Ask HN: What to do about distracting mental chatter? | Hacker News Reader

Ask HN: What to do about distracting mental chatter?

45 pointsjpeterson49 comments

This is a bit strange, but somehow I figured I would find fellows among this crowd. For some time now, I've been experiencing what I would characterize as highly distracting and annoying dialogue going on in my head, out of my control. This goes far beyond the usual stuff that happens during e.g. debugging or any other puzzle-solving activity. There are various different disconnected voices, and they will constantly whisper, speak, and shout inanities. Oftentimes it's quite profane, and sometimes I catch myself unintentionally vocalizing it.

Does anyone else here face this? Have you found any remedy? Have I gone nuts?

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I mirror the sentiments of everyone who said to see a psychiatrist. If you do have schizophrenia, the good news is that it's not the end of the world. Start taking medication, establish routines for yourself, and you can (continue to) lead a meaningful life. One of the smartest and most productive people that I know is a paranoid schizophrenic; another of the smartest people I know is a chronic untreatable undifferentiated schizophrenic. I myself am a disorganized schizophrenic, having been diagnosed eight years ago.

Now for the bad news: you should never have posted this, unfortunately, and you should definitely keep information regarding your mental health very private. Make sure everybody that you tell understands that it is confidential information. I'd love to tell you that we live in a tolerant and understanding society, but we don't. Schizophrenia is not well-understood by the general population, and if people find out that you have it, you will have been marked by the proverbial scarlet letter. If you're lucky, you'll find a group of people who support you. If you're not, you can expect to be hounded, and you may never escape it.

you should never have posted this, unfortunately, and you should definitely keep information regarding your mental health very private

Since I have no experience of having mental illnesses myself, I cannot disagree with you. And you're probably right - many people react with intolerance to anything that's different and hard to understand. However, that could be said for other quirks too (such as an unhealthy passion for programming...), and I would imagine most people on this community are well used to being treated as different. From entrepreneurs to technical gurus (or both at the same time), we have severed ourselves from "normal society" in a number of ways already.

Because of that, I would imagine that this kind of community is probably more tolerant of these sorts of differences than most others. One piece of evidence for that would be the useful advice posted here, and general lack of "Lolz you're nuts" or "Get off the drugs" type of comment (well, there's one or two..).

I'd like to also offer the anecdotal evidence that I know a number of people with mental disorders and those mental disorders don't get in the way of us being friends (in some cases very close friends). Not everyone ostracises people with mental disorders.

Yes. The more serious problem is: Google loves Hacker news. What happens in here does not stay here.

It's no big deal; just email pg and he'll kill the thread.

See a doctor and do it soon, unless you're in your late teens or early 20's, in which case do it yesterday. That's the peak age range for the onset of schizophrenia.

To clarify this, hearing voices in the way you describe is a common symptom of schizophrenia.

More info is available here: http://www.schizophrenia.com/diag.php

No one here can diagnose whether or not you have schizophrenia. Only a qualified, experienced psychiatrist can do that. And if you have schizophrenia, you very probably need medical help because it can get worse with time, if left untreated.

People here want to be helpful and responsible and so they are recommending seeing a doctor or psychiatrist immediately.

I certainly wouldn't advise against that. However, it is also helpful to put up a few countervailing arguments:

(1) Whether the psychiatric profession knows anything much is a legitimate question. See for example,

http://www.spiritus-temporis.com/rosenhan-experiment/ http://www.flickr.com/photos/romasita/1801370299/ http://www.szasz.com/freeman15.html

(2) The diagnostic criteria for schizophrenia seem incoherent and lacking in empirical content. Prostate cancer, OTOH, is an uncontroversially real condition with clear cut symptoms and diagnosis.

(3) Being labelled with a mental disorder can be a huge stigma that you have to deal with for the rest of your life. It might affect, for example, your job prospects and your parenting propects. (People are learning in the UK that new mothers are unwise to admit feeling depressed to medical staff.)

(3) Everybody has voices or at least one voice in their heads. It is just that only a few people such as the poster and Richard Feynman have the necessary self-awareness and intellectual integrity to talk about them openly.

As Eckhart Tolle might say, the real question is whether one identifies with the chattering voice. People who are completely identified don't perceive it as an external entity, but it is still there: they are the voice.

(4) Such voices are thoughts, and many of our thoughts are random and contradictory. When we daydream (or dream at night) they are connected only by loose associations. Nobody really has control of their thoughts. Try drinking 6 cups of coffee after a 24 hour fast and watch the cascade begin!

(5) By listening to our thoughts and becoming more aware of them we remain in control of our actions. Just because we have a particular thought, it doesn't follow we must enact it. The psychiatric profession is all about regulating people's behaviour for social reasons.

As someone with a close family member who is schizophrenic and has spent a lot of his life refusing treatment, I think it is inadvisable in the extreme to deliberately avoid recognizing the condition, to minimize or trivalize it, and deliberately avoid seeking help for it. The kind of voices the poster describes do not seem to match the kind of stray thoughts that most people have.

As an adult, unless you pose an acute danger to yourself or others (which this fellow gives no indication of being), nobody can force you into treatment or medication that you do not want to take. The least he should do is learn about the condition, find out from a professional whether or not it actually applies to him at all, and his options if it does.

While psychiatry certainly does have its shortcomings, I have not seen a lot of good come from the Scientology anti-psychiatry approach, or trying to deal with problems of this magnitude (potential schizophrenia) on a pure self-help basis.

See a doctor and do it soon

Soon ==> today.

Make the appointment and stick to it. You and your mental health is more important than any work/home tasks Friday may bring.

http://en.wikipedia.org/wiki/Hallucination#Auditory_hallucin...

If it's enough of a concern for you to ask about here, you should seek other expert (medical/psychological) counsel, or at least discuss with a trusted friend or family member, in person.

Where people have previously mentioned similar experiences to me, the incidents were ultimately attributable to either (1) drug use (including misprescribed stimulants); or (2) onset of mental illness. However, the Wikipedia article also mentions a movement to manage hearing voices without considering it a medical problem:

http://en.wikipedia.org/wiki/Hearing_Voices_Movement

Still, since it's bothering you, I think you should talk to someone wiser than this comment thread in person.

The hearing voices movement is interesting. Just makes me wonder: maybe for some hearing a voices is just a minor anomaly in their brain, similar to people who can hear colors? What I mean is, perhaps we all have voices in our heads, but only for some they actually become audible - because brain regions "overlap"?

I don't think people who can hear colors are considered to be ill. If anything, they are considered to be advantaged?

(This is the first time I think about hearing voices, I have no real knowledge about it whatsoever).

Edit: found Wikipedia article, http://en.wikipedia.org/wiki/Synaesthesia - think I mixed it up, it is usually seeing tones as colors, not colors as tones. But other things, too, like "numbers, days of the week and months of the year evoke personalities"

Similarly perspective-bending ideas (which I first learned about via Snow Crash):

http://en.wikipedia.org/wiki/Bicameralism_(psychology)

Exactly what I thought of when I read Tichy's comment. The Origin of Consciousness in the Breakdown of the Bicameral Mind might be total BS, but I can't say it wasn't a fun read.

Well, it might have been a "fun read" but this is someone's life and mental health we're talking about.

Yes. Perhaps "interesting and thought-provoking book" might have been more apt than "fun read".

??? Sorry I can't follow anymore. So thinking about possibilities is inappropriate? Doctors are never allowed to enjoy their job? (I am not a doctor, but it would be a similar situation)

It might be a helpful and fun read for someone dealing with hearing voices, too.

The diversity of comments here (as well as the referenced Wikipedia articles) indicate the situation could require a more complex and long-term strategy than simply "run to doctor; do what doctor says." (Even though talking with experts is almost certainly part of the right course.) In that case, discussing "fun reads" with relevant perspectives is part of coping.

I haven't experienced what you describe, but have had different involuntary auditory experiences for years. The key for me has been to learn not to be bothered by them. Everyone has involuntary thought processes; I don't see why some shouldn't be connected to the auditory parts of the brain.

It helped me to see that what was bothering me was not whatever I was "hearing" but entirely a secondary process - thoughts about what I was hearing, like worrying or frustration. I don't know if that makes sense, but it's a critical point and I recommend it.

Equally helpful (and intimately related) has been to develop simple somatic awareness. A good way to grasp this is to pay attention to the space between thoughts. That is silent, so it is a mode you can shift to when you don't want to deal with mental chatter. Having that option provides relief. It is also grounded in the body in a way that most thoughts are not (I'm speaking purely experientially). Developing that awareness over time gives you greater inner depth, which turns out to be invaluable in a lot of ways.

If the auditory stuff never settles down, maybe the space "between" thoughts is inaccessible; in that case I switch to the silence behind them. Inner silence is never far away, but you need to find your own way of connecting with it.

As I said, I don't know if this will make sense. These things are hard to articulate. I will say that sometimes they are challenges that pay off if you learn what you need to learn.

As for whether you're going nuts, who cares? You can be a balanced, well-grounded nutcase. This is an example of a secondary idea that pretends to be about the underlying experience but actually isn't; it's a meta-worry.

You have not gone nuts; that's when you give the voices greater priority than your external sensorium. But such symptoms could (at worst) be a sign of schizophrenia or Tourette's syndrome (particularly the profanity and involuntary vocalization).

There is much good advice above. Have a chat with a psychiatrist - call a few of them in your area to find out what they charge, and pick one you that sounds busy but pleasant. Don't feel bad about trying another if you leave the first meeting feeling unsatisfied in some way, that's not unusual. Setting some time and money aside to visit a doctor and having their number handy can be a good stress-reducer in and of itself. There isn't a pharmaceutical 'magic bullet' for this, by the way. Your brain chemistry is as individual as you and your thought processes, so whatever therapeutic approach you adopt, if any, will require some experimentation and patience.

Meantime, don't stress too much. Learn about the voices if you can: do they have persistent identity? do they respond to question or challenge? do they remind you of anyone? If you set aside some quiet time and just listen to the chatter, does anything of substance emerge? Having some experience with this, the best analogy I can make is that it's your regular dreaming process but with the volume turned up so that you can still hear it from the next (waking) room. I'm sure you can think of coding analogies too. Doesn't mean you're broken, and it's not necessarily a one-way thing either. It may just as well tail off in its own time.

Also, another vote for The Origin of Consciousness in the Breakdown of the Bicameral Mind by Julian Jaynes; Daniel Dennett is also worth reading, and so is Stanislaw Lem.

Many thanks to all who have responded here. I will go with the prevailing opinion and talk to a doctor.

Very wise decision. I would also recommend resisting the temptation to follow every link you can find (below, in the googlesphere, etc) that may give you information (correct, or very very wrong) about what may or may not be your medical condition. The Internet cannot diagnose you, but it's all too easy (in my experience, and that of close friends) to fall into the trap of web browsing as a displacement activity for getting real help.

If you are in the UK, free advice is available by calling SANEline on 0845 767 8000 (6pm - 11pm). Good luck and please let us know how you get along.

For what it's worth, I've had a similar thing a year ago, but arguably less intense than yours.

I was experimenting with meditation, and after a while I started hearing a disordered stream of voices during the process. First I could barely hear them, but I did not resist and with time the volume rose; some phrases where as loud as screaming.

I also started hearing the chatter without meditation, usually when it was quiet or I was calm enough. It actually was fascinating, as most of the phrases where quite surreal. I even wrote down some of them (it's hard to remember the actual words I was hearing, they disappear rapidly from the memory).

Anyway, right now I don't meditate (and sleep significantly more than I was back then); the voices are no more. I'd actually love to see some explanation, and while I have no desire to see a doctor (I don't think it's a decease), maybe you'll tell us what he thinks it is?

PS. Can you remember the actual phrases, and give a few examples?

Meditation affects people differently; for a few people it is associated with seizures or other problems. See this article for more info:

http://www.sfweekly.com/content/printVersion/313883

Today. Now. Go to a doctor and camp outside their office until you get to see them.

The great news is that your ability to perceive these voices and think about them makes it highly likely that you will be able to deal with it, and not have it destroy you. All the people I know who have described similar symptoms are now active and productive people.

However, without getting proper medical assistance there is serious danger.

So deal with it now, and it's likely you'll be fine.

@jpeterson. Can you give more insight. I have similar situations- sometimes swear words just come out of my mouth(mostly alone..like when i am sitting on the throne or in shower). I would like to know if there is any similarity. I don't have any kill someone thoughts, but death of my close ones sometimes engulf me. Sometimes, I catch myself making weird groans/grunts in the shower. (i try to reduce this by reading while s(h)itting and sometimes reading aloud)

I have problems concentrating on anything - lately i have been trying to work on SICP and then I read about "achievers" - who of the same age - have forged ahead and i get depressed. small things like the ongoing world-war on rails-django affects me - in terms of picking which one. I start a project (after the long battle of picking which platform) and then lose the motivation in between. (lately i thought of an idea of twitter app and then read of these out of the world ideas/apps coming out and this literally gives me the sinking feeling, i get sweaty and out of energy)

PS: i have been unemployed for a while. i am severely under-confident while giving interviews.i am highly depressed - not knowing what to concentrate on (i will do an ask-hn on this later). I think I have no programming skills.this after sitting thru enterprisey application doing j2ee/ejbs etc that could have been done in simpler ways. I envisioned the whole 20 member team being done by 7 members with some reflection apis...but i never mustered courage. Now when i start something, i think why? how is it going to help the world? i see the news - srilanka so many homeless people, darfur, faith based killings and i think what is my to-do app going to help? I cannot explain in words the depression - it is the niagara waterfall and not a stream that i can try to concentrate and pinpoint.

I tried to pen my thoughts to make myself thoughts "active". but at that instant, my mind freezes and i have nothing to write. my ever-patient wife helps me everytime she can, but while she is at work, i am getting paranoid in my isolated cell.

i have been thinking of doing an ask-hn on this for a while and everytime i dread getting these apathetic one liners - go see a doctor/ get a gf/ get laid. but i think i will post and do a reference to this one.

@jpeterson - care to share more of your thoughts/experiences and your contact info?

> how is it going to help the world?

Perhaps http://www.paulgraham.com/hamming.html will make for an interesting read.

Maybe you are just exhausted?

Don't bother with the ask-HN post; just see a @#$%! doctor! While a lot less alarming than the TLP, this sounds vaguely like bipolar disorder, but you're not going to get help or a diagnosis on an internet forum, even if anyone who reads your post is a qualified psychologist (which I'm not).

(1) First of all, definitely see a doctor--depression, anxiety, and/or whatever else you've got can and should be treated.

There are some other things worth doing as well that may help alter your mental state for the better:

* Get exercise--the brain is part of the body and is affected by its state. Regular exercise can help clear out some of the cobwebs/gloom-and-doom, etc. Exercise connects us to the physical reality that we inhabit. The endorphins may give you a boost as well.

Additionally, if you go to a gym, you will interact with other people, which will likely help your mood and, perhaps, can lead to more tangible things, i.e. a job -- that's right, you can actually do social-networking away from a computer!

* Get some sunlight.

* Eat properly.

* Sleep regularly.

* Get out of the house during the day.

If you want to work on coding, go to a Starbucks or a library or a friend with spare office space or whathaveyou.

Just get the hell out of the house.

* Get a job--any job.

Even a temp job, if necessary--something to get you out of the house, doing something useful and getting compensated for it. A non-technical job might take some of the pressure off you, let you approach technical stuff in a more relaxed way, etc. The social aspect can be useful too. If you get bored, well, that'll give you an incentive to study-up so you can get a more interesting job. And, it'll give you something to talk to your wife about, will bring more money into your household, etc.

Also, you may find out about problems that need solving that can be turned into opportunities for consulting, etc. You might even be able to build a company based on solving such problems.

If things are really bad where you are, perhaps you can volunteer and get some of these benefits too.

Good luck.

And, as stated the top, see a doctor.

Three possibilities depending on what the voices in your head are saying

- If they are random useless sayings: ignore them (see a doc)

- If they are good ideas : write them down

- If they tell you to do anything harmful: go see a doctor immediately

It's healthy to talk with your self in your head... like playing devils advocate and viewing the same problem/idea in different perspectives... but if it's unintentional, might be something else. Wish you best of luck.

"If they are random useless sayings: ignore them"

This seems irresponsible advice. There are serious conditions whose symptoms are hearing voices. He should at least consult a doctor.

Good point, fixed.

Just to clarify with regards to everyone saying "doctor": you could see your doctor to get a referral to a psychiatrist but make sure you are getting your mental health care from a mental health care professional.

In contrast to what these others are suggesting, I think you should be somewhat reticent to approach a doctor about the situation.

My take on what qualifies as a mental illness is this: If something is harming you to the extent that it is disrupting your ability to survive in society, it might be in your best interest to classify that thing as an illness and seek medical help.

If, on the other hand, your brain functions in a way that is toward the end of the human bell curve but you're a functional member of society, take pride in your unique situation and learn to deal with the areas where you're rough around the edges. So if you hear Abe Lincoln in your head telling you you're a swell guy every day and it doesn't affect you negatively, who cares?

A couple other things to weight before you decide to classify yourself as having a mental illness:

As some of the other posters have mentioned, there is a stigma associated with mental illness.

I don't know what your health insurance situation is, but if you're self-insured in the US, having this kind of thing on your medical record can cause you significant grief.

I would agree with you for many lighter disorders, but schizophrenia is a pretty serious disorder that's well known to have a tendency to degenerate from "harmless, I-can-live-with-it" to complete disaster if not cared for.

Your advice is akin to telling someone not to see a doctor about the lump on their prostate.

While I believe it's important the 'Ask HN' poster talk to an expert or wise family/friends, I also think the grandparent 'pysch_skeptic' post has a fair perspective.

Definitively treating this as the worst thing it could be -- schizophrenia or some other issue requiring fast medical intervention -- may be unnecessarily alarming and stigmatizing. From the diversity of comments and sources cited in this thread, there are other explanations that require a long-term understanding-and-management approach, that might sometimes lean on medical experts, but don't involve simply "run to the first doctor that will see you; do what that doctor says".

I would say the most important thing no matter what course is taken is to have a local, in-person confidant who can monitor/discuss the situation daily for worsening, and who can know all the other details that can't (and shouldn't!) be shared here -- such as any other drug history (prescribed or otherwise), family history, or work and personal matters that could shed additional light on the situation.

Your point is well made if you believe that a mental illness and its treatment are comparable to a physical illness and its treatment. But I have a lot more faith in the medical establishment's ability to treat prostate cancer than I do in it's ability to treat something like schizophrenia.

Now, you can probably point to various statistics to demonstrate that the mental health community is doing something right, but from my personal experience their approach is completely wrong and I want to offer an alternative viewpoint to what you'll get from the pamphlet in the doctor's office.

Depression very clearly runs in my family. And I've personally had a long history of depression as well, psychotic depression at some points (hearing voices). So, in your view, I'd probably be an excellent candidate for having my condition treated like a physical disease (genetic basis, serious risk profile). And that's what I did after a couple of years. I went to a psychiatrist, took various drugs, and received therapy. And it accomplished nothing positive whatsoever: the drugs made me stupid and slow; when my friends and extended family learned of my 'disease' they began treating me differently (there really is a stigma); and I had real issues getting health insurance further down the line.

But most importantly, the whole message behind my treatment was "you are suffering from a DISEASE - it's like cancer - an occurrence of nature and beyond your control." But, in my view, that's not the solution - the solution is to come to terms with who you are, tell yourself that most things are under your control, and recognize that the failure to deal with your problems are your own fault. The day I started 'getting better' was when I quit the meds cold-turkey, cut off communication with my psychiatrists, and took responsibility for my own behavior and mental state. That was several years ago and my only regret is that I ever medicalized my condition in the first place.

Are the voices you, or not?

This might sound crazy. I used to hear voices as well, and I thought I was losing my mind.

In my experience, the voices were not random chatter. They tell you where your mind is at. Listen to them and get to know yourself. Maybe try talking to them. You may not be "broken", your mind may just work in a slightly different way. Respect it.

In my case the voices were paranoid. As I worked on my self-esteem, they slowly transformed into positive voices, and then disappeared.

See a doctor if you wish, but you might end up on drugs and not learning about yourself.

Read Jungian writers for more on this perspective (Robert A. Johnson "Inner Work: Using Dreams and Active Imagination for Personal Growth" might be very relevant, the voices could be seen as different aspects of you).

Of course I dont know your situation so please take this with salt.

For the record I am against psychiatric drugs, since they appeared to play a big role in my mothers suicide.

Apart from the obvious "seek help" answer, try meditating. Some practice clearing your mind might help.

I agree, but I'd nuance it a bit more.

If, upon seeking help, you find that the voices are just the everyday mental chatter that most of us have. you should give meditation a try, as it can definitely help with that.

Hey, check this book "Power of now", the author explains this issue in detail.

drop drugs

A lot of people hear voices. Most of them are completely healthy. You should stay away from psychiatrists, who will not look out for your best interests but will instead tell you that your mind is broken and you should defer to the ideas in their minds.

Have some self-confidence and self-esteem. Don't turn your life over to people with impressive uniforms and titles.

A lot of people hear voices that shout profanities and chatter constantly to the point of distraction?

No, I don't think so.

Post a message for one of the meditators at Dharma Overground. They might have some insights on what's going on there.

NO!

The last thing he needs is spiritual/religious/new-agey/hippy/pseudo-science bullshit.

Get medication: REAL doctors, trained and licensed.

Indeed ... meditation _has_ been shown to relieve some symptoms of depression, dysthymia, cyclothymia, etc. but those are not the symptoms you are showing here.

I'm glad you've decided to see a doctor.

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