Reader’s Question

I am being tortured by very disturbing Intrusive Thoughts. My GP is treating me for Depression, and he has given me Citalopram. I would like to know what’s causing this terrifying disorder.

Our Clinical Psychologist’s Reply

Two things are probably producing your intrusive, disturbing thoughts. You are being treated for depression, and the presence of obsessive thoughts, especially thoughts that are personally/morally offensive, is very common in depression. When we’re depressed, the brain generates evil/disturbing thoughts and searches our past memories for anything it finds upsetting. In the bottom line — such thoughts are common in depression.

The second problem is that some antidepressant medications can accidentially increase the number and intensity of these disturbing thoughts. When this happens, it’s important to remember that it’s a chemical reaction — not anything you should pay attention to — although they can get pretty nasty. Most commonly, people get increased thoughts of suicide, death, homicide, profanities, and other morally uncomfortable topics.

I’d recommend notifying your physician about the increase in obsessive thoughts. Again, this is very common — but highly uncomfortable. It can be corrected with a medication adjustment. For more information on this topic, you can read my handout on Understanding Depression or review the articles on depression and antidepressant medication available on this website. Remember, this tells us there’s a need for a medication adjustment — those thoughts are not to be followed, seriously considered, or thought about. In fact, your best bet is to view them as passing thoughts and go about your business. If you try to repress them, they actually become stronger. It’s like trying to push a basketball under water. The harder you push it under, the stronger its resistance becomes.