Overcoming Self-Curse Thoughts: Managing Anxiety and Medication Fears - Psychiatry

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Frequently cursing oneself internally?


Hello, Dr.
Lin.
I am very afraid of getting sick, getting injured, or becoming disabled.
The more I fear, the more I can't help but think about it.
Recently, I don't know why, but whenever I want to do something I enjoy or any small thing in life, I find myself cursing myself in my mind, such as "If I play this game again, I will die" or "If I don't turn off the TV now, I will become disabled." I even have thoughts like "I hope I get sick and die soon." I clearly don't want to think this way, but I am so scared that it has turned into a hope.
I am terrified that these thoughts will become reality.
Will it really come true because I often think this way? Every time I have such thoughts, I cast divination blocks to ask the gods for forgiveness, pleading with them not to heed my nonsensical thoughts and to bless me with good health (I always get a favorable response), but I still can't feel at ease.
I looked it up online, and it seems this is obsessive thinking.
I have always had anxiety disorder, and recently I have started experiencing panic attacks.
I was supposed to take Western medication, but previously, taking Sertraline caused my menstrual cycle to become irregular and led to violent tendencies (I would throw things and self-harm).
Another medication, Alprazolam, caused me insomnia and muscle weakness, making me unable to move.
So, I am very scared and eventually stopped taking the medication.
My body is very sensitive, and the side effects are always particularly severe; even getting a flu vaccine makes me run a fever (the doctors always say there are no side effects, but I still experience them).
Recently, my doctor prescribed a new medication called "Liyou," but I am afraid to take it because I found online that the side effects include nausea and vomiting.
Ever since I developed anxiety, my gastrointestinal health has worsened; I often experience bloating and vomiting, and my appetite has decreased.
If I take the medication, will it make things worse? Just thinking about it makes me too scared to take it.
Therefore, I have turned to traditional Chinese medicine for treatment.
Although I feel it is effective, it is indeed slower, and I still often find myself unable to control my thoughts.
I feel useless; my mind is already unwell, yet I lack the courage to take even the most basic medication.
I don't know how to recover more quickly.
Doctor, if traditional Chinese medicine does not yield results in the end, will I really have to resort to medication? How can I overcome the psychological barriers regarding side effects? What else can I do to help myself think more positively? Thank you, doctor, for taking the time to read my complaints.
I appreciate your efforts.

Xiao Liu, 20~29 year old female. Ask Date: 2023/06/17

Dr. Lin Mianzhang reply Psychiatry


Hello, Xiao Liu: It seems that your situation is causing you significant distress.
I recommend that you combine pharmacological treatment with psychotherapy to effectively improve your condition.
Regarding medication, serotonin-based antidepressants such as "Luvox" (Fluvoxamine) should be helpful for you.
Generally, while these medications may cause gastrointestinal side effects during the initial phase of treatment, these side effects usually diminish after some time.
Additionally, starting with a low dose can help minimize the severity of side effects.
Therefore, I still suggest that you consider taking Luvox! On the other hand, since you are more sensitive to medications, it would be best to incorporate psychotherapy, which may allow you to reduce your medication dosage.
I recommend that you ask your doctor for a referral to a psychotherapist! I believe you have been working very hard, and seeking professional assistance at this time can help you more quickly overcome the challenges of obsessive-compulsive and anxiety symptoms.
Wishing you a speedy recovery!

Reply Date: 2023/06/17

More Info


Hello, thank you for reaching out and sharing your experiences and concerns. It’s clear that you are going through a very challenging time, and I commend you for your courage in seeking help and trying to understand your feelings and thoughts better.

From what you've described, it seems like you are experiencing a combination of anxiety, obsessive thoughts, and fears about your health and well-being. This is not uncommon among individuals who struggle with anxiety disorders, particularly obsessive-compulsive disorder (OCD), which can manifest as intrusive thoughts that cause significant distress. These thoughts can often feel overwhelming and may lead to compulsive behaviors, such as seeking reassurance from spiritual practices or avoiding situations that trigger your fears.

Your fear of becoming ill or injured, coupled with the intrusive thoughts that you might "curse" yourself, can create a vicious cycle of anxiety. The more you try to suppress these thoughts, the more they may persist, leading to increased anxiety and distress. It’s important to recognize that having these thoughts does not mean they will come true. Thoughts are not inherently predictive of reality; they are simply mental events that can be influenced by various factors, including anxiety.

You mentioned that you have had negative experiences with certain medications, which can understandably lead to apprehension about trying new treatments. It’s crucial to communicate these concerns with your healthcare provider. They can help you explore alternative medications or therapies that may have fewer side effects or work better for your specific sensitivities. Additionally, they can provide reassurance and support as you navigate these challenges.

While you are currently exploring herbal remedies, it’s essential to keep in mind that while they may offer some benefits, they might not be sufficient for addressing severe anxiety or OCD symptoms. If you find that your symptoms persist or worsen, it may be necessary to reconsider medication as part of your treatment plan. Many individuals find that a combination of medication and therapy, such as cognitive-behavioral therapy (CBT), is effective in managing anxiety and obsessive thoughts. CBT can help you learn to challenge and reframe your intrusive thoughts, reducing their power over you.

In terms of managing your fears about medication side effects, it can be helpful to approach this gradually. Consider discussing with your doctor the possibility of starting with a lower dose of the new medication to see how your body reacts. This can sometimes alleviate the fear of experiencing severe side effects while still allowing you to gauge the medication's effectiveness.

Additionally, practicing mindfulness and relaxation techniques can be beneficial in managing anxiety. Techniques such as deep breathing, progressive muscle relaxation, or guided imagery can help ground you in the present moment and reduce the intensity of anxious thoughts. Engaging in regular physical activity, maintaining a balanced diet, and ensuring adequate sleep can also contribute positively to your mental health.

Lastly, it’s essential to be kind to yourself during this process. Recovery from anxiety and obsessive thoughts can take time, and it’s okay to seek support from friends, family, or mental health professionals. You are not alone in this journey, and there are resources available to help you navigate these challenges.

In summary, while it’s understandable to have fears about medication and its side effects, it’s crucial to work closely with your healthcare provider to find a treatment plan that works for you. Consider exploring therapy options alongside any herbal treatments, and remember that managing anxiety is a process that often requires patience and support. Take care, and I wish you the best on your journey to feeling better.

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