Intrusive Thoughts: Is It OCD or Something Else?

I wonder if it could be obsessive-compulsive disorder (OCD)?

Hello Doctor: I often experience disrespectful thoughts or images related to deities or the deceased (usually involving profanity or sexual content), especially when I am writing or pressing a switch.
I then feel compelled to erase and rewrite or press the switch again to counteract the intrusive thoughts (I know these two actions are unrelated, but I feel that if I don’t repeat them, something bad will happen, which makes me very anxious).

1.
My symptoms include constantly forgetting what I have read and needing to repeatedly confirm it.
I often lock the door and check it multiple times; this can take over ten minutes.
Even after riding my bike one kilometer away from home, I still feel the need to return to check if the door is locked.

2.
When reading text, I cannot immediately confirm it and must repeatedly check the text.
I also have to continuously review and check things every day.
When watching videos, I need to watch them several times to understand the content, and even while typing this message, I keep confirming what I have written.
3.
Additionally, when a teacher verbally explains something without writing it on the board, I forget it immediately after hearing it and cannot recall it later.
I doubt whether I am experiencing memory decline, and I constantly ask myself if I remember, which feels very unnatural.
As my symptoms have worsened, I find it difficult to follow conversations on television and worry about forgetting what others have communicated.
4.
I cannot adapt quickly when doing things; I need to repeatedly confirm things before I feel secure enough to make a decision.
5.
I am unsure what this strange condition is, and I hope the doctor can help me understand it.
Thank you.

Niming, 10~19 year old female. Ask Date: 2018/11/06

Dr. Wu Enliang reply Psychiatry

Hello, it does seem like you might be experiencing obsessive-compulsive disorder.
I recommend seeking treatment at a mental health facility.
Wishing you a speedy recovery.
Wu Enliang

Reply Date: 2018/11/06

More Info

Understanding intrusive thoughts and compulsive behaviors can be complex, and your description suggests that you may be experiencing symptoms consistent with Obsessive-Compulsive Disorder (OCD). OCD is characterized by unwanted, intrusive thoughts (obsessions) that lead to repetitive behaviors or mental acts (compulsions) aimed at reducing the anxiety associated with those thoughts.
1. Intrusive Thoughts: The thoughts you describe, such as disrespectful or inappropriate images or phrases, are common in OCD. These thoughts are not reflective of your true beliefs or desires; rather, they are unwanted and can cause significant distress. The key aspect of OCD is that individuals often recognize that these thoughts are irrational, yet they feel compelled to respond to them in some way.

2. Compulsive Behaviors: Your need to repeatedly check locks, rewrite text, or confirm information is indicative of compulsive behavior. These actions are performed in an attempt to alleviate the anxiety caused by the intrusive thoughts. For example, checking the door multiple times may provide temporary relief, but it often leads to a cycle of doubt and further checking. This behavior can consume a considerable amount of time and interfere with daily functioning.

3. Reassurance Seeking: The need to repeatedly confirm information, whether it's checking if a door is locked or reviewing text, is another hallmark of OCD. This behavior is often driven by a fear of something bad happening if the compulsive action is not performed. It can also manifest as a fear of forgetting important information, leading to excessive reviewing or checking.

4. Memory Concerns: Your worries about memory, especially regarding information presented verbally, can also be linked to OCD. Many individuals with OCD experience heightened anxiety about their memory and often engage in compulsive reviewing or reassurance-seeking to mitigate this anxiety. However, it's important to differentiate between genuine memory issues and the cognitive distortions that can occur with OCD.

5. Decision-Making Difficulties: The struggle to make decisions without first engaging in repetitive checking or reassurance is another common symptom of OCD. This can lead to significant delays and frustration, as you may feel paralyzed by the need to confirm your thoughts or actions.

Given your experiences, it would be beneficial to seek a professional evaluation from a mental health provider who specializes in OCD and anxiety disorders. They can provide a comprehensive assessment and discuss treatment options, which may include cognitive-behavioral therapy (CBT), particularly exposure and response prevention (ERP), and possibly medication if appropriate.

In summary, while your symptoms align with OCD, a thorough evaluation by a qualified professional is essential for an accurate diagnosis and effective treatment plan. Remember, you are not alone in this experience, and help is available to manage and reduce the impact of these intrusive thoughts and compulsive behaviors on your life.

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