Anxiety and OCD: Coping with Persistent Worries

Q: Anxiety and OCD: Coping with Persistent Worries

Hello, netizen： <br>1. <br>Is my condition obsessive-compulsive disorder, anxiety disorder, and hypochondriasis? I am worried about diseases that currently have no medical cure, and I can't relax every day. <br><br>A： It is indeed possible that you have the aforementioned conditi

Suspected anxiety and obsessive-compulsive disorder (OCD)?

Hello, doctor.
I have noticed the following issues that have persisted for several years (5-6 years).
I thought they would resolve on their own, but they have not improved and seem to have worsened.
I feel tense every day and cannot relax.
My symptoms include fatigue (but I do not have insomnia; I just wake up feeling tired), chest tightness, occasional heart discomfort, and gastrointestinal issues (I have undergone examinations, but doctors have said there are only minor problems with no significant abnormalities).
Here are my circumstances:
1.
When riding my motorcycle, I am very afraid of hitting someone.
Sometimes I ride back and forth on the same road multiple times to check if I have hit anyone, which is a waste of time.
2.
When I am out riding, I am very afraid that someone will attack me.
Sometimes I experience sudden prickling sensations on my skin, leading me to suspect that someone might be trying to stab me with a needle, and I worry about contracting HIV or something similar.
Therefore, whether walking or riding, I am always tense and have to be aware of my surroundings, which is exhausting.
3.
I work in a suburban area, and when I go out, I constantly pay attention to whether wild animals are approaching me.
I worry about being bitten and contracting rabies, which leads me to check for any wounds on my body.
If I find any, I become extremely anxious, even though there usually aren't any.
The sudden prickling sensations also make me paranoid.
I am always on edge at work, unable to relax or concentrate, which is very tiring.
4.
Since the outbreak of the pandemic, I have been very worried about getting sick.
I tend to magnify my physical symptoms and constantly compare them with information I find.
I suddenly become particularly aware of whether people around me are wearing masks and if they are wearing them properly...
I feel anxious every day.
5.
I continuously check to ensure that the gas, windows, and doors are securely closed.
Therefore, I would like to ask the doctor:
1.
Is my condition indicative of obsessive-compulsive disorder, anxiety disorder, and hypochondria? I am constantly worried about illnesses that currently have no medical cure, and I cannot relax each day.
2.
Are some of my physical discomforts, such as sudden prickling sensations and chest tightness, caused by anxiety and obsessive-compulsive behavior leading to autonomic nervous system dysregulation?
3.
I have been considering visiting a mental health specialist, but I have heard that anti-anxiety medications need to be taken long-term and may lead to dependency.
My family also expresses concerns, which makes me hesitant to go.
Additionally, due to the pandemic, I am reluctant to go out.
Previously, when I visited a nearby clinic for my physical discomfort, the doctor felt that I was too anxious and prescribed a low dose of fluoxetine.
She said it would not lead to dependency, and I found that taking it made me feel much more relaxed.
4.
Will I not get better without medication? Is there a chance of recovery with medication?
5.
I have experienced panic attacks twice in the past, but it has been a long time since the last one, which was about 4-5 years ago.
I hope the doctor can kindly answer my questions.
I am truly worried and anxious every day, especially due to the sudden prickling sensations, which intensify my anxiety.
Thank you, doctor.

Wei Ge, 20~29 year old female. Ask Date: 2021/06/17

Dr. Wu Enliang reply Psychiatry

Hello, netizen:
1.
Is my condition obsessive-compulsive disorder, anxiety disorder, and hypochondriasis? I am worried about diseases that currently have no medical cure, and I can't relax every day.

A: It is indeed possible that you have the aforementioned conditions.
These disorders can be treated with medication.
2.
Are some physical discomforts, such as sudden tingling sensations and chest tightness, caused by anxiety and obsessive-compulsive disorder leading to autonomic nervous system dysregulation?
A: Yes, when you are very anxious, your body can become very sensitive.
3.
I have been wanting to see a psychiatrist, but I heard that anti-anxiety medications need to be taken long-term and may lead to dependence.
My family also says this, so I am hesitant to go.
Now, with the pandemic, I am also reluctant to go out.
Previously, I visited a nearby clinic due to physical discomfort, and the doctor thought I was too anxious and prescribed a dose of fluoxetine.
She said it wouldn’t lead to dependence, and I found that it really made me feel much more relaxed.

A: Long-term use of sedatives like fluoxetine can indeed lead to dependence, so they are used for emergencies or occasionally.
However, the mainstay medications are antidepressants, which help replenish the brain's stress-coping chemicals and do not have dependence issues.
4.
If I don’t take medication, will I not get better? Is there a chance of recovery with medication?
A: Non-pharmacological methods such as psychotherapy should also be considered.
There is a chance of recovery with medication.
5.
I have had two panic attacks in the past, but it has been a long time since the last one, which was about 4-5 years ago.

A: Panic attacks are also a manifestation of extreme anxiety.

Dr.
Wu Enliang

Reply Date: 2021/06/17

More Info

It sounds like you are experiencing significant anxiety and possibly symptoms of obsessive-compulsive disorder (OCD) and health anxiety (hypochondria). Your concerns about safety, health, and the need to check and recheck things are common in individuals dealing with these conditions. Let's break down your questions and concerns.

1. Diagnosis: Based on your description, it seems you might be dealing with a combination of generalized anxiety disorder (GAD), OCD, and health anxiety. GAD is characterized by excessive worry about various aspects of life, while OCD involves intrusive thoughts (obsessions) and repetitive behaviors (compulsions) aimed at reducing anxiety. Health anxiety, on the other hand, is when a person is excessively worried about having a serious illness, often misinterpreting normal bodily sensations as signs of disease. Your symptoms, such as the fear of accidents while riding your motorcycle, the constant checking for safety, and the heightened awareness of your health, align with these conditions.

2. Physical Symptoms: The physical symptoms you are experiencing, such as chest tightness and sudden skin sensations, can indeed be related to anxiety and stress. Anxiety can lead to a heightened state of arousal in the body, which can cause various physical sensations, including muscle tension, increased heart rate, and gastrointestinal discomfort. These symptoms can be exacerbated by the body's fight-or-flight response, which is activated during periods of intense anxiety.

3. Seeking Help: It's understandable to feel apprehensive about seeking help, especially with concerns about medication dependency. However, it's important to note that not all anxiety medications lead to addiction, and many people find relief through a combination of therapy and medication. The medication you mentioned, Fluoxetine (an SSRI), is commonly prescribed for anxiety and depression and is generally considered safe for long-term use under a doctor's supervision. It can help regulate mood and reduce anxiety symptoms, making it easier for you to engage in therapy and other coping strategies.

4. Medication vs. Therapy: While medication can be effective in managing symptoms, therapy—especially cognitive-behavioral therapy (CBT)—is crucial for addressing the underlying thought patterns and behaviors associated with anxiety and OCD. CBT helps individuals identify and challenge irrational thoughts and develop healthier coping mechanisms. Many people find that a combination of medication and therapy provides the best results.

5. Coping Strategies: In addition to seeking professional help, there are several self-care strategies you can implement to help manage your anxiety. These include:
- Mindfulness and Relaxation Techniques: Practices such as deep breathing, meditation, and progressive muscle relaxation can help reduce anxiety and promote a sense of calm.

- Physical Activity: Regular exercise is known to reduce anxiety and improve mood. Aim for at least 30 minutes of moderate exercise most days of the week.

- Limit Information Overload: Given your concerns about health, it may be beneficial to limit your exposure to health-related information online, as this can exacerbate anxiety.

- Establish a Routine: Creating a daily routine can provide structure and predictability, which can be comforting when you're feeling anxious.

- Connect with Others: Sharing your feelings with trusted friends or family members can help alleviate feelings of isolation and provide support.

In conclusion, your experiences are valid, and it's important to seek help from a mental health professional who can provide a comprehensive assessment and appropriate treatment plan. Remember, you are not alone in this, and with the right support, it is possible to manage your anxiety and improve your quality of life.

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