My beautiful, smart, confident, and happy 19-year-old 2nd year college student is going thought a harrowing experience, and I hope you can shed some light and hope for her. Literally, as though a switch had been hit, she was at a party with her friends (New Year’s Eve) and prior to any drinking, started having obsessive thoughts she could not turn off. They were related to the other girls (HOCD?), and she continues to have these thoughts — and the associated depression — especially when her mind is at rest. She now cannot even stand to be around other females and can’t even listen to some musical lyrics! She has had boyfriends for years and does not think she is gay, yet this is literally changing her disposition and outlook on life, and she feels hopeless. She has seen a psychiatrist here at home and will be treated while at school. She just started taking Zoloft a few days ago, prescribed by her doctor. Can you give any advice or counseling? She is so terrified this will change her forever.
Your daughter’s experience is associated with an Obsessive-Compulsive neurological mechanism. Obsessive thoughts can be triggered by a variety of situations and the content of the thoughts (homosexual fears, germs, rabies, radioactivity, STDs, etc.) is not as important as the mechanism that produces them. Obsessive thoughts are always uncomfortable and often against the beliefs and attitudes of the individual. Obsessive thoughts always torment the individual and tend to remain “locked on” or focused in one area such as germs, disease, contamination, homosexuality, etc. Obsessive thoughts regarding homosexuality are so frequent that we have used “HOCD” to represent obsessive and uncomfortable thoughts/fears regarding homosexuality, but in truth, obsessive thoughts target many subjects — we just don’t use specific labels for them such as ROCD (Radioactivity OCD) or AOCD (AIDS OCD). I mention radioactivity, as I practice near a nuclear energy facility and “ROCD” is a common obsessive thought in my area.
How did your daughter develop these obsessive thoughts? Obsessive thoughts can surface in several ways:
- Obsessive thoughts and other OCD symptoms are linked to low levels of a neurotransmitter called Serotonin. Low Serotonin is also associated with clinical depression. It’s very common for individuals who are becoming depressed — gradually becoming more and more depressed — to suddenly develop OCD symptoms. When depressed individuals experience a traumatic incident, it’s very common for that incident or issues associated with the incident to be the topic of obsessive thoughts. Depressed medical and nursing professionals, following a blood splash, may begin to obsessively think about disease or contamination. Depressed construction workers, if bitten by a spider, may become obsessed with rabies. While you mention clear depressive signs in your daughter, these may have been slowly emerging over the past number of months, with an incident at the party triggering the obsessive thoughts. A “party kiss” from an intoxicated female friend could have easily prompted the situation if your daughter was at-risk by already being depressed and stressed.
- When you mention a New Year’s Eve party, I’ve got to mention drugs — ingested intentionally or unintentionally (spiking her drink). One “recreational” drug that can produce OC symptoms is Ecstasy. Ecstasy is a drug that when ingested, releases large amounts of the neurotransmitter Serotonin, producing a warm, loving, at-peace-with-the-universe sensation. As Serotonin is also a body regulator, you have temperature flushes, dehydration, and other physical symptoms. When Ecstasy leaves the body system, users experience a form of Serotonin depletion. As in in the above, Serotonin depletion can produce obsessive thoughts. Sudden Serotonin depletion can produce obsessive thoughts related to the environment at the time, the same way that Dopamine surges (the neurotransmitter linked to paranoia) can produce dramatic delusions instantly related to the current experience. I worked with an individual who was using amphetamines while watching television. He suddenly developed the paranoid delusion that a regional restaurant was trying to kill him — probably from watching a commercial at the time. If your daughter had a euphoric experience at the party, followed by the obsessive thoughts, then Ecstasy is a likely candidate for this situation.
Additional recommendations include:
- Remind your daughter that she is experiencing a neurochemical event. While she may have obsessive thoughts about homosexuality, the brain might just as easily have picked cancer, rabies or — in my area — radioactivity. It’s the mechanism of the obsessive thought that is important, not the topic.
- Read the replies to similar questions by selecting OCD from the list of tags in the sidebar of this page. Once she understands the OCD mechanism, she can relax until treatment provides some relief. As a college student, she may be interested to know that OC symptoms can also include an “earworm” — that song or musical phrase that becomes stuck in your head and plays repetitively.
- The psychiatrist is on the right track. Zoloft is a Serotonin increaser. However, increasing the availability of Serotonin is a slow process — too much at once and you can become toxic. For this reason, she can expect gradual relief over the next four to six weeks. If she has no improvement in four weeks, consult with the psychiatric for a more aggressive approach.
- Read articles on Depression and Chemical Imbalance on my website at www.drjoecarver.com. Take the screening tests for depression and OCD on this website. It’s very likely that your daughter may already have been depressed before the party. There is no question that she is currently depressed, however, and she will need to continue with medication and therapy/counseling.
- Her experience will have created significant Emotional Memories — emotion-filled memories of these obsessive thoughts. I’d read my article on Emotional Memory on this website, as it offers strategies to deal with those memories of the experience.
- The fact that her obsessive thoughts increase when her mind is at rest tells us that her mind isn’t at rest. This increased mind/thinking speed is a classic low-Serotonin symptom. To combat it, suggest that she keep busy, even with puzzles and other distracting activities. Right now, the idle speed of her brain is too high, and it may be a week before it returns to normal.
- Remind your daughter that such an experience, while traumatic and needing treatment, won’t change the course of her life. Winston Churchill had frequent bouts with depression, before treatment was available, and called it his “black dog” that visited. With proper treatment, her depression and OCD symptoms will fade away. However, in my clinical experience, once you’ve had a bout with depression and OCD symptoms, what you’ve experienced will be a sign of stress in the future. For years to come, any time she experiences similar symptoms or concerns, it will be her personal sign that her stress level is getting too high. At that time, she’ll need to de-stress or return to treatment.
I hope this reply is helpful during this difficult time.
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