Intrusive Thoughts: Managing OCD During Recovery

Q: Intrusive Thoughts: Managing OCD During Recovery

Hello Ayue： Your concerns about the meaning of words, whether your speech is correct, and even the fear of losing your ability to speak and read are indeed symptoms of obsessive thinking. <br>These obsessive thoughts can become more severe when you interrupt your medication or ha

Strange obsessive thinking?

Hello Doctor,
I am a patient who has been suffering from obsessive-compulsive disorder (OCD) for ten years and have been undergoing medication treatment.
When my condition is stable, I experience almost no symptoms and my life is quite normal.
Even when symptoms do arise, they are primarily obsessive thoughts rather than compulsive behaviors.

Recently, I had foot surgery and have been resting in bed for almost three weeks, only getting up to use the bathroom or to read and use my phone.
My work and life plans have come to a halt because of this.
However, I have been troubled by a recent development: it seems that my obsessive thoughts have resurfaced.
Currently, my symptoms include worrying about strange things.
Most distressing is my preoccupation with the meaning of words.
For example, when I talk to my family, I find myself questioning whether my choice of words is correct, whether the things I say are being expressed as I intend, and whether my family truly understands what I am saying.
I worry that my speech is incoherent and that I am communicating differently than a normal person would...
(even though my family thinks I speak normally, it is only me who feels anxious).
I often find myself ruminating over the words and phrases in my mind, wondering if they are appropriate.

I am unsure if you understand what I am trying to convey, but it feels like a very strange thought process.
I have been trying to resist these thoughts (and I know that the more I resist, the stronger they become), but they keep swirling in my mind, causing me great concern.
I even worry that I might lose my ability to speak and read, and that I will be unable to work because of this.
I feel scared and panicked.

Doctor, I would like to ask you if these persistent strange thoughts are indeed obsessive thoughts? If I keep thinking about them, will I one day truly lose my ability to speak and read? I am very worried...
OCD feels like a demon living in my mind, constantly frightening me, interfering with my life, and causing me trouble.
I would like to ask you, besides medication, what other methods can help me overcome this? Does regular exercise help in recovering from OCD? After all, I have been on medication for ten years, and I am quite resistant to it due to the side effects.
I feel that medication only addresses the symptoms and not the root cause; whenever I stop taking it or when I have idle time, I easily fall into rumination...

Thank you for taking the time to address my concerns; I truly appreciate it!

A Yue, 20~29 year old female. Ask Date: 2023/01/14

Dr. Lin Mianzhang reply Psychiatry

Hello Ayue: Your concerns about the meaning of words, whether your speech is correct, and even the fear of losing your ability to speak and read are indeed symptoms of obsessive thinking.
These obsessive thoughts can become more severe when you interrupt your medication or have idle time.
Therefore, to improve your obsessive thinking, I suggest the following:
1.
Continue your medication: There are medications that target symptoms and those that address the underlying issues.
Sedatives are considered symptom-relieving medications, while serotonin-based antidepressants are aimed at treating the root cause.
If you experience side effects from your medication, discuss them with your physician to adjust the dosage or switch medications, which should help alleviate the side effects.
2.
Plan your time effectively: Find activities to engage in, which can help you focus on what you are doing instead of being preoccupied with obsessive thoughts.
3.
Exercise: Research shows that regular aerobic exercise can improve symptoms of obsessive-compulsive disorder (OCD).
Aim for at least three times a week, with each session lasting 30 minutes.
If you have an injury that makes it difficult to exercise, consider trying yoga or other forms of aerobic activity.
4.
Engage in psychotherapy: Psychotherapy can also help alleviate OCD symptoms.
I recommend asking your physician for a referral for psychological treatment.
Wishing you a speedy recovery from your foot injury and good health!

Reply Date: 2023/01/14

More Info

Understanding and managing obsessive-compulsive disorder (OCD) can be particularly challenging, especially during periods of stress or recovery from physical ailments, such as your recent foot surgery. It’s commendable that you have been proactive in seeking help and understanding your condition.
From your description, it appears that you are experiencing intrusive thoughts, which are a hallmark of OCD. These thoughts can manifest as excessive worry about the meaning of your words and whether you are communicating effectively. It’s important to recognize that these thoughts are a symptom of your OCD and not a reflection of your actual communication abilities or mental state. Many individuals with OCD experience similar patterns of intrusive thoughts, often leading to significant anxiety and distress.

The cycle of OCD often involves obsessions (intrusive thoughts) and compulsions (behaviors aimed at reducing anxiety). In your case, the compulsive behavior may not be overtly visible, as you mentioned that you do not engage in compulsive actions but rather engage in compulsive thinking. This can be just as debilitating. The more you try to resist or suppress these thoughts, the more they tend to persist, creating a vicious cycle of anxiety.

Regarding your concerns about losing your ability to speak or read, it’s essential to understand that while OCD can create intense fears and worries, these fears are typically unfounded. The brain is quite resilient, and while OCD can distort your perception of reality, it does not cause actual cognitive decline or impair your abilities in the way you fear.
In terms of management strategies beyond medication, cognitive-behavioral therapy (CBT), particularly exposure and response prevention (ERP), has been shown to be highly effective for OCD. ERP involves gradually exposing yourself to the sources of your anxiety (in this case, your intrusive thoughts) and learning to refrain from engaging in compulsive behaviors or mental rituals. This process can help diminish the power of the intrusive thoughts over time.

Additionally, regular physical activity can indeed be beneficial for managing OCD symptoms. Exercise has been shown to reduce anxiety and improve mood, which can help mitigate some of the distress associated with intrusive thoughts. Incorporating a routine that includes physical activity, mindfulness practices, or relaxation techniques can be helpful in managing your overall anxiety levels.

It’s also worth considering support groups or therapy focused on OCD, where you can connect with others who understand what you’re going through. Sharing experiences and coping strategies can provide additional support and validation.

Lastly, if you find that your current medication is causing significant side effects or you feel it’s not addressing your symptoms effectively, it may be worth discussing this with your healthcare provider. They can help you explore alternative medications or adjunct therapies that may be more suitable for your needs.

In conclusion, while your current experience with intrusive thoughts can be distressing, it is a common aspect of OCD. Engaging in therapy, maintaining a healthy lifestyle, and seeking support can significantly aid in managing your symptoms. Remember, you are not alone in this journey, and with the right strategies and support, it is possible to regain control over your thoughts and improve your quality of life.

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