about dying.  One was about dying and going to be buried which terrified me because at that time I didn't feel ready for it.  I think I got quite sleep deprived during this period.
I'm trying to remember when this happened.  I'm really tired at the moment and can't think it through.  I think I may have posted how I felt at medhelp somewhere.

I am very anti-meds so I am perhaps not the best person to ask.
I think the side-effects from meds tend to pass relatively quickly (especially when you put things into perspective and consider the bigger picture).
There is always the option of adding another med for a short period to help with your anxiety of taking other medication.

I would say do what feels best or right for you.
I would usually also say to follow your doctor's advice.

Regardless of what you decide regarding medication I think that psychotherapy is important.

I think if I were you I would put off any decision until your final exam.  I don't think that I would start medication in that time (?although something for anxiety could be helpful).

I would advice you to do what you feel you need to do to get better.  You know yourself best.  Trust yourself to make the best decision for you at this time.

This forum expert is probably better able to advise regarding treatment.
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Avatar universal
what symptoms you were suffering from ?
you can send me amessage
iam thinking to take medication as my doctor advice me but iam afraid of the side effects  
what is your advice ?
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Avatar universal
Could the depression and anxiety be due to unprocessed grief?

Psychotherapy.  I found psychoanalytical psychotherapy most helpful.  I guess any talk therapy would do.

I have learned that worrying about something such as exams is a huge waste of energy.  Have you tried to break it down into smaller goals for yourself so that you don't feel so overwhelmed?
People say that it is better to focus on your performance rather than the outcome as that will take care of itself.
What information do you need to learn to pass your exam?  What is the best use of your time now?

What would you say to a patient if they were presenting with similar symptoms?  What would you advise?

In medicine you will be confronted by death but also a lot of healthy outcomes too.

The repetitive thoughts sound quite obsessive too.  I have found that focusing on reality has helped with other aspects of repetitive behavior (ocd).
Realistically speaking, what are the chances that you will die anytime soon?  You could draw on your medical skills for this if it helps.
You're not anywhere near the life expectancy rate, etc, etc.

I'm not sure how to advise. I just know that these thoughts disappeared when I was in therapy.

Good luck.  And good luck for your final exam.  Maybe after your exam is over things will improve slightly??
Helpful - 0
1308134 tn?1295187619
MEDICAL PROFESSIONAL
I have a summary that I share with my patients with depression of the seven fastest treatments for depression (all of them have been shown to be effective in controlled studies) -
1. Light - Get at least forty-five minutes of bright light (sunshine or light from a light therapy light) per day before 9 am.
2. Mindfulness meditation (there are a lot of good resources on the internet that can tell you more about this).
3. Physical activity - 30 minutes a day of some kind of physical activity that raises your heart rate (walking is a perfect form)
4. Social connection - This has two parts: have regular (a couple of times a week) conversations with someone that include discussions about your fears and hopes; have regular (every morning) contact with people you know (I call this "coffee shop" therapy - these conversations are just to establish what is called a "social rhythm").
5. Healthy pleasure - Do one thing per day that is healthy (eg, not using drugs, or drinking, or....) and that at least used to be pleasurable (included because sometimes nothing seems to actually be pleasurable.
6. Competence - Notice one thing that you do well every day (this doesn't have to be something that you did very well... and yes, I am sure that you do at least one thing well every day... but most folks with depression stop noticing those things).
7. Proactivity - Have an idea of what you want in your life and do one thing per day that moves you closer to that idea (going to school probably qualifies, but, again, you need to notice what you are doing).

Hope some of those ideas are useful.

Peter
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Avatar universal
recently no but last year my uncle died and it affect me to much.
what type of therapy you mean ?
iam worried about my exams  i will final exam next week ,until now  i cant study.
i cant stop these thoughts iam really suffering
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Avatar universal
Has someone close to you or that you know of died recently?

I found those thoughts at there worst when I lost four family members and one neighbor all within the space of four weeks.  I found the thoughts quite disabling.  It even got to the point where I didn't want to go to sleep at night because I was afraid of dying while I was asleep.

I found therapy helpful.

Just wondering what kind of time frame you are allowing yourself before you trial ad's.
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Avatar universal
yes , i refuse to take drugs and prefer to begin with behavioral therapy first , if it show no benefit i will go to the medication.
but really this problem trouble me alot i cant study iam worry about exams.
when i start such thinking ( i will die soon and imagine what will happen to my mother and my family) i begin to cry then i cant stop it. even at home they notice iam not active as before.
Helpful - 0
1308134 tn?1295187619
MEDICAL PROFESSIONAL
This is a very typical presentation of depression. In a way it is the most dramatic example of negative and pessimistic thinking that is the key to depression.
I know that you have posted before, have you been able to get treatment?
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