I Keep Replaying Conversations with My Therapist in My Head

Reader’s Question

Would you be able to tell me if I have OCD or another problem and what I should do? I find this very tormenting but I don’t know who to ask. I had been seeing a therapist for help with some depression over a year ago, but I stopped once the depression seemed to have lifted. I went for maybe six months, twice weekly and then monthly.

But after I quit, I found that I was constantly having therapy session type conversations in my mind with myself. It was OK for awhile, maybe even helpful at first but then it kept on until the point where I am having these imaginary conversations with the therapist in my mind almost the entire day all the time. Its not like I am a stalker and have any interest in the therapist, I just can’t get this way of thinking out of my mind and it is driving me crazy. I can’t go for help because I will look like I am totally crazy, but I can hardly stand living with the same thing in my mind all the time. What do you think this could be from? I am cursing the day I ever went for help, it has made me worse.

Any thoughts would be appreciated…

Psychologist’s Reply

My immediate clinical impression? Your brain is running too fast! Those thoughts you are experiencing are often found in not only OCD (Obsessive-Compulsive Disorder) but Depression as well. It’s a situation related to brain chemistry. Depression can be produced by prolonged exposure to high stress, a situation that lowers the availability of Serotonin, an important brain neurotransmitter and regulator. Low Serotonin produces fatigue, sleep problems, poor concentration, appetite changes, and obsessive thoughts. The most common complaint with depression is “My mind won’t shut up!” OCD is also created by low levels of Serotonin so it’s not unusual for depressed individuals to have obsessive thoughts (as in your case), to begin counting everything, to become germ phobic, or preoccupied with illness. Depression, due to Serotonin being a body regulator, also produces leg cramps, stomach distress, hot flushes and cold spells, headaches, muscle twitches, etc.

This has nothing to do with stalking at all. Your depression has returned. The depressed brain always torments the individual with negative thoughts — usually something that is specifically bothersome to the individual. Ministers hear profanities, that kind of thing. The conversations with your prior therapist are replayed to torment you. No depressed individual ever hears positive or calming repetitive thoughts — it’s always tormenting.

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I would strongly recommend that you return to treatment. Maybe with a different approach. The presence of the OCD features suggests that an antidepressant medication might be needed. You can read more on depression on this website or my home website at www.drjoecarver.com. These intrusive thoughts can get worse so I’d consider seeing a psychiatrist or at least a physician as soon as possible.

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