Overcoming Anxiety and Intrusive Thoughts: A Student's Guide

I feel like I have anxiety and obsessive thinking?

Hello, doctor.
I read your responses to others and felt a strong connection.
I am currently a sophomore in college.
My issue is that during my senior year of high school, when I was under a lot of pressure, I experienced a state where I would have strange thoughts.
For example, I would think that if someone next to me was shaking their leg during an exam, it would affect me.
Consequently, I would unconsciously observe whether the person next to me was shaking their leg during the exam, and I would indeed be influenced by it.
These types of thoughts would continuously arise during the exam, and naturally, every time I thought about it, I would feel extremely anxious.
This is just one aspect; it started with the initial fearful thoughts, and then I began to worry that if I kept having these nonsensical thoughts, it would never end.
As expected, every time I thought of such ideas (thoughts that could affect my exam performance), they would influence me to some extent.
I know that this behavior is not right, but I still get disturbed by it.
Therefore, I am particularly cautious about thinking of such ideas, especially during exams or while studying.
Whenever I have any thoughts that I fear might lead to a negative outcome, I try to force myself to stop thinking about them.
However, it seems that I am particularly prone to these thoughts during exams or studying.
I keep telling myself not to think about them, but then I wonder if I will be unable to do so, and I end up spiraling into endless thoughts.
What should I do? The most frustrating part is that I know this is not right, yet I continue to fall into this vicious cycle.
It’s so distressing, painful, and exhausting.
What should I do?

Anna, 20~29 year old female. Ask Date: 2016/04/29

Dr. Ding Shuyan reply Psychiatry

Hello, the nature of our mind is that it constantly generates thoughts, and because these thoughts are related to topics that concern us, we habitually pay attention to them.
For example, studying for exams, interpersonal relationships, our health and appearance, or even what delicious food to eat tonight, one thought after another.
When these scattered thoughts carry a sense of threat or anxiety, such as dangerous people or situations, the coping mechanism inherited from our ancestors is to continuously pay attention to these thoughts until we feel the threat is removed.
In ancient times, our ancestors lived in the wild, surrounded by tigers and venomous snakes, which kept them alert, and ultimately, their caution allowed them to survive.
Thus, this became part of our genetic inheritance.
However, when this sense of threat comes from within and some thoughts become more fixed topics, it essentially represents a danger that does not actually exist.
This constant vigilance, such as obsessive thinking, leads to endless worries, day and night.
While tigers and snakes may leave, the vigilance can be lifted; obsessive thoughts, however, linger, causing us to worry continuously.
The power of the mind is strong; when we believe something will happen, it often does, whether positive or negative.
Negative worries continuously fuel the likelihood of those worries manifesting, leading to a vicious cycle.
When obsessive thinking becomes entrenched, its power can be so great that we cannot rationally think our way out of it.
We find that shifting our attention and reducing the time spent fixating on these obsessive thoughts can stop supplying fuel to this "demon's furnace," allowing it to gradually shrink and weaken.
When we notice it becoming less bothersome and frightening, positive thinking can more effectively replace it.
Those who struggle with obsessive thoughts often force themselves to confront these ideas, fearing that if they do not pay attention, something unfortunate will happen.
In reality, forcing oneself to pay attention is completely futile.
Clinically, how do those with obsessive-compulsive disorder improve? It is not about coming to a realization; rather, it is about feeling that there is no need to think about it anymore, allowing life to return to normal.
Therefore, we must bravely tell ourselves to temporarily stop worrying about this issue, even if just for one second.
One second of not thinking about it won’t hurt, right? Focus on your breathing and the sensations in your body at this moment.
Soon, we may start worrying again, and that’s okay; just notice it and then redirect your attention back to your breath for a few more seconds.
The more we practice this daily, the more space our mind will have to breathe, and the smaller and weaker obsessive thoughts will become.
This requires time and consistent practice; the more familiar we become with it, the better the results.
You can give it a try.
Wishing you all the best, Dr.
Ding Shuo-Yan.

Reply Date: 2016/04/29

More Info

It sounds like you are experiencing a significant amount of anxiety and intrusive thoughts, particularly in high-pressure situations like exams. This is a common issue among students, especially during critical academic periods. Your situation is not uncommon, and many students face similar challenges. Understanding the nature of your thoughts and learning how to manage them can be crucial in overcoming these feelings.

First, it's important to recognize that intrusive thoughts are a normal part of human cognition. They can be distressing, especially when they occur in situations where you feel vulnerable, such as during exams. These thoughts can create a cycle of anxiety, where the more you try to suppress them, the more they seem to intrude. This is often referred to as the "white bear phenomenon," where trying not to think about something makes you think about it even more.

One effective strategy to manage anxiety and intrusive thoughts is cognitive-behavioral therapy (CBT). CBT focuses on identifying and challenging negative thought patterns and replacing them with more constructive ones. Here are some steps you can take to help manage your anxiety:
1. Acknowledge Your Thoughts: Instead of trying to suppress your intrusive thoughts, acknowledge them. Recognize that these thoughts are just that—thoughts. They do not define you or your abilities. By acknowledging them, you can reduce their power over you.

2. Practice Mindfulness: Mindfulness techniques can help you stay grounded in the present moment. This can include deep breathing exercises, meditation, or simply focusing on your surroundings. Mindfulness can help you observe your thoughts without judgment and reduce the anxiety associated with them.

3. Reframe Your Thoughts: When you notice an intrusive thought, try to reframe it. For example, instead of thinking, "If I see someone shaking their leg, I will fail," you might reframe it to, "I can focus on my own performance regardless of what others are doing." This shift in perspective can help reduce anxiety.

4. Set Realistic Goals: Break your study sessions into manageable chunks. Instead of focusing on the entire exam, concentrate on one section or topic at a time. This can help reduce the overwhelming feeling that often accompanies anxiety.

5. Seek Support: Don’t hesitate to reach out to friends, family, or a mental health professional. Talking about your feelings can provide relief and help you gain perspective. Many universities offer counseling services that can provide support tailored to students.

6. Limit Caffeine and Sugar: Both caffeine and sugar can exacerbate anxiety symptoms. Try to limit your intake, especially before exams or study sessions.

7. Establish a Routine: Having a consistent study routine can help create a sense of normalcy and control. This can include regular breaks, exercise, and relaxation techniques.

8. Consider Professional Help: If your anxiety continues to interfere with your daily life, it may be beneficial to seek help from a mental health professional. They can provide you with coping strategies and, if necessary, discuss medication options.

Remember, overcoming anxiety and intrusive thoughts is a process that takes time and practice. Be patient with yourself and recognize that it’s okay to seek help. You are not alone in this struggle, and with the right tools and support, you can learn to manage your anxiety effectively.

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