Interrupting Brain

One of my biggest pet peeves is being interrupted. I can’t stand it, I just think it is so rude. Perhaps the reason that interruptions annoy me so much is because I live with regular interruptions going on in my mind every day. These interruptions are called intrusive thoughts, and it kind of goes like this:

Knock knock!

Who’s there?

Interrupting cow.

Interrupting co…

MOO!!!

That, in a nutshell, is what it is like to have an interrupting brain, only instead of being aggressively moo-ed at as in the above joke, you get pummeled with a weighty and hard to manage thought. You’re carrying on just living your life and out of nowhere your brain interrupts the regularly scheduled programming with a weird/scary/panicky/irrational and random thought.

Intrusive thoughts aren’t a special treat only for those of us with mental health issues; everyone has intrusive thoughts. Who among us hasn’t left home and then wondered whether or not we actually locked the door? Even though we can remember locking the door, we can picture it, even! Still our brains say, “but what if you didn’t?”

The difference comes into play when it comes to how the brain handles the thought. The majority of people can think “did I lock the door?”, reason with themselves that they probably did, and go on about their day. But then there are those of us, about six million Americans according to the smarties at Harvard, who simply cannot let the thought go.

I can only speak to my own experiences with intrusive thoughts. It is possible that others encounter these types of thoughts differently so I won’t say what follows is true for everyone, but it is true for me.

I do not remember a time when I haven’t had intrusive thoughts. I’m fairly certain that I came out of my mother already worried. (I was born quite quickly: I saw daylight and ran. So maybe in the womb I was thinking OMG what if I’m late for my own birthday and then my family won’t want me?!?) Of course when I was younger I did not understand what an intrusive thought was, so I would act on them. The most significant one I remember was thinking that my hands were constantly dirty, even when I had just washed them. So I would wash my hands over and over again, leaving my skin raw. I think I was the only first grader with a bottle of lotion in my pencil case to treat my raw little hands. The thought was constant and unchanging: my hands are dirty, there are germs on them, gotta wash them again.

I couldn’t get rid of the thought that my hands were dirty. Once it occurred to me it would be all that I thought about until I washed my hands again. This is similar to what happens when I have a thought such as “did I lock the door?” With a thought like that I cannot let go. I have to turn the car around, go back home, and check the door. Once or twice I have actually forgotten to lock the door, so while it is inconvenient at the time it is also a good thing that I turned around.

Thoughts like these are annoying, but manageable. The thought occurs, you do what you have to in order to mollify the thought, and you move on. It won’t necessarily throw off your whole day or send you into a spiral of unhelpful thoughts.

But of course there are intrusive thoughts that do just that: they kick you off a cliff and point and laugh while you descend in an ever-tightening spiral of increasingly terrible thoughts. Example: a few weeks ago I came down with a nasty cold. It started differently than a typical cold. While I normally start with head and nasal congestion, this one began in my throat with soreness and my chest had that clogged, congested feeling. It was harder to get a deep breath and I was very tired, so I spent a lot of time laying on the couch or in bed. While laying down, my Fitbit notified me that I was earning zone minutes, meaning that my heart was in the “active” zone. I was horrified to see that my heart rate was over 100 while I was laying down. The first thought was “OMG this isn’t a cold, it’s some kind of heart problem”. That spiked my heart rate even higher. I did some breathing exercises to calm down and was able to bring my heart rate down into the 90s, but my brain kept going.

“My heart must be working harder to get oxygen into my blood. What if it can’t keep up and my oxygen drops while I’m sleeping? What if I wake up and my oxygen is so low that I cannot move or get help? Should I go to the hospital now? No one knows I’m sick, it’s the weekend, no one will notice something is wrong until Monday. What if no one checks on me and I die here alone? Then Moishe will definitely eat my face and my body will only be found once it starts to stink and Moishe will end up homeless because who wants to have a cat with a track record of eating human flesh?”

This was a spiral that had me up at 2:30 in the morning taking my temperature, doing a Covid test, and monitoring my heart rate. Obviously I lived through it and everything was fine, but in the moment those irrational thoughts seemed very real. And it can be very hard to tell the difference between a genuine concern and an anxiety-inflated intrusive thought, especially during moments of stress.

Other intrusive thoughts that I have had:

On any bridge: “This bridge could collapse right now. If I survive the fall to the water, how would I get out of the car?”

On any elevator: “This elevator could plummet to the ground floor or get stuck and I will suffocate and die in here.” (I did recently learn from a reliable source that elevators do not plummet which makes me feel better, but the thought still occurs.)

When I get anxious while driving: “What if I pass out and cause a massive accident?”

Going to a massive public event: “Someone could get sick and this becomes a super-spreader of some type of plague.”

Any time the cat does anything even slightly out of the ordinary: “Is he sick? Do I need to take him to the vet? Did he eat something he shouldn’t have? What if he needs surgery? What if he doesn’t get better?”

When I have to get up early for work: “What if I oversleep and am horribly late and I get fired?

Those are all pretty standard and occur all the time. Then there are the fun, super weird ones. This past Tuesday I was driving the cat up to the specialist vet in New York state for a check up. On two separate occasions I was behind a vehicle with writing on the back that was misspelled. One was a school vehicle that said, “This vehicle stops at all reailroad crossings.” I laughed at the irony of a school vehicle with such an obvious spelling mistake and then swept it from my mind and continued driving. That is until I found myself behind another vehicle, a work van for a construction company or something similar. There was a slogan written on the van which was along the lines of “We work the hardest to bring you the best” only “hardest” was spelled “heardest”. I laughed again and got super judgmental because I admit I am a bit of a spelling and grammar snob. But then I thought about it and realized that both “reailraod” and “heardest” had an extra e. And poof, my brain interrupted my laughter with the thought that maybe this was the first sign of a brain tumor or disorder which causes me to see extras of the letter e where there are none. Thankfully I have not seen another word misspelled with an extra e since Tuesday or I would be headed down that rabbit hole right now.

I have found that the most important thing with intrusive thoughts is to learn how to recognize them for what they are. Is it real? Is it realistic? Does this thought need to be followed and acted upon? These are all questions that I ask myself when a strange inkling arrives unbidden. Thinking about it helps me to figure out my next steps in dealing with these interruptions.

For some folks, myself included, medicine helps. While there is no pill or therapy that will make the thoughts stop, there is a lovely little drug called risperidone (the generic for Risperdal) which helps to manage obsessive thinking. So I still have all of the intrusive thoughts, but my medicine helps me to look at the thought, acknowledge it, and (most often) just shrug it off as something best ignored.

In moments of high stress, anxiety, or depression, intrusive thoughts become more prevalent and harder to ignore. They are more likely to cause a spiral, or a ride on the doom loop as my dad calls it. And it is harder to stop the spiral and get out of it when you’re already cooking at higher levels of stress. But nonetheless, there are things you can do to help yourself.

1) When a thought occurs, acknowledge it. Trying to ignore an intrusive thought just makes it louder. Think about it and listen to what your brain is telling you. This step should be quickly followed by:

2) Analyze the thought. Where did it come from? Why do you think it is happening now? What is going on around you that might be causing the thought? And most importantly: is it realistic and rational, or is it fake news?

3) Take action to change the subject in your brain.

If you’re in a situation that is triggering the thought, get out of that situation as fast and safely as you can. Example: if you’re driving on a bridge and thinking it’s going to collapse, keep breathing and keep going. Don’t speed and drive erratically, just breathe and keep a safe and steady pace. Before you know it you will be back on land.

If the thought is not caused by a particular situation, but is just your brain fucking with you for funzies, change the subject. Occupy your mind with something else, something engaging. Don’t play a mindless game on your phone, that won’t help. Do something mindful, something that takes your attention and requires active thought. Make a list in your head. It could be anything: see if you can remember all of the birthdays in your family. List all the states and their capitals. Think through the starting lineup of your baseball team of choice. Or do something physical like going for a walk or doing a workout. Moving your body often gets you out of your head.

4) Accept that sometimes the intrusive thought raises a good point. Because occasionally the thoughts aren’t entirely unrealistic. They are still outlandish and unlikely, but not impossible. That can be hard to ignore, but also leads to an important reminder: we cannot control most of what happens in life. Whatever will be, will be. There isn’t much we can do except choose how we respond to any given situation. So do your best to choose your response to the thought as well. Try not to let it control you. Try to find peace in the uncertainty that is existing. If something bad or unpleasant is going to happen, there isn’t much you can do about it. But trust yourself: you’ve made it this far and whatever happens, you will deal with it as it comes. No point worrying about it now.

I say all of this from the perspective of someone who has been dealing with this for a long time and with a lot of help I have been able to shut up my obnoxious interrupting brain. Sure she’s still chatty and says stuff I’d be better off not hearing, but I’m on to her. I can ignore her or rationalize her into submission.

But it’s not easy, and it certainly isn’t easy if you’re just starting out dealing with such things. The best advice for if you’re struggling with intrusive thoughts is this: ask for help. Tell someone. Get advice from a professional. It might feel silly that you cannot ignore thoughts that are patently ridiculous, but the struggle is real friend! You’re not alone in this, and nothing you can say is going to shock any mental health professional. Believe me, I’ve been trying for years to surprise my therapist. It cannot be done. They’ve heard it all.

Interrupting is so rude. It sucks when people do it to you, and is just as unacceptable from your own brain. Learn how to shut that bitch down and recognize the fake news for what it is. It will never go away completely, but you will have so much more peace in your own mind.