Intrusive Thoughts: Coping Strategies for Anxiety and Fear

Delusions of strange things?

Due to the previous murder incident on the Taipei Metro, I often find myself thinking about it.
On one hand, I am afraid to take the subway, and on the other hand, I sometimes wonder if I might lose control and commit a terrible act myself.
I really do not want to engage in such behavior, and it frightens me.
I have talked to my girlfriend about these feelings, and she told me not to think too much about it.
She said that if I find myself thinking about it in the future, I should focus on the outcome, which is that I would never commit murder.
I also realize that I tend to overthink about my grades or other matters.
Is this a form of obsessive-compulsive disorder or delusional disorder? I know I would never act on these thoughts, but they still come to me involuntarily.
I would like to ask the doctor if there are any suggestions or methods to gradually improve this situation.
Thank you, doctor.

CC, 20~29 year old female. Ask Date: 2014/05/30

Dr. Ding Shuyan reply Psychiatry

Hello, something shocking has happened, and the process has been repeatedly broadcasted on television, which can cause psychological impact on many people.
The extent and duration of this impact vary from person to person.
A few days after the incident, I felt uneasy while taking the high-speed train, even though I had enjoyed countless rides in the past.
As time passes, everyone should gradually forget about this event.
The reason is simple: we shift our focus to other more important, personal, and practical matters.
This incident is essentially in the past, it will not happen again, and it will not return to our daily lives.

If your worries do not gradually diminish and you become increasingly concerned about whether you might also act in such a way, you can try to redirect your attention to other activities.
Avoid giving yourself too much idle time to think alone.
More importantly, when you find yourself thinking about this incident again, immediately get up, look around, find something to do, or talk to someone to interrupt that thought process.
If these strategies do not help, consider seeing a doctor.
However, such situations are rare, so you can relax.

Wishing you all the best,
Dr.
Ding Shuo-Yan

Reply Date: 2014/05/30

More Info

It's understandable to feel anxious and fearful after hearing about traumatic events like the recent subway attack. Such incidents can trigger intrusive thoughts, which are unwanted and often distressing ideas that can lead to significant anxiety. It’s important to recognize that these thoughts do not reflect your true intentions or desires. Many people experience similar thoughts, especially in response to stress or fear, and it does not mean you will act on them.

Understanding Intrusive Thoughts
Intrusive thoughts can manifest in various forms, including fears of harming others or oneself, doubts about one's abilities, or worries about future events. These thoughts can be particularly distressing because they often conflict with our values and self-image. For instance, the fear of losing control and acting violently is a common concern for those who experience anxiety, but it is crucial to understand that having these thoughts does not mean you will act on them.

Coping Strategies
1. Acknowledge the Thoughts: The first step in managing intrusive thoughts is to acknowledge them without judgment. Understand that these thoughts are a product of anxiety and do not define who you are. Instead of trying to suppress them, allow yourself to recognize their presence and then let them pass.

2. Cognitive Behavioral Therapy (CBT): CBT is an effective treatment for anxiety and intrusive thoughts. It helps individuals identify and challenge irrational beliefs and thought patterns. Working with a therapist can provide you with tools to reframe your thoughts and reduce anxiety.

3. Mindfulness and Acceptance: Practicing mindfulness can help you stay grounded in the present moment. Techniques such as meditation, deep breathing, and grounding exercises can help you detach from intrusive thoughts. Acceptance and Commitment Therapy (ACT) is another approach that encourages individuals to accept their thoughts and feelings rather than fight against them.

4. Exposure Therapy: Gradual exposure to the situations that trigger your anxiety can help desensitize you to those fears. For example, if riding the subway causes anxiety, you might start by visualizing yourself on the subway, then progress to taking short rides during less busy times.

5. Limit Triggers: While it’s important to confront fears, it can also be helpful to limit exposure to news or media that may exacerbate your anxiety. This doesn’t mean avoiding reality, but rather managing how much distressing information you consume.

6. Talk About It: Sharing your feelings with someone you trust, like your girlfriend, can provide relief. Sometimes, just verbalizing your fears can help diminish their power. Consider seeking support from a mental health professional who can provide guidance tailored to your situation.

7. Medication: If your intrusive thoughts and anxiety are significantly impacting your daily life, discussing medication options with a psychiatrist may be beneficial. Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for anxiety disorders and can help alleviate symptoms.

8. Self-Compassion: Practice being kind to yourself. Understand that experiencing anxiety and intrusive thoughts is a common human experience. Remind yourself that it’s okay to seek help and that you are not alone in this struggle.

Conclusion
It’s important to remember that intrusive thoughts are a symptom of anxiety and do not reflect your true character or intentions. By employing coping strategies such as mindfulness, cognitive behavioral therapy, and seeking support, you can gradually reduce the power these thoughts hold over you. If you find that your anxiety persists or worsens, consider reaching out to a mental health professional for further assistance. You deserve to feel safe and secure in your thoughts and actions.

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