Anxiety: Are My Thoughts Signs of Delusion or OCD?

I have a medical condition?

Hello, doctor.
I have been struggling with anxiety for a long time, and recently I've been experiencing some strange thoughts that I would like to ask about.
For example, sometimes when I see others talking, I have a fleeting thought that they might be saying bad things about me.
Additionally, when I see the color red, I think about the end of the world, and I sometimes wonder if I am possessed.
I also feel anxious at work, fearing that others might want to harm me.
However, I am fully aware that these thoughts are not true, and my rational mind tries to convince me that they are incorrect.
It doesn't feel like delusions, but I find that these thoughts have developed because I have read a lot about the symptoms of delusional disorder and schizophrenia online.
After reading, it seems like these ideas have stuck in my mind and have become instinctive reactions.
For instance, when I see a red car, the thought of the end of the world flashes in my mind.
I even fear that one day I might experience auditory or visual hallucinations, which makes me worry that I could develop schizophrenia.
This is my greatest fear.
I have seen several doctors, and each one has told me that I do not have delusions or schizophrenia, but I still feel uneasy.
So, I would like to ask you, doctor, are these strange thoughts indicative of a delusional disorder, or could it be obsessive thinking? I am very concerned that one day I might end up on the path to schizophrenia, and I don't want that...

A-Ming, 20~29 year old female. Ask Date: 2016/04/30

Dr. Wu Enliang reply Psychiatry

It sounds like these thoughts are not external but rather ones you have come up with yourself, thoughts that you don't want to think about but feel compelled to.
This is very similar to obsessive thinking, which is a common symptom in individuals with anxiety disorders, and is not indicative of schizophrenia or delusional disorder.
It is advisable to discuss with your treating physician whether further pharmacological treatment or psychotherapy is necessary for your anxiety disorder.

Reply Date: 2016/04/30

More Info

It sounds like you are experiencing a significant amount of anxiety and intrusive thoughts, which can be quite distressing. Based on your description, it seems that you are grappling with obsessive thoughts rather than delusions or a psychotic disorder. Let's break this down further.

Understanding Your Thoughts:
1. Intrusive Thoughts vs. Delusions:
- Intrusive thoughts are unwanted thoughts that can cause anxiety and distress. They often manifest as worries or fears about various situations, such as fearing that others are speaking ill of you or that you might be possessed. These thoughts are typically recognized by the individual as irrational or exaggerated, which aligns with your experience of knowing that these thoughts are not true.

- Delusions, on the other hand, are fixed beliefs that are not based in reality and are resistant to reason or contrary evidence. Since you mentioned that you can rationalize and understand that these thoughts are not true, it suggests that you are not experiencing delusions.

2. Obsessive-Compulsive Disorder (OCD):
- Your experience of having persistent, unwanted thoughts that cause anxiety could be indicative of OCD. In OCD, individuals often have obsessions (intrusive thoughts) and compulsions (repetitive behaviors or mental acts performed to reduce anxiety). While you did not mention compulsions, the nature of your thoughts suggests a pattern of obsessive thinking.

3. Anxiety Disorders:
- It is also important to recognize that anxiety disorders can manifest in various ways, including generalized anxiety disorder (GAD), social anxiety disorder, and panic disorder. Your fears about others' perceptions and catastrophic thoughts (like the world ending) can be symptoms of generalized anxiety.

Coping Strategies:
1. Cognitive Behavioral Therapy (CBT):
- Engaging in CBT can be highly beneficial. This form of therapy helps individuals identify and challenge irrational thoughts and beliefs, replacing them with more balanced and rational thoughts. A therapist can guide you through this process and help you develop coping strategies.

2. Mindfulness and Relaxation Techniques:
- Practicing mindfulness can help you become more aware of your thoughts without judgment. Techniques such as deep breathing, meditation, or yoga can also reduce anxiety and help you manage intrusive thoughts.

3. Medication:
- If your symptoms are significantly impacting your daily life, discussing medication options with a psychiatrist may be worthwhile. Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for OCD and anxiety disorders and can help alleviate symptoms.

4. Limit Exposure to Triggers:
- Since you mentioned that reading about delusions and psychotic disorders has heightened your anxiety, it may be helpful to limit your exposure to such content. This can help reduce the reinforcement of anxious thoughts.

5. Support System:
- Sharing your feelings with trusted friends or family members can provide emotional support. Sometimes, just talking about your fears can help alleviate some of the burden.

Conclusion:
In summary, while your thoughts may feel overwhelming and concerning, they do not appear to indicate a psychotic disorder. Instead, they align more closely with anxiety and possibly OCD. Seeking professional help, particularly through therapy, can provide you with the tools to manage these thoughts effectively. Remember, you are not alone in this, and there are effective treatments available to help you regain control over your thoughts and reduce your anxiety.

Similar Q&A

Delusions or Obsessive Thoughts? Understanding Anxiety Symptoms

Hello, doctor. I have anxiety disorder, and I often worry that I might develop schizophrenia, and this worry is uncontrollable. I have been constantly searching online for symptoms of mental illness, which has led me to frequently think about whether others might harm me, whether...

Dr. Liang Sunyuan reply Psychiatry
Hello: The symptoms of anxiety disorder include endless worrying, which may also involve concerns about having other more serious illnesses. If you can still recognize that the thoughts of being harmed are unreasonable, it likely has not reached the level of delusion. However, pr...

Understanding Anxiety from Intrusive Thoughts: A Mental Health Perspective

Hello, doctor. I apologize for the length of the following message, and I appreciate your patience in reading it. As the title suggests, I have been struggling with anxiety caused by obsessive thoughts. I first experienced these symptoms in fifth grade, but at that time, I could ...

Dr. Lin Mianzhang reply Psychiatry
Hi there! Indeed, obsessive thoughts can be quite bothersome, and it's clear that you're feeling distressed and trying hard to suppress them. However, attempting to suppress such thoughts often leads to the opposite effect. The more you focus on them, the greater their ...

Understanding Intrusive Thoughts: OCD vs. Delusional Disorder

Hello, Doctor. I am a patient diagnosed with obsessive-compulsive disorder (OCD) and have been suffering from it for ten years (I have previously consulted you online). Currently, my symptoms mainly manifest as obsessive thoughts, with very few compulsive behaviors. Here’s what...

Dr. Lin Mianzhang reply Psychiatry
Hello Ayue: Your thoughts are symptoms of obsessive-compulsive disorder, not delusional disorder. When such thoughts arise, you can try to redirect your attention and avoid dwelling on them, as continuing to think about them will only lead to increased discomfort and anxiety. How...

Understanding OCD and Anxiety: Coping with Intrusive Thoughts

Hello, doctor. I used to be a very optimistic person, able to forget things by the next day. However, ever since an incident where someone honked at me unexpectedly on the road, I started to overthink. I began to worry if I had been involved in a serious accident that caused me i...

Dr. Lin Mianzhang reply Psychiatry
Hello Ah-Ming: It seems that your situation began after being startled by someone honking their horn, which may be related to significant psychological stress following the incident. Engaging in psychotherapy to understand the sources of your stress, or utilizing mindfulness and ...