and Managing Anxiety: A Guide for Students Facing OCD Symptoms

Obsessive-Compulsive Disorder (OCD)?

Hello, Doctor: (The content is quite long) I am a second-year high school student, and I have been experiencing symptoms for almost six months that feel like obsessive thoughts, but I'm not sure.
My symptoms are as follows:
PS: I know cheating is wrong, and I no longer do it, but...
I often feel pressured by my classmates.
1.
At school, my classmates expect each other to help cover during quizzes.
In my first year, I didn't feel anything about it, but in my second year, I started to feel anxious and began to reject this behavior.
However, I think, "Okay, helping out shouldn't be a big deal," and if I don't help, my classmates might say something about me or think I'm not fitting in, leading to peer pressure.
After helping, thoughts immediately flood my mind: "What if the teacher saw me changing my answers? What if they collect the papers and notice the changes? What if the teacher saw and is just waiting to talk to me after class?" I get caught up in endless speculation and start simulating various scenarios, analyzing, worrying, and feeling anxious.
I then feel the need to confirm whether my fears are valid because only by confirming can I alleviate my anxiety.
So, I check if the quiz papers are with the teacher, whether the teacher suddenly collected them for registration (usually, it's the student teacher who registers them, and the teacher doesn't collect them).
After confirming, my anxiety subsides, but then various "what if" thoughts arise, and my anxiety symptoms return, even to the point of worrying about the next class just to confirm whether I was discovered, so I can relieve my anxious state.
Because of this, I hate cheating, and whenever someone mentions the words "cheating," I start to feel anxious and worried.

2.
I fear that what I say or do might make my classmates uncomfortable or even feel bullied, and I'm afraid they might take drastic actions because of it.
This leads me to get caught up in various simulations and analyses, causing anxiety that lasts a long time.

3.
When something happens and I need to find out who did it, even though I know I didn't do it and have no relation to the matter, I still think, "Could that person be me? Is someone trying to frame me so that it looks like I did it?" I know I haven't done anything and am not involved, but I keep wondering if that person will eventually be connected to me, leading to an endless cycle of anxiety and an inability to concentrate.

4.
I avoid numbers related to four or that add up to four, such as 04-18, 03-01, etc., because I feel that if I come into contact with anything related to four or sums to four, something bad will happen.

5.
I even felt anxious after accidentally running over a discarded Styrofoam box while riding my bike, fearing I would be accused of hit-and-run.

6.
Lastly, I want to say that this anxiety and irritability have been troubling me for almost six months.
I know that all of the above is unreasonable and unlikely to happen, but my mind keeps fixating on these worries, often imagining the worst-case scenarios.
The more I resist, the more I struggle, and whenever one anxiety episode ends, my mind automatically seeks the next thing to worry about.
Recently, my anxiety has started to affect my studies, making it difficult for me to concentrate on my schoolwork.
Doctor, if I want to choose self-treatment, how should I go about it? Or would you recommend that I seek medical help? I'm worried it will affect my studies as I approach university entrance exams.
If treatment is necessary, how long might it take?

Niming, 10~19 year old female. Ask Date: 2019/06/30

Dr. Huang Xiaoxian reply Psychiatry

Dear Johnny, thank you for your question.
It sounds like these symptoms have been troubling you for a long time.
Often, the origins of obsessive-compulsive symptoms may stem from certain life events, but over time, more and more factors can influence you, leading to feelings of irrationality that are difficult to adjust to.
From a medical perspective, it may start with the psychological impact of a stressful event, but gradually, physiological changes can also occur.
At this point, relying solely on psychological adjustment may not be very effective.
I recommend seeking an evaluation from a psychosomatic specialist to receive appropriate medication and psychological counseling, with the aim of improving and shortening the duration of your condition.
Wishing you all the best!

Reply Date: 2019/06/30

More Info

Hello,
Thank you for sharing your experiences and concerns regarding your anxiety and obsessive-compulsive symptoms. It sounds like you are going through a challenging time, and it's important to address these feelings and behaviors before they further impact your academic performance and overall well-being.

From what you've described, it seems you are experiencing symptoms that align with obsessive-compulsive disorder (OCD) and generalized anxiety disorder (GAD). The intrusive thoughts and compulsive behaviors—such as the need to confirm situations to alleviate anxiety, the fear of being perceived negatively by peers, and the avoidance of certain numbers—are common in OCD. Additionally, the overwhelming anxiety you feel in social situations and the pressure to conform to peer expectations can contribute to a cycle of anxiety that is difficult to break.

Understanding Your Symptoms
1. Intrusive Thoughts: These are unwanted thoughts that cause significant anxiety. In your case, thoughts about cheating, being judged by peers, or causing harm to others are distressing and lead you to engage in compulsive behaviors to alleviate that anxiety.

2. Compulsive Behaviors: Your need to check if the teacher has collected the exam or to confirm that you are not implicated in any wrongdoing are examples of compulsions. These behaviors provide temporary relief but ultimately reinforce the cycle of anxiety.

3. Avoidance and Fear: Your avoidance of certain numbers and situations reflects a common coping mechanism for anxiety, where individuals try to steer clear of triggers. However, this can limit your daily functioning and increase feelings of isolation.

Recommendations for Managing Anxiety and OCD Symptoms
1. Seek Professional Help: While self-help strategies can be beneficial, professional guidance is crucial, especially since your symptoms are affecting your academic performance and daily life. A mental health professional can provide a proper diagnosis and develop a tailored treatment plan. Cognitive-behavioral therapy (CBT), particularly exposure and response prevention (ERP), is effective for OCD.

2. Practice Mindfulness and Relaxation Techniques: Mindfulness meditation, deep breathing exercises, and progressive muscle relaxation can help reduce anxiety levels. These techniques encourage you to focus on the present moment rather than getting caught up in anxious thoughts.

3. Challenge Negative Thoughts: Work on identifying and challenging irrational thoughts. Keeping a journal can help you track your thoughts and feelings, allowing you to recognize patterns and develop healthier thinking habits.

4. Gradual Exposure: If certain situations trigger your anxiety, gradually exposing yourself to these situations can help desensitize you over time. Start with less anxiety-provoking scenarios and work your way up.

5. Build a Support System: Talk to trusted friends or family members about your feelings. Having a support system can provide comfort and reduce feelings of isolation.

6. Limit Information Seeking: While it’s natural to want to seek reassurance, try to limit the amount of time you spend checking or researching your fears. Set boundaries for yourself to reduce compulsive behaviors.

Conclusion
It's understandable to feel apprehensive about seeking help, especially with the pressures of upcoming exams. However, addressing these symptoms early on can prevent them from worsening and impacting your future. Treatment duration can vary, but many individuals see improvement within a few months of consistent therapy. Remember, you are not alone in this, and there are effective treatments available that can help you regain control over your thoughts and feelings.

I encourage you to reach out to a mental health professional who can guide you through this process. Your mental health is just as important as your academic success, and taking this step can lead to a healthier, more balanced life.

Best wishes on your journey to recovery.

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