Is This Still OCD? Unreality and Mental Health Concerns

Q: Is This Still OCD? Unreality and Mental Health Concerns

Hello Ah Yue： Your situation aligns well with the symptoms of obsessive-compulsive disorder (OCD). <br>Some individuals with OCD may experience irrational thoughts and feelings, but this does not necessarily lead to the development of other mental illnesses! However, if you find

Is this still obsessive-compulsive disorder?

Hello, doctor.
I am the patient who has been suffering from obsessive-compulsive disorder (OCD) for ten years.
Recently, I have been experiencing a feeling of fear and worry that everything I see is not real, and I am concerned that I might be living in an illusion.
For example, if I am at a gathering with friends, I start to wonder if I am actually at a gathering or if everything is just a figment of my imagination and is fake.
I find these thoughts absurd and exaggerated, yet I still worry about and even believe them, which leads to a sense of unreality that is very uncomfortable.
This, in turn, makes me feel scared and anxious, trapping me in a vicious cycle.

I am wondering if this feeling of unreality is related to my obsessive thoughts.
Can obsessive thinking really cause such strange feelings? I would like to ask you, based on my description, if this sense of unreality is still a result of my OCD, or could it be that I have another mental illness that I am unaware of? I am genuinely worried and frightened by this feeling.
Additionally, if this is indeed caused by obsessive thinking, is it possible that constantly worrying and being in this state could develop into another mental disorder? I appreciate your help in clarifying this for me.
Thank you!

A Yue, 20~29 year old female. Ask Date: 2023/03/02

Dr. Lin Mianzhang reply Psychiatry

Hello Ah Yue: Your situation aligns well with the symptoms of obsessive-compulsive disorder (OCD).
Some individuals with OCD may experience irrational thoughts and feelings, but this does not necessarily lead to the development of other mental illnesses! However, if you find this situation distressing, you may want to discuss it with your physician to see if medication adjustments are needed or if psychological therapy could help improve your condition.
Wishing you peace and good health.

Reply Date: 2023/03/02

More Info

It sounds like you are experiencing a very distressing and confusing set of symptoms that may be linked to your long-standing struggle with Obsessive-Compulsive Disorder (OCD). The feelings of unreality and the fear that everything around you might not be real can indeed be associated with OCD, particularly when it manifests with intrusive thoughts and compulsive behaviors. However, it is also important to consider that these feelings could be indicative of other mental health issues, such as derealization or depersonalization, which can occur in various anxiety disorders.

Derealization is a dissociative symptom where a person feels detached from their surroundings, as if the world is not real. This can happen in the context of anxiety and stress, and it can be exacerbated by obsessive thoughts. When you are preoccupied with the fear that your experiences are not genuine, it can create a feedback loop where the anxiety intensifies, leading to more intrusive thoughts and feelings of unreality. This cycle can be particularly challenging to break, as the more you focus on these thoughts, the more they can feel real and overwhelming.

Your concern about whether these feelings might indicate a different mental health condition is valid. While OCD can certainly lead to feelings of unreality, it is essential to differentiate between symptoms of OCD and those that might suggest another disorder, such as generalized anxiety disorder (GAD) or a dissociative disorder. It is also possible for individuals with OCD to develop additional anxiety disorders, especially when their compulsive behaviors and intrusive thoughts become more complex and pervasive.

To address your concerns, it would be beneficial to consult with a mental health professional who can provide a thorough evaluation of your symptoms. They can help determine whether your experiences are primarily related to OCD or if there are other underlying issues that need to be addressed. Cognitive-behavioral therapy (CBT), particularly exposure and response prevention (ERP), is often effective for OCD and can help you manage intrusive thoughts and the associated feelings of unreality.
Additionally, it is crucial to practice self-care and grounding techniques to help manage anxiety and feelings of detachment. Mindfulness exercises, deep breathing, and engaging in activities that bring you joy and connection can help anchor you in reality. It may also be helpful to discuss your medication options with a psychiatrist, as certain medications can alleviate anxiety and OCD symptoms, potentially reducing the intensity of your feelings of unreality.

In summary, while your feelings of unreality may stem from your OCD, it is essential to seek professional guidance to explore these symptoms further. Understanding the root of your experiences can empower you to take steps toward managing your mental health effectively. Remember, you are not alone in this journey, and there are resources and support available to help you navigate these challenges.

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