Intrusive Thoughts After Bout With Depression

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Reader’s Question

I’m fairly certain I’m experiencing something that’s not normal people for people to deal with. In my later teenage years I experienced a severe depression and received treatment and medication. The bad feelings slowly ebbed away, but since then I’ve been having feelings of extreme anxiety (constantly for the past three or four years), all relating to very intrusive thoughts about mutilation, bodily catastrophe, death, and of non-existence after dying. These thoughts seem to take more control and are more prominent when I am alone (which is most of the time) and have nothing else to occupying my attention.

I cannot escape these thoughts, and they invade what seems like every part of my mind. My chest begins to tighten, my heart races, I start sweating, and I can feel a tight discomfort at the base of my skull like the feeling before fainting/blacking out. These kinds of episodes give me the most anxiety, almost to the point where I feel “out of touch with reality” — and they happen at least once a week.

I’ve never told anyone about this.

The most I’ve done about it is try to control these thoughts by working them out in paintings and through other media such as writing and meditation/spiritual practices. So far nothing has made it go away and I am afraid of anyone knowing about it (besides anonymously). Recently I’ve been having trouble, especially in the few hours after I first wake up, distinguishing these images and thoughts as ‘not real’, if that makes any sense. Also, I want to make it clear that however bad these thoughts are, they have not made me suicidal. Those kinds of feelings went away with the depression. My main concern is to put a possible name to or get a professional read on what these symptoms might mean. If I know what I’m dealing with, I might be more inclined to see a therapist.

Psychologist’s Reply

Much of what you describe is consistent with the symptoms of an anxiety disorder. It’s not uncommon for anxiety disorders to co-occur with depression and even to linger when other depressive symptoms are resolved. And feelings of unreality are not an uncommonly reported symptom when anxiety levels are high.

Some types of anxiety symptoms can be so distressing that they strongly suggest danger to the person experiencing them. This of course only serves to exacerbate the anxiety and increase the frequency and severity of symptoms.

The good news is that anxiety disorders can be effectively treated in a variety of ways. My best suggestion: help break the vicious cycle by securing a consultation with a mental health professional experienced in the treatment of both mood and anxiety disorders.

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