Anxiety, Intrusive Thoughts, and Self-Harm in Mental Health

Anxiety, repetitive thinking, and self-harm?

Hello, doctor.
I have a serious problem with procrastination at work, and I struggle with time management.
My colleagues don't complain much about me, but I always feel like I'm doing a terrible job and that everyone is just tolerating me.
I constantly have thoughts and voices in my head saying, "I'm doomed," "I'm finished," and "I'm worthless." When I'm anxious, these voices roar in my mind, leading me to self-harm, such as slapping myself.
Even when I successfully complete a task or project, I briefly feel a sense of achievement, only to immediately feel that I did a poor job.
I used to think this was just a personal character flaw, but now I suspect it might be pathological.
This realization came after I had to submit a delayed document yesterday, during which I was slapping myself while working and occasionally shouting, "I'm doomed." My partner thinks my situation is abnormal and has suggested that I seek external resources.
In meetings related to my personal responsibilities, I feel extremely tense and shaky.
When these meetings are online (when no one can see me), I slap myself whenever I feel I've done something wrong.
I easily develop a strong sense of guilt towards my colleagues and superiors, even if they haven't blamed me.
Whenever I think of something I haven't done well, a message I forgot to respond to, or something I avoided addressing, I end up slapping myself.
I experienced similar phenomena back in 2015-2016 when I was under a lot of pressure as the head of an organization.
At that time, I would bite my arms and pull my hair.
I had managed to gradually overcome these behaviors for a long time, but they have resurfaced recently.
I have always been prone to anxiety and have had gastrointestinal issues.
I've consulted various traditional and Western medicine practitioners, and they all said I have irritable bowel syndrome related to psychological factors.
I've also researched a lot about anxiety disorders online, but I don't think my condition resembles generalized anxiety disorder (I have clear sources of anxiety), and I don't exhibit other obvious symptoms of autonomic nervous system dysfunction, such as palpitations or insomnia, which are common in general anxiety disorders.
Therefore, I didn't initially think I had any symptoms.
I would like to ask if there is a possibility that I am experiencing rumination or obsessive thinking.
Additionally, I want to know if there is a term in emotional disorders that closely relates to my situation, or if you could suggest methods to help myself.
I have long relied on my partner's support for my emotional distress, but my partner now feels exhausted from providing that support, and this issue has begun to affect my work, daily life, and relationship.

ting, 30~39 year old female. Ask Date: 2023/07/21

Dr. Qiu Junda reply Psychiatry

Hello.
It seems that you may fall under the category of anxiety disorders.
This is actually similar to the diagnoses you mentioned earlier, such as irritable bowel syndrome, generalized anxiety disorder, autonomic nervous system dysregulation, and obsessive thinking.
All of these are within the scope of anxiety disorders.
Since they have caused you physical and mental distress, I recommend that you seek consultation from a mental health professional and continue follow-up visits for treatment.
You should see improvement soon.

Reply Date: 2023/07/21

More Info

It sounds like you are experiencing a complex interplay of anxiety, intrusive thoughts, and self-harm behaviors that are significantly impacting your daily life and mental health. Your description indicates that you are grappling with feelings of inadequacy, guilt, and self-criticism, which can be overwhelming and distressing. Let's break down some of the key elements of your experience and explore potential avenues for support and self-help.

Firstly, the intrusive thoughts you mentioned, such as "I'm doomed" or "I'm a waste," are indicative of negative cognitive patterns often associated with anxiety and depression. These thoughts can become cyclical, leading to a heightened state of anxiety and self-harm behaviors, such as hitting yourself. This pattern is not uncommon among individuals who struggle with anxiety disorders, particularly when they feel overwhelmed by their responsibilities or perceive themselves as failing to meet expectations.

Your experience of self-harm, even if it is not severe, is a significant signal that you are in distress. Self-harm can serve as a coping mechanism for some individuals, providing a temporary release from emotional pain or anxiety. However, it is crucial to recognize that this behavior often exacerbates feelings of guilt and shame, creating a vicious cycle that can be difficult to break. It’s important to seek professional help to address these behaviors and the underlying issues contributing to them.

You mentioned that your partner has expressed concern about your mental state and suggested seeking external resources. This is a positive step, as professional support can provide you with the tools and strategies needed to manage your anxiety and intrusive thoughts effectively. Cognitive Behavioral Therapy (CBT) is one approach that has been shown to be effective for individuals dealing with anxiety and negative thought patterns. CBT focuses on identifying and challenging distorted thoughts, helping you to develop healthier thinking patterns and coping strategies.

Additionally, it might be helpful to explore mindfulness and relaxation techniques. Practices such as meditation, deep breathing exercises, or progressive muscle relaxation can help reduce anxiety and create a sense of calm. These techniques can also assist in grounding you during moments of heightened anxiety or intrusive thoughts.

You also mentioned experiencing gastrointestinal issues, which can often be linked to anxiety and stress. It’s essential to address these physical symptoms, as they can further contribute to your overall sense of distress. Consulting with a healthcare professional who understands the connection between mental and physical health may provide you with additional insights and treatment options.

In terms of self-help strategies, consider keeping a journal to document your thoughts and feelings. Writing can be a therapeutic outlet, allowing you to express your emotions and reflect on your experiences. Additionally, setting small, achievable goals for yourself can help build a sense of accomplishment and counteract feelings of inadequacy.

Lastly, it’s important to communicate openly with your partner about your struggles. While you may feel that you are relying heavily on their support, sharing your feelings can foster understanding and strengthen your relationship. It’s crucial to find a balance where you can seek support while also working on your self-management strategies.

In summary, your experiences suggest a need for professional support to address the anxiety, intrusive thoughts, and self-harm behaviors you are facing. Engaging in therapy, exploring mindfulness techniques, and maintaining open communication with your partner can all contribute to your healing journey. Remember, seeking help is a sign of strength, and taking proactive steps toward understanding and managing your mental health is essential for your well-being.

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