I Suffer from Obsessive Thoughts that Last Months or Years

Reader’s Question

I am hoping with your experience you can help me. I suffer with “obsessions”, one thought that will stay with me almost the entire time I am awake. They can go on for months, sometimes years. They can vary but usually don’t really involve something I am really worried about. I start out worried about it, but in the end thoughts kind of cement to my brain. Two years ago I went to see a psycholgist because I began obsessing non-stop about going crazy. Here is the thing, I have had treatment on and off for one year and basically I still have the same thought in my head. The difference is now I obsess about not being able to stop therapy for fear that I will go crazy. Naturally I am too embarassed to discuss this with the therapist and I want to quit but the thought causes me major anxiety. It’s like the therapy itself has become some sort of ritual for me that I think will prevent me from going crazy. Maybe I should have taken medication for this all along. I know it sounds like the most stupid problem, it’s just all day long I have to put up with the same thoughts and it is very frustrating to have the same worry all along. How could I possibly be so worried about something that it is in my mind all the time? What should I do? Should I quit my sessions and deal with the anxiety? Will it make me worse?

Would look forward to your professional opinion, thanks.

Psychologist’s Reply

Obsessive thoughts are associated with both Obsessive-Compulsive Disorder and Depression. Both of those are linked to low levels of the neurotransmitter Serotonin. As you discovered, obsessive thoughts can take many forms and can be about 1) nothing special, 2) fears, 3) doom and gloom, 4) religion or sex, 5) germs, and even 6) “earworms” — a song stuck in your head. If you review the responses under the OCD link in the sidebar of this page, you’ll find lots of questions and discussions on obsessive thoughts.

The obsessive thoughts you describe are very common. People obsessively worry about insanity, death, therapy, relapse, etc. While the topic/subject of the obsessive thought is different, the neurobiological mechanism remains the same — increased anxiety, increase thinking speed, obsessive thoughts, and attached rituals. Due to the strong link with low Serotonin, I recommend medication for OCD and depression. As Serotonin availability increases in the brain, the obsessive thoughts will reduce, then fade. I would also recommend that you continue with your psychologist. There is no problem discussing your thoughts with the psychologist and the combination of therapy and medication offers the best opportunity for improvement in your situation.

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Medications are very effective in dealing with the obsessive thoughts. However, in the future, the presence of obsessive thoughts will always be a warning sign that you’re becoming stressed. Anyone who has been very depressed can tell you what their warning sign will be — headaches, thoughts about a deceased loved one, obsessive thoughts, dreaming about a trauma, etc. The brain operates in a predictable manner. We just need to recognize the pattern. Years from now, if the obsessive thoughts return, you’ll need to return to medications.