Intrusive Thoughts and Impulses: A Mental Health Perspective

It feels like there is another thought in my head?

Hello, doctor.
Actually, I don't quite understand my issue; I just know that I seem to have some symptoms of attention deficit, so I came to consult you.
I apologize if I'm mistaken.
As a child, I was someone who found it difficult to concentrate, and sometimes I would have very unusual thoughts urging me to do certain things.
I vividly remember a time in kindergarten when I sat next to a child who was not very hygienic and often had a runny nose.
To put it bluntly, he looked like an easy target for bullying.
For some reason, I followed the thoughts in my head and forcefully poked him with a pencil on his arm, not just a quick jab but slowly and deliberately, almost in a cruel manner.
I only stopped when he cried out in pain.
After that incident, I realized I needed to suppress such thoughts and actions.
Fortunately, even though I still had similar thoughts and impulses later on, I managed to keep them under control.
Before middle school, such thoughts rarely appeared, but in high school, their frequency began to increase slightly.
The thoughts were often quite negative, like violent urges, especially under stress, which made them occur more frequently.
Sometimes, I can clearly feel that my thoughts are being taken over by someone else, but I am aware of it.
Initially, I could control it, like when I was using a computer and someone suddenly pushed me away from it.
My mind would start to recall or rehearse certain things.
In those moments, I would strongly urge myself to bring my thoughts back to the book in front of me.
However, it was difficult; even if I managed to pull my thoughts back, within five or ten minutes, it would start again.
I looked up terms like thought disorder, schizophrenia, and dissociative identity disorder on Wikipedia, but I don't experience severe hallucinations or sudden memory loss.
It feels like those symptoms are somewhat similar but completely unrelated to what I'm experiencing.
Sometimes, I also exhibit symptoms similar to Tourette syndrome; for example, while I'm typing, my body will suddenly repeat a certain movement, and I feel compelled to hover my palm over the keyboard, shaking between touching and not touching it.
I had this symptom in middle school, but at that time, I could still suppress it.
Sometimes friends would notice, and I would just brush it off.
However, as I grew older, it became more severe; I try to suppress it in public, but when I'm alone, I can't control it.
Sometimes I feel that if it weren't for legal restrictions, my true nature would emerge and cause chaos.
I apologize for writing such a long message.
I'm not quite sure how to describe my symptoms and I'm afraid I might have left something out.
I really appreciate you taking the time to read this.
Thank you.

Kai Hsuan, 20~29 year old female. Ask Date: 2016/01/22

Dr. Song Chengxian reply Psychiatry

Hello Kai-Hsuan, based on your description, it seems that you have been experiencing persistent obsessive thoughts, poor concentration, and involuntary movements.
I recommend that you seek evaluation from a psychiatrist or a mental health specialist to assess whether you may have Tourette syndrome or other related issues.
It is common for Tourette syndrome to coexist with attention deficit disorders or obsessive-compulsive symptoms, and appropriate treatment can lead to improvement.
Best regards, Dr.
Song.

Reply Date: 2016/01/22

More Info

Understanding intrusive thoughts and impulses is a complex area of mental health that often intertwines with various psychological conditions, including Attention Deficit Hyperactivity Disorder (ADHD), Obsessive-Compulsive Disorder (OCD), and even aspects of impulse control disorders. Your experiences, as you described, suggest a struggle with attention regulation and intrusive thoughts that can lead to impulsive actions, which can be distressing and confusing.

From your account, it seems that you have had a history of difficulty concentrating, which is a hallmark symptom of ADHD. This condition can manifest in various ways, including challenges in maintaining focus, being easily distracted, and experiencing racing thoughts. The intrusive thoughts you mentioned, particularly those that compel you to act in ways that you later regret, could be linked to impulsivity often seen in ADHD. However, the nature of these thoughts—especially the violent or aggressive ones—could also suggest an overlap with OCD, where individuals experience unwanted thoughts (obsessions) that lead to anxiety and may compel them to engage in certain behaviors (compulsions) to alleviate that anxiety.

Your recollection of a specific incident in kindergarten, where you acted on an intrusive thought to harm another child, is particularly concerning. While it’s fortunate that you have been able to suppress similar thoughts since then, the fact that they have resurfaced with increased frequency during stressful periods indicates that they may be a coping mechanism for underlying anxiety or stress. The awareness you have of these thoughts and your attempts to control them are important; however, the distress they cause you suggests that they may require further exploration and understanding.

The physical symptoms you described, such as the involuntary movements resembling Tourette syndrome, could also be indicative of a tic disorder, which is not uncommon in individuals with ADHD. Tics can manifest as sudden, repetitive movements or sounds and can be exacerbated by stress or anxiety. The feeling of losing control over your thoughts and actions, especially in high-pressure situations, can be alarming and may contribute to a cycle of anxiety and impulsivity.

It’s essential to approach these experiences with compassion and understanding. Mental health conditions are often multifaceted, and symptoms can overlap, making it challenging to pinpoint a single diagnosis. It’s crucial to seek a comprehensive evaluation from a mental health professional who can provide a thorough assessment of your symptoms and help you understand their origins. They can also offer strategies for managing intrusive thoughts and impulses, which may include cognitive-behavioral therapy (CBT), mindfulness techniques, or medication if appropriate.

In the meantime, consider implementing some self-care strategies to help manage your symptoms. Mindfulness practices, such as meditation or deep-breathing exercises, can help ground you when you feel overwhelmed by intrusive thoughts. Keeping a journal to express your thoughts and feelings can also provide an outlet for your emotions and help you identify patterns in your thinking.

Lastly, remember that you are not alone in this experience. Many individuals struggle with similar thoughts and impulses, and seeking help is a courageous step toward understanding and managing your mental health. Engaging with supportive friends, family, or mental health communities can also provide a sense of connection and understanding as you navigate these challenges.

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