Intrusive Thoughts: Navigating OCD and Sexual Anxiety in Young Adults

Strange and disturbing thoughts in the brain?

Hello Doctor, I am 19 years old and I have been diagnosed with Obsessive-Compulsive Disorder (OCD).
My symptoms first appeared when I was in the first year of junior high school, where I began to have irrational thoughts, such as imagining that my teachers or classmates might engage in inappropriate behavior in front of me, even though they were not.
I also found myself associating normal phrases with sexual connotations, leading to a barrage of strange and disturbing thoughts.

My condition worsened in the third year of junior high when I developed a fear of being infected by viruses, which made me reluctant to go outside.
My family noticed something was wrong, and I subsequently sought help from a psychiatrist, who diagnosed me with OCD.
After starting medication, my condition improved significantly, and I was able to attend school normally.
However, now that I am in my first year of college, these disturbing thoughts have resurfaced.
For instance, even though I am a girl, I find myself having inappropriate thoughts about girls who dress provocatively, such as wanting to touch or kiss them.
I have not acted on these thoughts, but I fear that one day I might, which terrifies me.
This has led to a fear of women, making me hesitant to go out, as I worry that I might encounter girls and spiral into these intrusive thoughts again.
During junior high, I even questioned my sexual orientation, wondering if I might be a lesbian, but those thoughts disappeared after treatment.
Throughout high school, I did not have any inappropriate thoughts about my female classmates and was able to interact with them normally, knowing that I was attracted to boys.
Now, in college, I am confused about why these thoughts have returned, and I find myself questioning my sexual orientation again.

I would like to ask the doctor what I should do about this situation.
Am I truly a lesbian, or are these just obsessive thoughts caused by my OCD? I am still regularly visiting my psychiatrist and taking medication, but for some reason, my symptoms seem to have intensified.
Additionally, I find myself needing to perform certain actions in a specific way, such as picking up objects or opening doors, or I feel that I might be in danger, like getting hit by a car.
Thank you for your help.

Xiao Lu, 10~19 year old female. Ask Date: 2022/05/30

Dr. Wu Enliang reply Psychiatry

Indeed, the symptoms described by netizens are characteristic of obsessive-compulsive disorder (OCD).
The symptoms of OCD can fluctuate with life stressors.
It is advisable to discuss with your physician whether to adjust your medication or to incorporate additional treatments such as psychotherapy.
Dr.
Wu En-Liang.

Reply Date: 2022/05/30

More Info

Navigating intrusive thoughts, especially those related to sexual anxiety and obsessive-compulsive disorder (OCD), can be particularly challenging for young adults. Your experience reflects a common struggle among individuals dealing with OCD, where intrusive thoughts can lead to significant distress and confusion about one’s identity and desires.
Firstly, it’s essential to understand that OCD is characterized by unwanted and intrusive thoughts (obsessions) that often lead to compulsive behaviors aimed at reducing the anxiety associated with those thoughts. In your case, the intrusive thoughts about inappropriate actions towards others, particularly women, can be distressing and may lead to feelings of fear and shame. It’s important to recognize that having these thoughts does not define who you are or what you will do. Many individuals with OCD experience similar thoughts, and they often do not act on them.
The resurgence of these intrusive thoughts during your transition to college can be attributed to various factors, including stress, changes in your environment, and the pressures of new social dynamics. College is often a time of significant change, which can exacerbate underlying anxiety disorders. It’s also common for individuals with OCD to experience fluctuations in their symptoms, sometimes feeling better for a period and then facing a resurgence of intrusive thoughts.

Your fear of acting on these thoughts is a common concern among those with OCD. It’s crucial to differentiate between thoughts and actions; having a thought does not mean you will act on it. Many people with OCD have thoughts that are contrary to their values and beliefs, which can be particularly distressing. This is often referred to as "ego-dystonic" thinking, where the thoughts are inconsistent with one’s self-image and moral beliefs.

To manage these intrusive thoughts, consider the following strategies:
1. Cognitive Behavioral Therapy (CBT): This is one of the most effective treatments for OCD. CBT, particularly Exposure and Response Prevention (ERP), involves gradually exposing yourself to the thoughts and situations that trigger your anxiety while refraining from engaging in compulsive behaviors. This can help reduce the power of the intrusive thoughts over time.

2. Mindfulness and Acceptance: Practicing mindfulness can help you observe your thoughts without judgment. Instead of trying to suppress or control the thoughts, acknowledge them as just thoughts. This can reduce the anxiety associated with them.

3. Medication: Since you are already under psychiatric care and taking medication, it’s essential to communicate with your healthcare provider about the resurgence of your symptoms. Sometimes, adjustments in medication or dosage may be necessary to better manage your symptoms.

4. Support Groups: Connecting with others who experience similar challenges can provide validation and support. Sharing your experiences in a safe environment can help reduce feelings of isolation and shame.

5. Journaling: Writing down your thoughts and feelings can help you process them. It can also serve as a tool to track your triggers and patterns, which can be useful for discussions with your therapist.

6. Education: Learning more about OCD and intrusive thoughts can empower you to understand your experiences better. Knowledge can help demystify the condition and reduce fear.

7. Avoidance of Triggers: While it’s important to face your fears, it’s also crucial to identify and manage situations that may trigger your intrusive thoughts, especially in the early stages of treatment.

It’s commendable that you are actively seeking help and continuing to attend psychiatric appointments. Remember, recovery is a process, and it’s okay to seek support when you need it. If you find that your symptoms are worsening or becoming unmanageable, don’t hesitate to reach out to your mental health professional for additional support and guidance. You are not alone in this journey, and with the right strategies and support, it is possible to navigate these challenges effectively.

Similar Q&A

Managing Anxiety and Intrusive Thoughts: A Guide for Students

Hello, Doctor: Last semester, due to the stress of preparing for exams, I came across information online suggesting that masturbation could relieve stress, so I started to try it. Since then, I have been masturbating whenever I feel the urge. Recently, I have noticed that after f...

Dr. Wang Yaoting reply Psychiatry
Hello: Everyone is born with sexual needs and impulses, which typically diminish with age, but some individuals may not experience this decline, or it may even worsen. If such thoughts occur occasionally without affecting normal life, work, or interpersonal relationships, it can ...

Overcoming OCD: A Personal Journey Through Anxiety and Intrusive Thoughts

I have read some posts here and looked at the questions raised by others and the doctors' responses. I found that I share many symptoms with them, such as feeling unable to pray when entering a temple because disrespectful thoughts about the deities arise in my mind, even th...

Dr. Liang Sunyuan reply Psychiatry
Hello: We cannot control what thoughts arise in our minds; we can only train ourselves to ignore those thoughts and redirect our attention to more meaningful and important people and things. Individuals with obsessive-compulsive disorder (OCD) often feel the need to repeat certai...

Understanding OCD: Coping with Intrusive Thoughts About Sexuality

Hello Doctor, this is Derek, who asked you a question a few days ago. I'm quite sure that I do not have an attraction to the same sex, but I am wondering why these thoughts are occurring. My anxiety was at its worst in April, and it has been fluctuating since then. I have re...

Dr. Lin Mianzhang reply Psychiatry
Hello Derek: What you are experiencing is compulsive thinking, which is one of the symptoms of obsessive-compulsive disorder (OCD). OCD is often triggered by factors such as anxiety and stress, and having a predisposition to this condition can also be a contributing factor. If yo...

Navigating Sexual Orientation and Anxiety: A High School Student's Journey

I am the high school student who asked you about sexual orientation a few days ago. After reading your response, I reflected on it carefully and felt better. I started to wonder if it’s possible that I have been subconsciously trying to confirm whether I am gay (I maintain a neut...

Dr. Lin Mianzhang reply Psychiatry
Hi there! The influence of the subconscious that you mentioned is indeed one possible reason, but it could also simply be due to curiosity about sexuality, which can lead to such phenomena. The brain tends to operate in a way where the more you try to suppress a thought, desire, ...