Is It OCD? Intrusive Thoughts and Anxiety Symptoms

Is this obsessive-compulsive disorder (OCD)?

I have been thinking about and worrying about these issues for the past year, and I can spend hours on them.
If I try not to think about them, I become anxious.

1.
As someone with epilepsy, if I ever need surgery, is the risk of anesthesia very high?
2.
Can I contract HIV or HPV after using a public restroom?
3.
Before the elevator reaches my floor, I need to have my stock app open on my phone; otherwise, I feel like my mind will be controlled by others.
When the elevator arrives at my floor and the app is not ready, I think this must be God's arrangement, and I become very worried about my mind being controlled.
4.
I found two articles online: the first states that a person has no consciousness after death, while the second claims that the soul can still perceive everything after death.
After reading both, my initial subconscious reaction was that the first article seemed more truthful and the second one less so.
However, another thought immediately crossed my mind: is my subconscious reaction a hint from God that I will have no consciousness after death, implying that I cannot achieve eternal life? This led to the thought that everyone in the world can achieve eternal life except for me.

The idea that I cannot achieve eternal life has been the most distressing thought for me in recent months.
I dread getting out of bed every morning, and at work, I struggle even with the simplest tasks, just wanting to slump in my chair.
I wonder if these thoughts are reasonable or if I can generate some comforting thoughts to tell myself that there is a chance for eternal life, or that if I cannot achieve it, then neither can others.
Such comforting thoughts might last a few seconds before being overtaken by the idea that only I cannot achieve eternal life, but after a few seconds, I find myself thinking about it again.
Even if I try not to think about it, I still feel extremely anxious.
1.
I would like to ask the doctor if I am experiencing obsessive-compulsive disorder (OCD) with these compulsive thoughts or if it is some other symptom?
2.
A few years ago, I had similar symptoms, and a doctor at a clinic in Taipei diagnosed me with OCD.
After taking the medication prescribed by the doctor, I felt better, my thoughts became more flexible, and I was able to shift to more positive thinking.
However, the doctor I am currently seeing in Hsinchu says that I am just a more anxious person and prescribed me one pill of Sertraline in the morning and evening, along with a sedative before bed.
After taking them for a few months, I have not seen any effect.
Could this be because the doctor is not treating me for OCD?

Niming, 30~39 year old female. Ask Date: 2021/11/19

Dr. Xue Gengming reply Psychiatry

We recommend that you discuss the above situation further with your attending physician to determine if any additional examinations are necessary.
Thank you, and wishing you good health!

Reply Date: 2021/11/19

More Info

Based on the symptoms you've described, it seems you are experiencing a combination of intrusive thoughts and anxiety, which can be indicative of Obsessive-Compulsive Disorder (OCD). OCD is characterized by persistent, unwanted thoughts (obsessions) that lead to repetitive behaviors or mental acts (compulsions) aimed at reducing the anxiety associated with those thoughts. However, it’s important to note that not all intrusive thoughts are indicative of OCD; they can also be a symptom of generalized anxiety disorder or other anxiety-related conditions.

Your specific concerns, such as the fear of surgical risks due to your epilepsy, worries about contracting diseases from public restrooms, and the compulsive need to check your phone in the elevator, suggest a pattern of anxiety-driven thoughts. The fact that you feel compelled to analyze and ruminate over these thoughts, often leading to heightened anxiety and distress, aligns with the characteristics of OCD.
The thoughts about life after death and the fear of not being able to experience eternal life also indicate a level of existential anxiety, which can be common in individuals with anxiety disorders. This kind of thinking can become cyclical, where the more you try to suppress these thoughts, the more they persist, leading to increased anxiety and distress.

Regarding your treatment, it’s crucial to have a comprehensive evaluation by a mental health professional who can accurately diagnose your condition. The medications you mentioned, such as the SSRIs (Selective Serotonin Reuptake Inhibitors) like Prozac (Fluoxetine), are often effective in treating OCD and anxiety disorders. However, if you feel that your current medication regimen is not effective, it may be worth discussing this with your psychiatrist. They might consider adjusting your dosage or trying a different medication that may work better for you.

In addition to medication, cognitive-behavioral therapy (CBT), particularly exposure and response prevention (ERP), is highly effective for treating OCD. This therapeutic approach involves gradually exposing you to the sources of your anxiety while helping you refrain from engaging in compulsive behaviors. Over time, this can help reduce the power of your intrusive thoughts and the anxiety they cause.

Regular physical activity can also be beneficial for managing anxiety symptoms. Exercise has been shown to release endorphins, which can improve mood and reduce stress. Even if you are currently limited due to physical constraints, finding alternative forms of exercise, such as yoga or gentle stretching, can still provide benefits.

Lastly, consider reaching out to a therapist or counselor who specializes in anxiety disorders. They can provide you with coping strategies and support as you navigate your symptoms. Remember, you are not alone in this, and there are effective treatments available to help you manage your anxiety and intrusive thoughts.
In summary, while your symptoms may suggest OCD, a thorough evaluation by a mental health professional is essential for an accurate diagnosis and appropriate treatment plan. Combining medication, therapy, and self-care strategies can significantly improve your quality of life and help you regain control over your thoughts and feelings.

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