Uncontrollable Worry: Insights into Anxiety and OCD

Uncontrollable worry, with increasingly bizarre content?

Everything started at the end of April when I was waiting for the results of the admissions process at National Taiwan University.
During that time, I felt very anxious, and I began to experience unexplained pain in specific areas of my body.
Even after I received confirmation of my acceptance, my condition did not improve, and I became increasingly anxious.
When I visited a doctor, I was prescribed only pain relievers and muscle relaxants.
Eventually, I started experiencing obsessive thoughts (fearing that I might lose control), along with sleep disturbances and early awakening.
After consulting a psychiatrist, I was diagnosed with obsessive-compulsive disorder (OCD) and generalized anxiety disorder (GAD), and I was prescribed Fluvoxamine to take at bedtime.

After six weeks, I began to feel moments of "calm" and "relaxation," although they were intermittent.
Recently, I have developed a fixed pattern: severe anxiety and low mood with hypersomnia in the morning, reduced anxiety and a more stable mood in the afternoon, and a sense of lightness and cheerfulness in the evening.
Initially, my anxiety was centered around health concerns, but it gradually shifted to anxiety caused by OCD.
The focus of my anxiety has continuously changed, and recently it has taken on a form resembling paranoid ideation.
I find myself avoiding actions that might upset others for fear of retaliation, and I refrain from drinking water out of sight.
I often worry that my behavior might displease others and lead to retaliation.
I am aware that these thoughts are completely unnecessary, but I cannot control them.
I would like to ask if this constitutes a mental illness.
Does the fixed daily pattern indicate that there are aspects of my lifestyle that need to change? (I usually go to bed at 11 PM and wake up at 7 AM.) Since my next follow-up appointment is still quite far away, I feel somewhat uneasy about the changes in my anxiety, which is why I submitted this consultation form.
Thank you for your patience, doctor.

Niming, 10~19 year old female. Ask Date: 2017/07/25

Dr. Zhang Fangrong reply Psychiatry

Dear Sir/Madam,
You mentioned experiencing uncontrollable worries, and that your symptoms have been fluctuating recently.
Initially, your discomfort was related to waiting for the results of the National Taiwan University admission process, but now you have received good news.
It is important to give yourself affirmation and blessings.
If your symptoms are currently unstable and you have concerns, I would recommend scheduling an earlier follow-up appointment with your primary physician to discuss the changes in your condition and whether an adjustment in medication is necessary.
Additionally, I suggest asking your doctor to arrange for a professional assessment by a psychologist to better understand your mental state.
Your sleep schedule is regular, so please maintain that.
Regular exercise habits can also be beneficial for you.
Wishing you good mental and physical health.
Sincerely,
Dr.
Fang-Rong Chang
General Psychiatry
Chianan Psychiatric Hospital

Reply Date: 2017/07/25

More Info

Your situation reflects a complex interplay of anxiety and obsessive-compulsive disorder (OCD) symptoms, which can be incredibly challenging to navigate. It's commendable that you've sought help from a mental health professional and have been prescribed medication, specifically Fluvoxamine, which is often used to treat both OCD and generalized anxiety disorder (GAD).
From your description, it seems that your anxiety began in response to a specific stressor—waiting for the results of your application to a prestigious university. This kind of anticipatory anxiety is common and can manifest physically, as you've experienced with unexplained pain. However, it appears that once you received the acceptance, instead of relief, your anxiety intensified and morphed into obsessive thoughts and compulsive behaviors.

The cycle of anxiety and OCD can often lead to a pattern where the individual feels trapped in their thoughts. For instance, your worries about causing displeasure to others and fearing retaliation are indicative of intrusive thoughts that many with OCD experience. These thoughts can feel very real and distressing, leading to compulsive behaviors aimed at reducing the anxiety they provoke. It's crucial to understand that these thoughts do not reflect your true intentions or character; they are symptoms of the disorder.

Your experience of fluctuating anxiety levels throughout the day—high in the morning, easing in the afternoon, and feeling more relaxed in the evening—suggests a possible link between your daily routine and your mental health. Sleep patterns can significantly affect mood and anxiety levels. If you're experiencing disrupted sleep or excessive daytime sleepiness, it may be beneficial to evaluate your sleep hygiene. Consistent sleep schedules, creating a calming bedtime routine, and ensuring your sleep environment is conducive to rest can help improve your overall well-being.

Regarding your concern about whether this constitutes a "mental illness," it’s important to recognize that anxiety disorders, including OCD, are classified as mental health conditions. They are not a reflection of personal weakness or failure but rather medical conditions that can be treated effectively with a combination of therapy and medication.
Cognitive-behavioral therapy (CBT), particularly exposure and response prevention (ERP), is highly effective for OCD. This therapeutic approach involves gradually exposing you to the sources of your anxiety while helping you refrain from engaging in compulsive behaviors. It might be worth discussing this option with your healthcare provider, especially if you feel that your current treatment plan isn't fully addressing your symptoms.

In the meantime, consider implementing some self-care strategies. Regular physical activity, mindfulness practices, and journaling can help manage anxiety levels. Engaging in hobbies or activities that bring you joy can also provide a much-needed distraction from intrusive thoughts.

Lastly, if you find that your anxiety is becoming overwhelming before your next appointment, don't hesitate to reach out to your healthcare provider for support. They may be able to adjust your treatment plan or provide additional resources to help you cope in the interim.

Remember, you are not alone in this journey, and with the right support and strategies, it is possible to manage your symptoms effectively.

Similar Q&A

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 ...

Understanding OCD: Coping with Anxiety and Intrusive Thoughts

Hello, Doctor. I have anxiety disorder and panic disorder, and I often worry about various things without any specific reason. Once I finish worrying about one thing, I move on to the next. Recently, I don't know if it's because my menstrual period is approaching, but I...

Dr. Cai Yunlin reply Psychiatry
Hello, the repetitive thoughts you mentioned may be related to obsessive thinking and might require further evaluation. However, these psychosomatic symptoms seem to be significantly affecting your well-being. I recommend that you seek prompt consultation with a psychosomatic med...

Managing Anxiety in OCD: Effective Self-Talk Strategies Beyond Medication

I have been diagnosed by a physician with obsessive-compulsive disorder (OCD), characterized by fears of losing control and harming myself or others. As a result, I feel anxious when I am in high places and when I am alone with young children, fearing that I might lose control an...

Dr. Wu Enliang reply Psychiatry
Hello, online user: Regarding non-pharmacological treatments for obsessive-compulsive disorder (OCD), it is generally recommended to engage in behavioral therapies similar to what you mentioned. For detailed discussions, it is advisable to address these during psychological thera...

Coping with Unexplained Anxiety and Panic Attacks: Expert Advice Needed

Hello Dr. Huang, I hesitated for a long time before deciding to ask for your advice. Since around the end of October last year, after securing a stable job, I began to exhibit tendencies of health anxiety. Whenever I experience any physical discomfort (mainly related to my eyes)...

Dr. Huang Xiaoxian reply Psychiatry
Dear HYAX, Thank you for your question. From your description, it seems that you originally had a bit of a perfectionist personality and experienced job-seeking pressure before October. However, after securing a job, instead of feeling relieved, you began to worry about your he...