Overcoming Obsessive Thoughts About STIs: A Guide to Mental Health

Regarding obsessive thinking?

Hello Doctor: I feel like I have been struggling with obsessive thoughts for many years.
The things I worry about change at different stages, and now I find myself easily associating many situations with the risk of contracting a sexually transmitted infection (STI).
I am very afraid of coming into contact with public restrooms (I don’t avoid using them, but I am scared of touching things) or restroom trash, and even large pieces of trash or garbage bins on the street.
Sometimes I worry that I might accidentally touch something and indirectly contract an STI, which often leads to feelings of paranoia.
I also fear coming into contact with blood or blood-like substances, and occasionally when I feel a tingling sensation in my body, I wonder if I was pricked by a needle and might have contracted HIV.
In the past few months, I started dating a boyfriend, and this issue seems to have intensified.
Although we have only engaged in petting, I still have concerns about the transmission of STIs.
My boyfriend is aware of my worries, so he went to the Red Cross to get tested for HIV, and the results were negative.
However, there was one occasion when I thought I might have come into contact with his bodily fluids, which caused me to start worrying again.
Even though I believe he is healthy, I still feel anxious, and I also worry about other STIs.
I feel that this might affect my ability to form a relationship, and it seems to be a problem, but I feel somewhat powerless and unsure how to resolve it.
I don’t like feeling this way.
Could you please provide some suggestions for improvement? Thank you.

Niming, 20~29 year old female. Ask Date: 2013/06/06

Dr. Ding Shuyan reply Psychiatry

Hello, the content of obsessive thoughts is mostly mundane and consists of things that could happen in real life.
Most people occasionally have these thoughts, but they can usually handle them more easily.
The reason why these thoughts become persistent may be very deep and internal.
Some theories suggest that early childhood experiences may be the cause, while biological theories propose that abnormalities in neurotransmitters in the brain could be a factor.
Just hearing this makes it clear that self-adjustment can be a truly challenging task, and changes are not something that can be seen overnight.
In my experience, the quickest results come from pharmacological treatment, provided that the medication chosen by the physician is effective for our obsessive symptoms.
The downside is the need for long-term use and the possibility of future relapse.
Psychological therapy can also significantly alleviate obsessive symptoms and address potential underlying causes, as well as the various adaptive difficulties and emotional distress that arise from the symptoms.
However, psychological therapy requires a longer time commitment, and besides the therapist, the individual must also possess a certain level of self-exploration ability and be willing to put in considerable effort during the treatment process, which sometimes leads to uncertain and unsatisfactory outcomes.
You are only 21 years old, and your wonderful life is just beginning.
It would be unfortunate if obsessive symptoms were to affect your friendships, work, and personal life.
I suggest that you see a doctor first, who can help diagnose and arrange appropriate treatment options and combinations for you.
Wishing you all the best.

Reply Date: 2013/06/06

More Info

It sounds like you're grappling with significant anxiety and obsessive thoughts related to the fear of sexually transmitted infections (STIs). This is a common issue for many individuals, especially those who may have experienced anxiety or obsessive-compulsive tendencies in the past. Your concerns about potential exposure to STIs, particularly in public spaces or during intimate moments, can be distressing and may interfere with your relationships and overall quality of life.

First, it's important to recognize that your fears, while they may feel very real, are often rooted in anxiety rather than actual risk. The human mind has a tendency to amplify fears, especially when it comes to health-related issues. This is particularly true for conditions like obsessive-compulsive disorder (OCD), where intrusive thoughts can lead to compulsive behaviors aimed at reducing anxiety. In your case, the compulsive behaviors may include excessive cleaning, avoidance of certain situations, or seeking constant reassurance about your health and the health of your partner.

Here are some strategies that may help you manage these obsessive thoughts and reduce your anxiety:
1. Cognitive Behavioral Therapy (CBT): This is a highly effective treatment for anxiety and OCD. CBT helps you identify and challenge irrational thoughts and beliefs, replacing them with more balanced and realistic ones. A therapist can guide you through this process, helping you to confront your fears in a safe and structured way.

2. Exposure and Response Prevention (ERP): This is a specific type of CBT that is particularly effective for OCD. It involves gradually exposing yourself to the sources of your anxiety (in this case, situations that trigger your fears about STIs) while refraining from engaging in compulsive behaviors. Over time, this can help reduce your anxiety and desensitize you to your fears.

3. Mindfulness and Relaxation Techniques: Practicing mindfulness can help you stay grounded in the present moment and reduce the power of intrusive thoughts. Techniques such as deep breathing, progressive muscle relaxation, or guided imagery can help calm your mind and body when you feel overwhelmed.

4. Education and Awareness: Sometimes, understanding the actual risks associated with STIs and how they are transmitted can help alleviate fears. Consult with a healthcare provider to get accurate information about STIs, their transmission, and prevention methods. Knowing that your partner has been tested and is healthy can also provide reassurance.

5. Limit Information Seeking: While it’s natural to want to seek information to alleviate fears, excessive searching for information (like reading about STIs online) can often exacerbate anxiety. Try to limit your exposure to potentially distressing information and focus on reliable sources.

6. Open Communication with Your Partner: It’s great that your boyfriend is supportive and has taken steps to ensure his health. Continue to communicate openly about your fears and concerns. This can help build trust and reduce anxiety in your relationship.

7. Consider Professional Help: If your anxiety continues to interfere with your daily life or relationships, it may be beneficial to seek help from a mental health professional. They can provide tailored strategies and support to help you manage your symptoms effectively.

8. Medication: In some cases, medication may be appropriate to help manage anxiety symptoms. Discuss this option with a healthcare provider if you feel that your anxiety is significantly impacting your life.

Remember, overcoming obsessive thoughts and anxiety is a process that takes time and effort. Be patient with yourself as you work through these feelings. You are not alone in this struggle, and there are effective treatments available to help you regain control over your thoughts and feelings.

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