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Any experience or advice on medication for negative rumination?

NAS90609

I would like to hear people's experiences of using prescription medications to deal with negative rumination either directly or as a symptom of depression and/or anxiety so that I can start thinking about whether medication is an option for me.

I know these things are not autism - but it seems like they're often travelling partners and I'm not yet at a point in my own post-diagnosis journey where I can tell where one set of symptoms starts and others end.

I was diagnosed as autistic just over a year ago after a few years of noticeable decline in my mental health - particularly in my ability to deal with people - and as part of trying to unpick all that - it turns out I rate pretty highly on the depression scale.

I don't necessarily feel depressed in a literal sense - I feel like I have a reasonable grasp of what is and isn't working in my life - but I'm definitely showing many of the standard symptoms and constant negative rumination is by far the worst of them.

The things that trigger my rumination are basic everyday life things that I can't get away from or stop - so removing the source or removing myself from the source are not options.

I'm working hard to do all the right things - I've done some CBT counselling, I'm practicing cognitive diffusion, I'm meditating, I'm getting out of the house for walks, I'm drinking less and I'm trying to be easier on myself and more proactive about autistic things that feed into the problem like my sensitivity to noise and my general distrust and dislike of people.

Despite all this I'm now at a point where it's having a more severe impact on my daily life and I'm feeling like it's getting worse and maybe I'm at a point where I need to consider medication - which I assume will be some sort of SSRI or SNRI.

I'd appreciate any insights from your own experience.

Thanks.

Parents

  • I tried various …ines for a while (sertraline being the first) but each I quickly became resistant too, leaving me only with massive weight gain (my set point has moved two stone) and other unpleasant side effects like constant jumping limbs especially when trying to sleep. Eventually I came off them but the anxiety has been so intense for two years now that I felt I still needed help, and aware that CBT is less effective on the neurodiverse. 

    my proposed solution (and thankfully my GP has agreed) was to be allowed a repeat prescription of diazepam for carefully rationed use. So I take it on the tougher days, about three times a week. That means my system never builds up too much resistance and I also reduce the risk of addiction. It’s a 4 mg dose (2 was barely scratching the surface) at this point, and I’m grateful for the slight cushioning it gives me to help hold ruminating a little more at arm’s length. But I feel I also need my uin-cushioned days too, so that I can properly process worries, get back in touch with my core self and so on. And reassure myself that therapy is still needed, not just the suppressant effects of medication. As ever, balance seems to be key. 

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  • I tried various …ines for a while (sertraline being the first) but each I quickly became resistant too, leaving me only with massive weight gain (my set point has moved two stone) and other unpleasant side effects like constant jumping limbs especially when trying to sleep. Eventually I came off them but the anxiety has been so intense for two years now that I felt I still needed help, and aware that CBT is less effective on the neurodiverse. 

    my proposed solution (and thankfully my GP has agreed) was to be allowed a repeat prescription of diazepam for carefully rationed use. So I take it on the tougher days, about three times a week. That means my system never builds up too much resistance and I also reduce the risk of addiction. It’s a 4 mg dose (2 was barely scratching the surface) at this point, and I’m grateful for the slight cushioning it gives me to help hold ruminating a little more at arm’s length. But I feel I also need my uin-cushioned days too, so that I can properly process worries, get back in touch with my core self and so on. And reassure myself that therapy is still needed, not just the suppressant effects of medication. As ever, balance seems to be key. 

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