The Science of Overthinking : How to Stop the Endless Thought Loops

[@Jules-kp7rw]

Analysis paralysis, extreme indecisiveness and doubt, constant procrastination, perfectionnism, avoidance coping. These are the demons I am fighting and they are winning. Thank you very much for addressing this topic here dr Rege.

[@JKDVIPER]

Just remember, you’re not alone. 🧠

[@Jules-kp7rw]

@JKDVIPER I realized that recenly. The hard part is finding people like us in real life because we are a minority and we don't display it publicly as we're deeply ashamed of it. I have 1 friend like that and it's a blessing to share our burden and motivate each other to find solutions to make progress.

[@JKDVIPER]

One issue that plagues adults for sure. ADD distractions, stress, anxiety, fear from trauma, all add to the Pot.” ❤

[@sbocaj22]

Medications made my overthinking waaaay worse. I lost 8 years of my life to pharmaceuticals, 8 years that I can never get back. I’m 25 and starting college because I lost my ability to think and understand language. I couldn’t read. Ketogenic therapy and controlled doses of mushrooms and cannabis are what’s actually helped my condition and given me quality of life. I am now going back to college. Registered as a full time student (something I was never able to do while medicated). I cured my social anxiety. And came to find out that I’ve had epilepsy this whole time that was being treated as psychiatric illness. My epilepsy is worse due to the meds I was put on drastically lowering my seizure threshold. However, thanks to diet and lifestyle changes I am seizure free almost the entirety of each month. (I have catamenial epilepsy). So while meds can be useful for certain people at certain times they shouldn’t be the first thing drs jump to without ruling out all other possibilities (which they often do not do)

[@PsychiatrySimplified]

I’m sorry to hear. the missed diagnosis obviously wasn’t ideal and I’m glad that you’re back on your feet. You’re correct that medications aren’t for everybody and even then need to be prescribed appropriately Wish you all the best with your future.

[@sbocaj22]

@@PsychiatrySimplified thank you! 💞

[@JKDVIPER]

Hey, I had a similar path because of a devastating injury. My prognosis wasn’t good going forward without meds. I had NO CHOICE but to give them up. Life is much better/fairer now. ❤

[@Submit-to-your-Creator]

Psychedelics are a great tool

[@G.Fahsko]

Thank You for all the research and sharing!

[@PsychiatrySimplified]

@@G.Fahsko thanks for the support 🙏🏻

[@bobbiecaress4736]

Fear from past trauma is consuming for me

[@PsychiatrySimplified]

Im sorry to hear. It is treatable. Please have a discussion with a doctor.

[@dmitryivenskiy3752]

Thank you, doctor, for your excellent work. Unfortunately, it's not always possible to stay updated with the latest knowledge, read new articles, etc., and your channel is a real find in this regard! With respect from your colleague

[@PsychiatrySimplified]

Glad you find it helpful. Appreciate the feedback 🙏🏻

[@attheranch873]

I had IV ketamine infusions, that helped a lot with overthinking for about seven or eight months

[@PsychiatrySimplified]

This operates fundamentally on the principle of top down modulation - many treatments may kick this into gear but then may lose effect . Ketamine would fall into this category

[@sbocaj22]

@@PsychiatrySimplified do you think ketamine treatments would have longer lasting effects when also incorporating psychotherapy/meditation into the infusions? I’ve found quiet lasting effects from meditating and intention setting while on shrooms. As well as shroom like states achieved thru use of cannabis and deep meditation. And also deep sober medication isolated by myself out in nature

[@PsychiatrySimplified]

@ potentially - relay depends on the individual. It’s always the factors - bio-psychosocial ( the makeup of the individual ) that we are looking to match as best as we can with medication

[@ChrisHodge1978]

Finally, someone gets me!

[@AVENTUS7777]

Great video!! Make more like these please!

[@PsychiatrySimplified]

Sure. Happy to hear suggestions on topics. I've got anhedonia planned .

[@joannamarinova7352]

Thank you Dr Rege, you are amazing ❤

[@PsychiatrySimplified]

Thank you for the feedback 🙏🏻

[@dancer20617]

I focus on my breathing, which is a form of meditation, to help manage overthinking.

[@PsychiatrySimplified]

Yes that’s top down modulation as covered in the video

[@elibarikimeela2761]

Powerful knowledge of controlling our thinking God bless you abundantly?!

[@Lisa-ht7jk]

My cat was killed 2 months ago. I blamed myself then started thinking about all the traumas I have experienced. I have been ruminating over the past. So many different emotions have come up. From fear to panic to depression, disbelief, disassociation and anger. The NHS mental health system is crap so I am trying to get help privately.

[@bradford_shaun_murray]

That was extremely clear and very helpful. The different systemic contexts of the issue were easy to understand. Amazing insight, thanks!

[@PsychiatrySimplified]

@@bradford_shaun_murray I’m glad you found it useful. Thanks for the feedback 🙏🏻

[@bradford_shaun_murray]

@@PsychiatrySimplified You're welcome. Your intelligent perspective is appreciated.

[@Twent25]

10:00 there are times when intrusive thought is active but when becomes over active becomes rumination (if i understood correctly), is fine point when prescribing stimulates 12:23 overthinking is a continuum, a normal thought, we can control, intensity is proportional Slightly more: what if this or that happens, relatively controllable More: obsessional, relieve thoughts through OCD, move from impulsive to obsessive early stage to late stage OCD are different Next: rumination, often in context of depression, what percentage of day 70 percent, all consuming, hard to shift from negative to positive, obsessional guilt, internal stimuli Next: delusional thoughts can be part of psychosis or others mentioned, speed of thoughts can also be expressed as racing or crowded thoughts, linked to suicidality Impact: affects decision making, avoidance, hopelessness, Causes: sleep issues, physical psychological insults, pain, etc Sleep hygiene exercise can help in initial stages but 17:33 can require treatment Type of thoughts present Address associated issues (sleep dysfunction, melancholic depression or salience network activation other) Tailor the treatment: racing thoughts may need mood stabilizers. Mindfulness ACT therapy, observe thoughts without judgement But for some people meditation is unpleasant Individualized treatment required. Is not mental health in all cases.

[@Twent25]

Racing thoughts = rapid thoughts hypomania, example repeated going over and over same issue (eg recent social interaction)? Crowded thoughts hypomania+ unihibited thoughts : example? Jumble of competing thoughts? Note Causes Worsened sleep Hypomania=less severe form of elevated energy (at least in brain?)

[@galaxymetta5974]

Ancient oriental knowledge: to exercise the body, move it. But to exercise the mind, still it. Cheers.

[@PsychiatrySimplified]

Nice one. What I'm trying to convey the video is many of the mechanisms may not be under voluntary control.

[@hassanshahzad7380]

I am impressed by watching your first amazing video. Try to see all yr stuff. I am UAE based professional academic teacher in mathematics and physics.

[@PsychiatrySimplified]

I appreciate the feedback 🙏🏼

[@PEGGLORE]

"Over thinking, Over analysing separates the body from the mind"..

[@Qurlir]

Tool 😀

[@PEGGLORE]

@@Qurlir Haha. I wonder if people who like my comment know what it is or if they think I'm just really insightful? They can try to find it themselves. Won't tell them.

[@1fhasdfadf]

Ah ok. Let me post as a high level comment then. "​ @PsychiatrySimplified Gotcha. The D1-a1a receptor interaction and responsiveness to stress, is that based off of Amy Arnsten and similar peoples' work? Further, I saw one of your other videos about how under the ADHD umbrella is included all sorts of variations in deficits across each of the frontal, striatal and limbic circuits. One thing is that I don't see a lot of mention of the historical entity of "ADD psychosis" from L Bellak 1985 which would seem to have striatal dopamine hyperactivity, which greatly complicates getting enough frontal drive. Curious if you have any recommendations for clinically addressing this entity short of the whack-a-mole approach of using AP along with stimulants which seems undesirable due to harmful side effect profile of AP?

[@hassanshahzad7380]

Dr sanil. It's amazing video. Beneficial

[@1fhasdfadf]

​ @PsychiatrySimplified Thank you. Do you have any further in depth reading to suggest on racing vs crowded thoughts and why one vs the other could be more somatically damaging, short of that each of these tend to be associated more vs less with the DSM categories which are more or less related to SMI conditions? Is there anything that looks at the presence of racing vs crowded thoughts, a priori and analyzes why one may have a more harmful effect on the mind and body?

[@PsychiatrySimplified]

The symptom should always be evaluated with the others to form an opinion. It should ideally not be evaluated on its own. www.sciencedirect.com/science/article/abs/pii/S0165032709001918#:~:text=In%20depression%2C%20patients%20with%20racing,depression%20(Koukopoulos%2C%201999).

[@josep511]

can you explain about the pathways of schizophrenia, bipolar and other issues. It's fascinating. Other topics: marijuana mechanism of action, compulsive over eating,

[@garruksson]

I’m currently on brintellix for treating anxiety because escitalopram had too much impact on sexual well being. My body doesn’t have the symptoms anymore like heavy breathing or pit in my stomach etc, but my mind is often overactive, especially when I have to sleep ( this can be random negative memories but not that I obsess over them, they just wander from one to the next without much judgement, but it’s pretty annoying). But on escitalopram I had very little overthinking, what’s the difference in these drugs that could explain that? Thanks for the video

[@PsychiatrySimplified]

The emotional arousal is what SSRI reduce by calming the amygdala ( but this part is responsible for pleasure,reward etc ) hence the possibility for SE. Other agents can be used instead to do the same - this depends on the severity especially at sleep - agents like clonidine can help- not advice. Please have a look at the video I’ve done on clonidine.

[@Yasen1791]

When we are going to have new antidepressants medication in Australia??

[@PsychiatrySimplified]

We have Agomelatine , esketamine. Vortioxetine which are new antidepressants. Which others ?

[@1fhasdfadf]

What are the neural differences between racing vs crowded thoughts as far as you know? Is there a different treatment strategy depending on which type is more prominent?

[@PsychiatrySimplified]

Racing thoughts will often require a mood stabiliser as they are at higher end. Crowded thoughts may be part of either affective ( Mood stabiliser etc ) and or PFC executive top down modulation struggling - here it depends - for example in ADHD type picture , depression one can have crowded thoughts in which case one may need a bit of arousal reduction plus PFC ‘strengthening’

[@1fhasdfadf]

​@@PsychiatrySimplified Thank you. Do you have any further in depth reading to suggest on racing vs crowded thoughts and why one vs the other could be more somatically damaging, short of that each of these tend to be associated more vs less with the DSM categories which are more or less related to SMI conditions? Is there anything that looks at the presence of racing vs crowded thoughts, a priori and analyzes why one may have a more harmful effect on the mind and body?

[@gamingworld3803]

HLo doctor, when ever I fall asleep I wake up exactly 3-4hrs later and then it’s hard to fall asleep and even if I do I wake up 1hr to 30mins later everytime after that. I previously had high stress and anxiety which I am recovering and previously use to give me reflex when ever I would fall asleep but now it’s not there most of the times and I also changed my state and also check my phone everytime I wake up. Pls help if u can

[@PsychiatrySimplified]

Please listen to the video on insomnia .its best you have a discussion with the doctor for treatment? Also listen to the video on anxiety vs hyperarousal vs agitation

[@robertdimitrelis5567]

Thoughts on trintellix??

[@PsychiatrySimplified]

I’ve covered it in another video Vortioxetine vs SSRI - good medication when used appropriately.

[@1fhasdfadf]

is there no place for mind-body medicine and meditation to manage hypomanic states? does it all have to be medicated? Also what is the evidence for the pyramid analogy you used and what do the 'levels' represent beyond severity/rarity within the general population?

[@PsychiatrySimplified]

There is a place. The pyramid is phenomenology - levels of intensity, nature and quality of thoughts. Delusions are rarer than the worry or preoccupation. Individuals can have thoughts along any of those levels but it’s only when it is significantly causing distress or is affecting functioning is when the patient considers it pathology. Overvalued thinking is common and does not mean it’s pathological . E.g conspiracy theory can be very intense but isn’t necessarily pathological from a psychiatry sense unless this leads to a behaviour that would be deemed so .

[@1fhasdfadf]

@@PsychiatrySimplifiedGotcha. And yours is one of the first few videos (different video on your channel) where you mention the D1-a1a receptor overstimulation and lack of efficacy of stimulants for ADHD. Is this based from Amy Arnsten and similar people's work? Further--another questions. I hear your comment about the sheer diversity of mixing and matching different levels of limbic, striatal and prefrontal deficits that all are contained under the ADHD umbrella. However, I don't generally tend to see discussion around an ADHD with primarily overstriatal implication (for example, for whom extremely small doses of methylphenidate like 1 mg can induce severe disorganized thinking which I can't control), aka, which may be misdiagnosed as schizophrenia, even more so if cannabis induced psychosis hasn't remitted. In the literature I've seen scanty reference towards this subtype towards the historical "ADD Psychosis" subtype from Bellak, 1985. May you have any ideas on this subtype or how to best manage it?

[@1fhasdfadf]

​@@PsychiatrySimplified Gotcha. The D1-a1a receptor interaction and responsiveness to stress, is that based off of Amy Arnsten and similar peoples' work? Further, I saw one of your other videos about how under the ADHD umbrella is included all sorts of variations in deficits across each of the frontal, striatal and limbic circuits. One thing is that I don't see a lot of mention of the historical entity of "ADD psychosis" (Bellak 1985 paper's mentions it) which would seem to have striatal dopamine hyperactivity, and seems clinically distinct from schizophrenia. Nonetheless, transient disorganized or hallucinatory states may occur in ADD psychosis often with presentation of ridiculously miniscule amounts of stimulants (1 mg ritalin) which greatly complicates getting enough frontal drive. Have you studied this entity, and do you have any recommendations around it? Short of doing some dual whack-a-mole of AP/stimulant combo, knowing well the dangerous side effects of AP?

[@ismaaaciil]

Helo Dr.i have negative thinking wherever i look at tall buildings or ride a bicycle feeling like light headed, what is that?

[@shaneward_adhdreimagined]

I'm curious in light of this topic on overthinking and the link to ADHD, you infer cognitive dysregulation. Do you have an opinion the work being done wrt Cognitive Disengagement Syndrome (or, before branding specialists THOUGHT they'd improve the moniker, Sluggish Cognitive Tempo!)? I've recently watched some of Barkley's ideas re CDS but find that it feels more like an flawed attempt to return ADD as a separate diagnosis by decoupling the cognitive component of ADHD It suggests that it should not be confused with ADHD-I but it really is ADHD-I - the red herring being the claim that all ADHD starts as H but that the H is then internalised in adults to internal restlessness. Yet this is not the experience of many ADHD-I (at least not in my personal experience or those of my clients (ADHD coaching not therapy)). If its a topic you may cover in the course of time a short put me out of my misery line will do 🙂and hope that my opinion is not too obvious.

[@PsychiatrySimplified]

I think labels create significant issues. As they unfortunately can become identities for some. And circumscribed syndromes similar to RSD can create issues in management as a result. Ultimately the pathophysiology of cognitive dysfunction can be explored and individuals have multiple ways of expressing the barriers / distress. The way I see it is to develop a formulation that provides a broader understanding of the individual. So I agree the CDS is kind of like a cognitive bio type - similar to what is being now proposed in depression. Thing is it was always part of it - the split is needed to bring people’s attention to it but what happens that is counterproductive is now the focus is on CDS at the expense of the other domains.

[@shaneward_adhdreimagined]

@@PsychiatrySimplified Thanks for the thoughtful response. I do think we may differ on the utility of identification (as a lay person), but we don't disagree with the need to consider the whole and not only the part when considering treatment et al.

[@arjunratnadev]

[@PsychiatrySimplified]

thank you for your generosity🙏🏼

[@immobillien2453]

Man too deep for common man to understand 😢

[@PsychiatrySimplified]

Listen to it again. I would recommended listing to the video on understanding the brain and then coming back. Let me simplify it a bit before hopefully you listen again. There is a part of the brain that is responsible for activation. And there is a part of the brain necessary for focus and attention. Ideally we need a balance. So overthinking can happen because of one or both being affected. Hopefully with this basis you may find it helpful to listen again.

[@DennisBolanos]

Dr. Rege-is the “flow state” the same thing as hyperfocus? 💈

[@PsychiatrySimplified]

Yes it can be. Flow state the arousal is down, and person is engaged. Effort is also minimal. I’ve covered it in the video on Messi.

[@DennisBolanos]

@@PsychiatrySimplified Thanks, I'll check it out.

[@PsychiatrySimplified]

@ the insula ( key part of the salience network) forms an important part of this interoception - part of the flow state. This can be a double edged sword. As interoception of say bodily signals leading to increased arousal ( anxiety) can be negative while interception where the signals are all predictable keeps harmony allowing the individual to engage in an outward task effectively. This is why meditation and mindfulness can be a double edged sword ( also a video )

[@lokesh3428]

Ihv social phobia wt is solutions sir

[@Pial-w8v]

How are you doing? I am a regular viewer from your channel. I am just here to tell you that you are creating very amazing content. Good luck to you. I am also telling you some important problems that are preventing your channel growth. If you want I can fix all the problems in your video.

[@rickspalding3047]

My executive function has been broken since a child

[@PsychiatrySimplified]

It can be treated and modified. Neuroplasticity is a thing

[@Starchaser63]

Good information and topic 👏 but is it possible to condense the message into 10 minutes 🤔

[@PsychiatrySimplified]

There is always more...

[@arjunratnadev]

endless rumination

[@PsychiatrySimplified]

Covered in there

[@1fhasdfadf]

i tried to post a few replies to your comments but they got removed

[@PsychiatrySimplified]

Really? Haven’t removed any? Can you try again?

[@DamagedLion]

Sir is resparidone or which ssri help over thinking nagative thinking..i have tried fluvoxmine ..fluxotine ..escitalopram ..nothing worked ..sadly i tried 5mg clonazepam a day and i got rashesh inside my mouth..am in hell right now due to over thinking and side effects

[@ismaaaciil]

Deep breath, exercise, vitamin c plus zinc, spinach and sincere pray to creator of heavens and earth...

[@DamagedLion]

@ismaaaciil thanks brother

[@Kron-j3k]

If you think that all mental issues stem from the brain alone. Then you do not know what your talking about. No wonder most patients aren't cured. Sad. Look beyond the brain. And youll solve a whole lot more. ♥️

[@PsychiatrySimplified]

Thanks for your comment. You are correct re they don’t stem from the brain alone. But the latter - you listen to this video and make an inference that I think that all mental health issues come from the brain only. Then you make an inference I don’t know what I’m talking about. Perfect straw man. Usually a good way to release frustration .. but a better way is to ask what’s the need to say this. 😊

[@rickspalding3047]

But why is it happening? Science isn't perfect, some are spiritual issues. Jesus's blood. Not dismissing therapy nor medication but it's not going to the root of the issue.

[@n0rth426]

I agree, most of my “mental health” issues stem from how I am treated by others, anxiety stems from negative past experiences dealing with people, unfortunately when it comes to my anxiety, the negative thoughts come true. There is no delusion or thought disruption. Just reviewing how others have treated me in the past and accurately predicting how others will treat me in the future. The depression then stems from the outcasting that occurs, being social is key to human survival so it’s obvious that being outcasted will make you feel depressed and not produce feel good chemicals.

[@scopar5051]

U talk alot

[@PsychiatrySimplified]

Kind of the point

[@Qurlir]

@@PsychiatrySimplified Please dismiss this. This is the first video that i've seen really addresses what overthinking is and how dangerous i can be. Thank you for explaining explicitly on the matter. I like how you touched on meditation and mindfulness and how the prefrontal cortex plays a role in that. People don't understand how much their prefrontal cortex plays a role in how well they'll be able to meditate, it's why people don't understand why meditation is difficult for them.

[@JulioCesar-uo5oc]

​@@PsychiatrySimplified 😂😂😂😂

[@JulioCesar-uo5oc]

If you want no talking I have some ASMR playlist you can try