Coping with OCD, Anxiety, and Intrusive Thoughts: A Guide

What should I do about obsessive-compulsive disorder, anxiety, and racing thoughts?

Hello, doctor.
I'm really troubled by my constant overthinking.
For example, when I'm riding my bike on a bike lane and I see another cyclist approaching, I suddenly start to worry about whether I might have collided with that person, even though I have no sensation of impact or sound indicating a collision.
Yet, I can't shake the feeling that I might have hit them.
If I had really collided, I would expect to feel something, but I still find myself overthinking it.
What should I do in this situation? Additionally, I often force myself to apologize to objects I might have bumped into, and I only stop when I feel it's acceptable.
What can I do to address this?

KN, 10~19 year old female. Ask Date: 2016/08/27

Dr. Chen Wenke reply Psychiatry

Hello, based on what you described, if this occurs frequently, it can be quite uncomfortable.
These thoughts may linger in your mind, preventing you from focusing on your daily life, work, studies, and even interpersonal relationships.
Therefore, I suggest that you seek a nearby psychiatric clinic for a more thorough evaluation by a physician to understand your issues better.
Additionally, in such situations, family and friends may not fully comprehend what you're experiencing, and they might tell you not to overthink or suggest simple remedies like praying.
It's important to remind yourself that seeking medical attention is necessary.
At the very least, this will allow the physician to fully understand your problems and provide appropriate treatment options.
I believe you will see significant improvement.
Wishing you peace.

Reply Date: 2016/08/27

More Info

Coping with Obsessive-Compulsive Disorder (OCD), anxiety, and intrusive thoughts can be a challenging journey, but it is important to understand that you are not alone in this experience. Many individuals face similar struggles, and there are effective strategies and treatments available to help manage these symptoms.

Firstly, it is crucial to recognize that the intrusive thoughts you are experiencing, such as the fear of having harmed someone while riding your bike, are characteristic of OCD. These thoughts can be distressing and often lead to compulsive behaviors, such as apologizing repeatedly or seeking reassurance. The cycle of intrusive thoughts followed by compulsive actions can create a significant amount of anxiety and can interfere with daily life.

One of the most effective treatments for OCD is Cognitive Behavioral Therapy (CBT), specifically a subtype known as Exposure and Response Prevention (ERP). This therapy involves gradually exposing yourself to the thoughts or situations that trigger your anxiety while refraining from engaging in the compulsive behaviors. For example, if you have the intrusive thought of having hit someone while biking, ERP would encourage you to confront that thought without apologizing or seeking reassurance. Over time, this can help reduce the anxiety associated with the thought and diminish the compulsion to act on it.

In addition to therapy, medication can also be beneficial for managing OCD and anxiety. Selective Serotonin Reuptake Inhibitors (SSRIs) are commonly prescribed and have been shown to be effective in reducing symptoms. It is important to consult with a healthcare professional to discuss the best treatment options for your specific situation.

Mindfulness and relaxation techniques can also play a significant role in coping with anxiety and intrusive thoughts. Practices such as deep breathing, meditation, and progressive muscle relaxation can help ground you in the present moment and reduce overall anxiety levels. When you find yourself spiraling into intrusive thoughts, taking a moment to focus on your breath or engage in a mindfulness exercise can help create a sense of calm.

Another helpful strategy is to challenge the intrusive thoughts directly. When you have a thought that you may have harmed someone, remind yourself of the evidence that contradicts that thought. For instance, if you did not feel any impact or hear any sound, acknowledge that these are indicators that you did not hit anyone. Keeping a thought record can also be beneficial; write down the intrusive thought, the evidence for and against it, and how you felt. This practice can help you gain perspective and reduce the power of the intrusive thoughts over time.

Support from friends, family, or support groups can also be invaluable. Sharing your experiences with others who understand what you are going through can provide comfort and encouragement. Consider reaching out to a mental health professional who specializes in OCD and anxiety disorders for additional support and guidance.

In summary, coping with OCD, anxiety, and intrusive thoughts involves a combination of therapy, medication, mindfulness practices, and support. It is essential to approach these challenges with patience and compassion for yourself. Recovery is a process, and with the right tools and support, you can learn to manage your symptoms and lead a fulfilling life. If you have not already, consider seeking professional help to explore these options further. Remember, you are not alone, and there is hope for a brighter future.

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