Overcoming Intrusive Thoughts: A Journey Through Mental Health Challenges

Obsessive thinking

The situation is as follows: I am 26 years old and serving as a diplomatic substitute abroad.
I took English classes with a local teacher who used agricultural pesticides with food-grade utensils.
I was horrified and kept checking whether her kitchen utensils were clean.
Later, I even used the rented food utensils to test the pesticide myself to see if it would poison me.
I researched the pesticide data and found that an adult weighing 60 kg would be in danger after consuming 21 grams of pesticide, while a small infant weighing 3 kg would be at risk after ingesting just 1 gram.
I remember cleaning everything thoroughly, but I still doubt whether it could be fatal, fearing that I might become a murderer and face the death penalty! After returning to Taiwan, I took psychiatric medication for two years, recovering from a low point to a point where I could live and work.
I am currently studying abroad and have been off medication for five months, relying on willpower to get through life without it.
I returned to Taiwan after five months, and fear has followed me for three years.
I have learned to cope with the fear better, but I wonder why this is happening.
It seems that apart from acceptance, there are no other options.
Would a doctor recommend that I continue taking medication?

Maxy, 20~29 year old female. Ask Date: 2016/02/14

Dr. Ding Shuyan reply Psychiatry

Hello, the characteristic of obsessive thinking is that it tends to self-reinforce.
When we notice this thought in that moment, before we attach any value judgment of good or bad, there is actually no fear associated with it.
It is only when we have a fleeting thought that this idea is frightening or dirty, and feelings of disgust arise, that the persistent fear can suddenly escalate.
The more we try to rid ourselves of this obsessive thought, the more we end up thinking about it, inadvertently giving it more power to grow.
If you have observed how individuals with obsessive-compulsive disorder (OCD) manage their obsessive thoughts or how those with depression cope with negative thinking, you would understand that it is not because they have come to terms with it or are no longer afraid, but rather because they gradually feel that they no longer need to dwell on these issues, regardless of how their initial concerns may evolve, and thus they slowly recover.

Now that you are abroad, you may be experiencing a phase of self-reinforcing obsessive thinking.
If you can redirect your attention and engage in daily activities such as learning, leisure, and social interactions, this vicious cycle will not escalate further.
Redirecting attention does not require force or willpower; it simply involves noticing the obsessive thought and gently shifting your focus to the various sensations of the present moment in the real world.
Some people redirect their attention to their breathing, while others focus on bodily sensations or muscle movements to interrupt the cycle of obsessive thinking.
If this approach is still ineffective, medication can also be an option.

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

Reply Date: 2016/02/14

More Info

Overcoming intrusive thoughts and managing mental health challenges can be a complex journey, especially when dealing with anxiety and obsessive-compulsive tendencies. Your experience highlights a common struggle many face when intrusive thoughts lead to compulsive behaviors and heightened anxiety.
Firstly, it's important to understand that intrusive thoughts are unwanted and often distressing thoughts that can pop into our minds unexpectedly. They can be about a variety of topics, including fears of harming others or oneself, which seems to resonate with your experience. These thoughts can be particularly troubling when they conflict with our values and sense of self. In your case, the fear of accidentally harming someone due to the use of agricultural chemicals has understandably caused significant distress.

Your actions, such as checking the cleanliness of kitchen utensils and contemplating the effects of consuming pesticides, reflect a common compulsion associated with obsessive-compulsive disorder (OCD). These compulsions are often attempts to alleviate the anxiety caused by intrusive thoughts, but they can lead to a cycle of increased anxiety and compulsive behavior, which can be exhausting and debilitating.

It's commendable that you have sought help and have been on medication, which has helped you move from a place of despair to being able to live and work. The fact that you have been able to manage without medication for five months is a significant achievement, indicating your resilience and determination. However, the fear and anxiety you describe suggest that you may still benefit from professional support.

In terms of your question about whether your doctor would recommend continuing medication, it ultimately depends on your current mental health status and how well you feel you are coping without the medication. Some individuals find that they can manage their symptoms through therapy, lifestyle changes, and coping strategies, while others may require ongoing medication to maintain their mental health. It’s crucial to have an open and honest discussion with your healthcare provider about your experiences, fears, and the effectiveness of your current coping mechanisms.

Cognitive-behavioral therapy (CBT) is often recommended for individuals dealing with intrusive thoughts and OCD. CBT focuses on identifying and challenging negative thought patterns and developing healthier coping strategies. Exposure and response prevention (ERP), a specific type of CBT, can be particularly effective for OCD. It involves gradually exposing yourself to the source of your anxiety (in this case, the fear of using contaminated utensils) and learning to refrain from the compulsive behaviors that follow.

In addition to therapy, consider incorporating mindfulness practices into your daily routine. Mindfulness can help you become more aware of your thoughts and feelings without judgment, allowing you to observe intrusive thoughts without reacting to them. Techniques such as deep breathing, meditation, and grounding exercises can also help reduce anxiety and improve your overall mental well-being.

It's also essential to build a support network. Sharing your experiences with trusted friends or family members can provide emotional support and help you feel less isolated in your struggles. Connecting with others who have similar experiences, whether through support groups or online communities, can also be beneficial.

In summary, overcoming intrusive thoughts and managing mental health challenges is a journey that often requires a multifaceted approach. While medication can be an essential part of treatment for some, therapy, mindfulness, and support from loved ones can also play crucial roles in your recovery. Continue to communicate openly with your healthcare provider about your experiences, and don't hesitate to seek additional support if needed. Remember, you are not alone in this journey, and there are resources available to help you navigate these challenges.

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