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Suggest Treatment For Severe Anxiety Disorder

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Posted on Wed, 1 Mar 2017
Question: I have been suffering with terrible, involuntary intrusive flashing mental images throughout my head for the past 2 weeks. They are relentless and refuse to go away. With everything my eyes see, it becomes a flashing image of something terrible and horrible envisioned in my head. For example, when I see a blanket, my mind envisions me suffocating my baby with it. If I see a knife, my mind envisions me hurting the baby with it. It is no longer just stemming from my baby, but will jump to other people in my home, even onto my dog. There is no reason for why this is happening -- I absolutely love and adore my child and dog! I have suffered from anxiety disorder my whole life but have never experienced this before. I also am experiencing depersonalization and derealization very very badly in its chronic form.. I am so dissociated that everything in my house looks unfamiliar, as do my family members.

I really need some help. I am scared that it is the psychosis, even though such a lovely gentleman from this site confirmed that he does not believe it to be the psychosis at all. He is a psychiatrist as well.

thank you so much for your help and support!!!
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (1 hour later)
Brief Answer:
I reconfirm it is obsession

Detailed Answer:
Hello,
Thanks again for posting at Healthcaremagic.

We have discussed at length during last two days and I have confirmed along with Dr Bishnoi that it is not psychosis.

Rather than saying it simple anxiety I would say that it is definitely obsession with main theme of hurting self and loved ones despite having no intention to do so.

As The definition of obsession goes on "
1. recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress
2. the thoughts, impulses, or images are not simply excessive worries about real-life problems
3. the person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action
4. the person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without as in thought insertion)"

The above four criteria I have pasted from major classification system of psychiatry and I hope you will agree with me that your description meets word by word.


As suggested today morning I will request you to discuss same with your psychiatrist as venlafaxine have little potential in obsessive thoughts and SSRI are warranted.

I hope this reassures you that it is not psychosis.
As always I am ready to take more questions.

Thanks again
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ashok Kumar Choudhary (10 hours later)
thank you so much for your reply! I appreciate it. Can you please clarify something for me as I want to make certain of something please. Thank you kind sir for getting back to me.
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (42 minutes later)
Brief Answer:
Which part of definition you want me to explain

Detailed Answer:
Hello,
Thanks for reverting back to me.

Let me which part of the definition is not understood by you. As I can see that it is simplest terms but it is possible that you are not able to comprehend one or another part.

I request you to go through it and let me know which part not clear to you.

Thanks again.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ashok Kumar Choudhary (38 minutes later)
thank you kind sir for your reply. It is greatly appreciated.

I apologize for sounding repetitive. However I have never experienced this sort of thing and I am quite scared. I have never suffered from any mental illness and I am afraid that I may have something wrong with my brain.
you.
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (54 minutes later)
Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for follow up.

I understand that you never experienced these thoughts but we need to understand that anxiety was always there and they are directly related to your anxiety. In other words the obsession are part of anxiety spectrum disorder and occur due to same pathology characterised by deficiency of serotonin in certain brain areas.

I do not think your repetitive question are deliberate or you want to annoy somebody. Infact they are the part of pathology which you are experiencing.

We also need to understand that they are not normal but treatable condition like other anxiety disorders.

I hope this helps you further.
Thanks again.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ashok Kumar Choudhary (12 minutes later)
I understand your explanation and as I've stated before, I greatly appreciate you taking the time to explain it to me. But my question is : what is behind these intrusive images and impulses (is it anxiety, depression, psychosis, schizophrenia, bipolar disease)? For whatever reason, I feel like my mind is in some higher form and I also feel like my body is unable to relax. I have an extreme amount of dissociation-- let me explain this to you further. I feel as if my house and my family members are all strange and unfamiliar. I feel like I am trapped inside of my head and not living apart of the real world. I KNOW THAT this feeling is not normal. I haven't created my own reality but I live like I am outside of my body, as an observer watching myself, if that makes any sense to you. I feel like my head is constantly spinning and can't just stop and remain quiet. I am extremely confused and disoriented. And on top of it, I have the extreme suicidal obsessions or fear of suicide which is an intense incredible fear that is making me afraid of being alone. I get flashing mental images in my head of me killing myself -- they can be of seeing myself in a coffin, my wrists slit, or being hung. The amount of fear these images are causing is very distressing as I am sure you can understand and I would like to have some help understanding and processing all of this.

At this point I am not sure if this is what is defined as depression? I have never had it before so I don't know if it is that.

Thank you kind sir for all of your help. It is most appreciated and I would really like to know if what I am experiencing are suicidal thoughts because I am terrified that it is what I am having.

hope to hear from you soon. Thank
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (10 minutes later)
Brief Answer:
It is anxiety with secondary obsessive ruminations

Detailed Answer:
Hello,
Thanks for reverting back to me.

There is no doubt regarding their origin and association with anxiety. In refined terms the obsessions are most closely related to anxiety disorders when it comes to pathology and treatment options.

The recurrent suicidal thoughts are just one part of these obsessions and I think major impact on your brain.

I must clarify again that none of the described symptoms point toward, depression, psychosis, bipolar disorders and schizophrenia.

I hope this helps you again.
Thanks again.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ashok Kumar Choudhary (50 minutes later)
so do you think that I am describing is indeed 'suicidal thoughts ' that people must seek emergency help for? oh I hope not! I am so scared.
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (21 minutes later)
Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for follow up.

You do not need to go to emergency for suicidal concern. There is no plan for such acts and it can be reassured.

As I can see from your post over the last 48 hours I feel you need to be touch with health services so your health concerns can be addressed.

I hope this clarifies.
Thanks again.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ashok Kumar Choudhary (28 minutes later)
thank you for your help. By health setvices, what exactly do you mean? I donot understand.

thank you for your clarification on this.
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (4 minutes later)
Brief Answer:
Follow up

Detailed Answer:
Thanks for your feedback.

I mean to say that keep in touch with counsellor at this time. It is important as we sitting thousands miles away may not of any help.

Thanks again.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ashok Kumar Choudhary (21 minutes later)
not at all! you have been extremely helpful. There was one more question/experience that I would like your expert opinion on, if permissable. Please let me know if this is OK and I will send to you.

thank you as always.
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (0 minute later)
Brief Answer:
Follow up

Detailed Answer:
Yes definitely.

I will be more than glad to assist you further.

Thanks
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Ashok Kumar Choudhary (16 minutes later)
Thank you so much!

For example, since having my baby, if I see a blanket, it triggers a mental image in my head of me suffocating my baby with it. If I see anything that could potentially be dangerous, I see myself hurting her with it. I love my baby more than anything in the world and I would NEVER want to see her get hurt, especially by me.

I also get the flashing mental images of seeing myself dead, which I don't know where that one is coming from. I see myself wrists being slit, myself in a coffin, or myself hanging by a rope. It is very scary and frightening and I hope it does not indicate that I wish to kill myself. If I see the word 'SUICIDE', it gets me all scared and worried. I start sweating.

would you call this severe (extreme) anxiety or something like that? another example of something that had recently happened was when I was at the hospital where I work. I saw a man at the cafe that was staring at me and looked very creepy. All of a sudden, I got a mental image of the guy putting his arms around me and choking me! I hadto shake my head I was so scared. I don't know why my brain is looking for something fearful EVERYWHERE now. it's not even focused on my baby anymore. everything seems so scary and causes these intrusive images.

What about the severe dissociation that I am experiencing as well? can you provide any insight on that at all?

Thank you so much for your help. it means so much to me. Hope to hear from you soon.
doctor
Answered by Dr. Dr. Ashok Kumar Choudhary (30 minutes later)
Brief Answer:
Follow up

Detailed Answer:
Hello,
Thanks for follow up.

The mental images of any form including scary ones represent obsession and rather than calling it severe or extrene anxiety I would call it a different form of anxiety.

The simplest explanation for them is that' they occur because there is ongoing anxiety'. As we are aware that post partum period is significant life event and it is possible that it acted as precipitating factor for onset of new set of symptoms.

Dissociations do occur with them probably to nullify the impact of intrusive thoughts and images. In other words they do occur to protect the integrity of affected individual.

I hope this helps you further.
Thanks again.

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

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Dr. Ashok Kumar Choudhary

Psychiatrist

Practicing since :2000

Answered : 3355 Questions

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Suggest Treatment For Severe Anxiety Disorder

Brief Answer: I reconfirm it is obsession Detailed Answer: Hello, Thanks again for posting at Healthcaremagic. We have discussed at length during last two days and I have confirmed along with Dr Bishnoi that it is not psychosis. Rather than saying it simple anxiety I would say that it is definitely obsession with main theme of hurting self and loved ones despite having no intention to do so. As The definition of obsession goes on " 1. recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress 2. the thoughts, impulses, or images are not simply excessive worries about real-life problems 3. the person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action 4. the person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without as in thought insertion)" The above four criteria I have pasted from major classification system of psychiatry and I hope you will agree with me that your description meets word by word. As suggested today morning I will request you to discuss same with your psychiatrist as venlafaxine have little potential in obsessive thoughts and SSRI are warranted. I hope this reassures you that it is not psychosis. As always I am ready to take more questions. Thanks again