Anxiety from Intrusive Thoughts: A Mental Health Perspective

Anxiety generated by obsessive thinking?

Hello, doctor.
I apologize for the length of the following message, and I appreciate your patience in reading it.
As the title suggests, I have been struggling with anxiety caused by obsessive thoughts.
I first experienced these symptoms in fifth grade, but at that time, I could easily alleviate my anxiety by browsing the internet.
My condition remained stable for a while, and although I occasionally had obsessive thoughts, I was able to resolve them quickly.
However, I have recently noticed that I am losing control over my obsessive-compulsive disorder (OCD).
I become very concerned about whether my words and actions might affect others.
For example, if someone tries to sell me a product and I refuse, I worry about how it might impact their mood, or if I say something that could be interpreted as speaking ill of someone, I become extremely anxious.

What I fear the most are my following behaviors: every time I see someone, whether I know them or not, I find myself thinking of curse words related to death.
However, these thoughts are not what I truly want to express; I actually like them and hope nothing bad happens to them.
After having these thoughts, I constantly argue with myself, and even though I know that these are just thoughts and cannot cause events to happen, I still fear that my thoughts could somehow bring harm to them.
It feels as if "anything that happens in the world that I have thought about is my fault," which is very uncomfortable and anxiety-inducing.
Recently, I learned that an old classmate of mine has developed depression.
I genuinely hope he gets better soon, but my mind keeps bringing up thoughts related to death or that he might not recover.
He is a very good friend, and I sincerely wish for his happiness.
After seeing his updates, I realized that he is experiencing a depressive episode, and I am terrified that my thoughts might have affected him.
Just a few days ago, he seemed fine, and now I am feeling this anxiety because of what has happened.
I tried to distract myself by watching videos, but in an instant, I thought of something negative.
Coincidentally, just a few seconds into the video, the phrase "emotional illness" appeared, which felt too coincidental and made me wonder if my sudden negative thoughts are a sign.
I know I am not a witch or someone with supernatural abilities, but it still feels frightening.
Although this is the first coincidence, I can't shake off the anxiety and fear that I might be the cause of harm to those I have previously thought about.

12345, 10~19 year old female. Ask Date: 2021/01/19

Dr. Lin Mianzhang reply Psychiatry

Hi there! Indeed, obsessive thoughts can be quite bothersome, and it's clear that you're feeling distressed and trying hard to suppress them.
However, attempting to suppress such thoughts often leads to the opposite effect.
The more you focus on them, the greater their impact on you.
A more suitable approach is to allow those thoughts to arise when they do, without directing your attention to them or deliberately trying to suppress them.
Let the thoughts drift by like clouds in the sky; once they pass, the sky remains blue.
Here, the sky represents our mind, and the clouds represent thoughts.
When thoughts arise, let them come without focusing on them or judging them (for example, thinking that such thoughts are terrible).
Gradually, the thoughts will fade away, just as clouds slowly drift away.
This is essentially a practice of mindfulness.
If this practice does not lead to significant improvement, you may need to consider medication for assistance.
I recommend that you consult a psychiatrist to discuss treatment options, which can help you overcome the distress of obsessive thoughts more quickly.
Wishing you a speedy recovery!

Reply Date: 2021/01/19

More Info

Your concerns about intrusive thoughts and anxiety are valid and deserve careful consideration. It’s commendable that you are seeking to understand your mental health better. Intrusive thoughts, particularly those associated with anxiety and obsessive-compulsive disorder (OCD), can be distressing and often lead to a cycle of worry and fear.
From what you've described, it seems you are experiencing a heightened sensitivity to your thoughts and their potential consequences. This is not uncommon among individuals with anxiety disorders. The thoughts you have—such as fearing that your negative thoughts might somehow influence the well-being of others—can create a significant amount of distress. It’s important to recognize that having these thoughts does not mean you will cause harm or that they reflect your true desires or intentions.

Intrusive thoughts are often unwanted and can be disturbing. They can manifest as fears of harming others, fears of being judged, or even thoughts about death or disaster. These thoughts can lead to compulsive behaviors, such as seeking reassurance or avoiding situations that trigger these thoughts. The key here is to understand that these thoughts are a symptom of anxiety and do not define who you are or your intentions.

Cognitive-behavioral therapy (CBT) is one of the most effective treatments for managing intrusive thoughts and anxiety. CBT helps individuals identify and challenge distorted thinking patterns and develop healthier coping mechanisms. Here are some strategies that may help you manage your anxiety related to intrusive thoughts:
1. Mindfulness and Acceptance: Practicing mindfulness can help you observe your thoughts without judgment. Instead of trying to suppress or control your intrusive thoughts, acknowledge them as just thoughts—temporary and not necessarily reflective of reality. Techniques such as meditation or deep breathing can help ground you in the present moment.

2. Cognitive Restructuring: Work on identifying the cognitive distortions in your thinking. For instance, the belief that your thoughts can cause harm to others is a form of magical thinking. By challenging these thoughts and replacing them with more rational ones, you can reduce their power over you.

3. Exposure Therapy: Gradually exposing yourself to the situations that trigger your anxiety can help desensitize you to the fear. This should be done in a controlled and supportive environment, ideally with the guidance of a mental health professional.

4. Journaling: Writing down your thoughts can help you externalize them and reduce their intensity. It can also provide insight into patterns in your thinking that you may want to address.

5. Professional Help: If you haven’t already, consider seeking help from a mental health professional. They can provide you with tailored strategies and support. Medication may also be an option if your symptoms are significantly impacting your daily life.

6. Limit Information Consumption: Since you mentioned that certain media can trigger your anxiety, it might be helpful to limit your exposure to distressing content, especially if it relates to mental health issues that resonate with your fears.

7. Support System: Engage with friends or family who can provide support. Sharing your feelings with trusted individuals can help alleviate some of the burdens of anxiety.

It’s essential to remember that you are not alone in this experience. Many people struggle with intrusive thoughts and anxiety, and there is help available. Your thoughts do not have the power to dictate reality, and with the right tools and support, you can learn to manage them effectively.

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