Intrusive Thoughts: Coping with Mental Health Challenges

I have persistent absurd thoughts that I can't seem to shake off and cannot control?

Hello Doctor, my husband has been experiencing these issues for a long time, but he only opened up to me about his emotional struggles after we got married.
Recently, he had another episode, which he described as the most severe one yet.
He often hears disturbing thoughts in his mind, such as when driving, he might have a bad thought telling him to crash into the car in front of him; when passing by a funeral home, he gets a thought urging him to do something very disrespectful to the deceased (too explicit to describe here); and when working with others, he has thoughts about harming his colleagues.
In summary, he experiences intrusive thoughts related to violence, harm, and inappropriate sexual content that arise without warning.
He mentioned that when he is feeling well, he quickly reprimands himself and dismisses these strange thoughts.
He has been battling these intrusive thoughts since he was young, but during difficult times, he finds it hard to shake them off and occasionally succumbs to these demons, leading to inappropriate actions that further perpetuate a cycle of negative emotions.
His mind is constantly filled with these bad thoughts and images of wrongdoing, and he has been struggling with this until now, to the point of feeling exhausted and unable to communicate with others, fearing that he might lose his temper and show impatience.
Both my husband and I have stable jobs, but during this recent episode, he left work one day halfway through, unable to continue.
When he got home, he was in distress, had no appetite, and experienced insomnia (which has been a long-standing issue).
He has been in a continuous low mood, barely eating anything other than some vegetables.
He often tells me, "I'm so tired! Really, so tired! Even breathing feels exhausting!" or "If I could find someone to replace me, to be a good son to my parents, to be your husband, and a good father to our two daughters, that would be great.
I feel like I only have responsibilities left." He even shaved his head and engaged in behaviors that are contrary to his usual character, which frightens me.
Currently, he is still able to go to work, but the negative emotions have never ceased, and he is constantly fighting against them, fearing when he might succumb again.
Recently, during our conversations, he has been willing to share more specific details about his intrusive thoughts, and I realized just how distressing they are, as he described them as "absurd." He expressed his pain, questioning how he could have such thoughts.
It was only through our discussions that I learned he has seen therapists several times in the past and was prescribed medications like Prozac, but he never took them.
Besides the side effects mentioned, he felt that every time doctors, counselors, or social workers told him, "You need to change your thoughts! You can exercise more and stop thinking so much," it felt utterly useless to him.
I have encouraged him to take medication, and he has been taking it every night before bed.
I recently searched for information online and would like to ask the doctor if this falls under the category of obsessive-compulsive disorder (OCD) with intrusive thoughts? We have been struggling to identify any specific cause or symptoms.
Can you confirm a diagnosis or suggest any effective treatment methods? Thank you for taking the time to read this, and I look forward to your response.

xiang hui fu zheng chang sheng huo de ren, 30~39 year old female. Ask Date: 2017/07/20

Dr. Lin Niqi reply Psychiatry

Hello, you mentioned that your husband's mental condition has significantly affected his daily life, which necessitates medical treatment.
As for the cause, diagnosis, and treatment methods, these can only be confirmed through a consultation with the patient.
Therefore, please bring your husband to our hospital for a detailed discussion.
Thank you!

Reply Date: 2017/07/20

More Info

It sounds like your husband is experiencing significant distress due to intrusive thoughts, which can be a hallmark of obsessive-compulsive disorder (OCD) or other anxiety-related disorders. Intrusive thoughts are unwanted and often disturbing thoughts that can cause significant anxiety and distress. They can manifest in various forms, including violent or sexual thoughts, and can lead to a cycle of shame and guilt, especially when the individual feels that these thoughts are not reflective of their true self.

From what you've described, your husband has been struggling with these intrusive thoughts for a long time, and it appears that they have intensified recently, leading to emotional exhaustion and a sense of hopelessness. The fact that he has previously sought help but has been hesitant to take medication due to concerns about side effects is not uncommon. Many individuals with OCD or anxiety disorders experience a similar reluctance, often feeling that they should be able to manage their symptoms through willpower alone or through behavioral strategies like exercise or cognitive reframing.

It's important to understand that intrusive thoughts are not a reflection of one's character or desires. Many people with OCD experience thoughts that are completely contrary to their values and beliefs, which can be incredibly distressing. The key to managing these thoughts is recognizing them as symptoms of a disorder rather than as truths about oneself. Cognitive-behavioral therapy (CBT), particularly exposure and response prevention (ERP), is considered one of the most effective treatments for OCD. This therapeutic approach involves gradually exposing individuals to the thoughts or situations that trigger their anxiety while helping them learn to refrain from engaging in compulsive behaviors or mental rituals that they typically use to cope with the distress.

In your husband's case, it may be beneficial for him to revisit a mental health professional who specializes in OCD and anxiety disorders. A therapist can help him understand that these thoughts are not dangerous and can provide him with tools to manage them more effectively. If he is open to it, medication such as selective serotonin reuptake inhibitors (SSRIs) can also be effective in reducing the frequency and intensity of intrusive thoughts.

Encouraging your husband to take the medication as prescribed is a positive step. It may take some time to find the right medication and dosage, and side effects can vary from person to person. Open communication with his prescribing doctor about any side effects he experiences is crucial, as adjustments can often be made to improve tolerability.

Additionally, it might be helpful for both of you to engage in supportive activities together, such as mindfulness practices or relaxation techniques, which can help reduce overall anxiety levels. Mindfulness can teach individuals to observe their thoughts without judgment, allowing them to create distance from the intrusive thoughts and reduce their emotional impact.

In summary, your husband's experiences with intrusive thoughts are likely related to an anxiety disorder, possibly OCD. Seeking specialized treatment that includes both therapy and medication can provide him with the tools he needs to manage his symptoms effectively. It's commendable that you are supportive and encouraging him to seek help, as a strong support system is vital in the recovery process. Remember, recovery is a journey, and with the right resources and support, improvement is possible.

Similar Q&A

Understanding Intrusive Thoughts: Coping Strategies for Mental Clarity

Hello, doctor! Recently, I often find that certain thoughts and images automatically come to my mind. Sometimes, I wake up in the morning and immediately think of them, and throughout the day, no matter what I'm doing, those thoughts linger in my mind. I can't control t...

Dr. Huang Xiaoxian reply Psychiatry
Dear Saku, thank you for your question. You mentioned that you find yourself involuntarily thinking about a certain issue. I believe this matter holds some significance for you. Generally speaking, it is reasonable to repeatedly think about things that are important to us. Howeve...

Coping with Intrusive Thoughts: Understanding and Managing Disturbing Ideas

Hello Dr. Wang: Recently, I have been experiencing disturbing thoughts in my mind, such as thoughts of accidents, harming others, or suicide. I often wish for my enemies and those who bully me to disappear, and I feel that life is meaningless and that I want to die (currently une...

Dr. Wang Yazhen reply Psychiatry
Hello: It sounds like you are very troubled by persistent thoughts in your mind, many of which are accompanied by various emotions, including negative and frightening ones, and even thoughts of harming yourself or others. It is important to determine whether there are any underly...

Understanding Intrusive Thoughts: Seeking Help for Mental Health Concerns

Hello, I have been experiencing frequent thoughts of cursing and harming my family. I have tried many methods to distract myself, but nothing seems to work. I am very afraid that these thoughts might eventually lead to actions. Do I have a mental health issue, and what can I do t...

Dr. Qiu Junda reply Psychiatry
Hello: Due to the limited information provided, it is difficult to assess the situation. However, it is not uncommon for individuals to experience some negative thoughts. If attempts to redirect these thoughts are unsuccessful and they cause physical and mental distress, it would...

Coping with Intrusive Thoughts: Understanding OCD and Its Effects

If a patient suddenly experiences intrusive thoughts, such as saying disrespectful things about deities or the deceased, it's important to understand that these are often symptoms of obsessive-compulsive disorder (OCD). While these thoughts can be distressing, they do not re...

Dr. Cai Qijin reply Psychiatry
Hello: Obsessive thoughts are not easily overcome by willpower. Even though one knows that negative events will not occur due to irrational thinking, it is difficult to stop the intrusive thoughts and worries. If this causes significant distress in daily life, it is advisable to ...