Suggest Treatment For Intrusive Thoughts While Having Anxiety

Posted on Mon, 27 Feb 2017

Question: I have been suffering from intrusive mental images. they just suddenly started appearing and I have had anxiety disorder all of my life. I am scared that they are the psychosis. These images TERRIFY me. I also suffer from depersonalization/derealization and now all of a sudden, I feel that everything is strange and unfamiliar. Everyday life seems strange to me, although I know what I am doing and I am functioning normally (according to others, as I have asked numerous times). The mental images jump from one thing to another - one minute they will be about my baby and me visualizing myself hurting her (please don't misunderstand me -- I DONOT want to harm my child I am absolutely fearful of anything happening to her, so much that I am afraid to be alone with her in fear that I would do anything unintentionally). I am just so scared I don't know own what to do anymore. I am constantly in a great amount of terror and I am afraid that I have this condition called the psychosis. What if I end up killing myself?

I have seen a psychiatrist and have been placed on Effexor and have started at a low dose and just had it increased to 75mgs. But what if it doesn't help me? I am scared that I am going to die from this. Please if you can help I would really appreciate it. Thank you so much for your reply.

Answered by Dr. Seikhoo Bishnoi (2 hours later)

Brief Answer:
These symptoms are not psychosis

Detailed Answer:
Hi thanks for asking from HCM

I can understand your concern. First of all I'd like to tell you that the symptoms you've mentioned are not due to psychosis but are probably due to severe anxiety possibly due to OCD. The intrusive, distressing and dominating imagery is part of obsessive imagery.

Thoughts of hurting your child when you don't want to think about that are also obsessive thoughts. Fear of even having psychosis is also part of OCD.

None of your symptoms suggest psychosis. So remain relaxed you are not having psychosis. You will not die from these symptoms. These symptoms can be treated with medicines like SSRIs or SNRIs.

Venlafaxine is a SNRI drug and is efficacious in controlling depression and anxiety symptoms. The drug will help to improve the symptoms in about 4-6 weeks. So please avoid thinking about this, you have no psychosis. With Venlafaxine your symptoms will definitely controlled.

Thanks

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Seikhoo Bishnoi (29 minutes later)

so the obsessive imagery is a result of the severe anxiety? I just want to make sure that I understand you correctly or I will be very worried.

Thank you for letting me know.

Answered by Dr. Seikhoo Bishnoi (2 hours later)

Brief Answer:
Yes it's a result of severe anxiety

Detailed Answer:
Hello again

Yes obsessive imagery is part of severe anxiety. Anxiety results in obsessive thoughts.

This is not considered as psychosis.

Thanks

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Seikhoo Bishnoi (1 hour later)

but are "thoughts" the same as "images"? that is my question...thank you.

Answered by Dr. Seikhoo Bishnoi (4 hours later)

Brief Answer:
Yes we can say they are same

Detailed Answer:
Hello thanks for asking

Yes ideas, images, impulses and thoughts are almost same. These are seen in obsessions.

Thanks

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Seikhoo Bishnoi (20 minutes later)

obsessions? I thought that this was all related to anxiety? Am I misunderstanding? I am sorry if I have.

Answered by Dr. Seikhoo Bishnoi (4 minutes later)

Brief Answer:
Obsessions are related to anxiety.

Detailed Answer:
Hello again,

Obsessions are ideas, images, impulses or thoughts that produces significant distress. These are part of significant anxiety only.

If we go by classification then Obsessive disorders fall under anxiety disorders only. You are not misunderstanding.

The intrusive thoughts are occurring due to anxiety and are part of obsessions.

Thanks.

Above answer was peer-reviewed by : Dr. Nagamani Ng

Follow up: Dr. Seikhoo Bishnoi (40 minutes later)

Thank you very much for your detailed response. So, in other words, if I am able to try and reduce my anxiety level, will the mental images I am envisioning (involuntarily ofcourse) slowly start to lessen and go away? That is what I am hoping for.

Answered by Dr. Seikhoo Bishnoi (15 minutes later)

Brief Answer:
With reduction of anxiety the intrusive images will go away.

Detailed Answer:
Hello again

Yes with reduction of anxiety these symptoms will reduce by own. Medicines along with relaxation therapy are best modality of treatment for this. These will go away with improvement of anxiety.

Thanks. Just stay relaxed, this is not a serious thing.

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Seikhoo Bishnoi (24 minutes later)

I hope so because there is one specific image that is reoccurring that is bothering me greatly. May I describe/explain it to you in further detail please? thank you!

Answered by Dr. Seikhoo Bishnoi (24 minutes later)

Brief Answer:
Yes please provide more details.

Detailed Answer:
Hello again

Yes, please describe in details. How the images started appearing? Tell me about onset, any significant stressor prior to development of the symptoms? What kind of images you are seeing? Do you have awareness that the images you are seeing are not real but only in your mind?

Please provide the details.

Thanks.

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Seikhoo Bishnoi (6 hours later)

thank you again for your reply.

Yes, I know that the images are all in my mind. They are flashing and almost always related to my baby If I see a knife, I will envision her being hurt by it. If I see a blanket, I will get a flashing image throughout my head of her being suffocated with it. It is as if my brain is on some high alert or something and is constantly looking for something to be scared of. Whatever I see, it can turn it into something fearful to.scare me.

I am not purposely imagining these things, just so you know. The images occur involuntarily, come and go with different levels of intensity, and are tremendously bothersome.

Thank you again for you help!!!!!

Answered by Dr. Seikhoo Bishnoi (30 minutes later)

Brief Answer:
These symptoms are part of OCD only.

Detailed Answer:
Hello again

Thanks for providing details.

The symptoms don't point towards psychosis. You can remain assured. You have awareness that these are not real images. The ideas or images are coming in your mind following some stimulus like seeing a knife or a blanket or anything. The intrusive ideas which are repugnant, purposeless, dominating and are resulting in distress in your mind are nothing but part of OCD or Obsessive compulsive disorder.

As I've mentioned earlier too that this is a type of anxiety disorder. Relief of anxiety will decrease these intrusive ideas and you will feel better.

So please continue taking Effexor and if needed ask for increase in doses. For OCD or anxiety like symptoms SSRIs are better drugs compared to Effexor or other SNRIs.

Thanks.

Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Kampana