Obsessive, Intrusive Thoughts
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Q:  Obsessive, Intrusive Thoughts

I was diagnosed as BIpolar 4 months ago,after I had psychosis being 41 years old I was shocked.I was put on lithium,but have been battling with these obsessive thoughts,intrusive thoughts like a fast hiccup in my brain they are completely the opposite of me,fears,violence,sexual,blaspheme for example. What does this sound like to you and is there a treatment for this?

Desperate,please help in between psychiatrist now,because I need to be taken seriously.

Dear Cheryl -- 
Yes, those symptoms should be taken very seriously.   They can indeed be symptoms of bipolar disorder, although you'll have to be keeping in mind some other diagnoses as you go in case the treatment of bipolar disorder doesn't get all your symptoms under control: e.g "obsessive compulsive disorder", OCD.  But the usual medication treatment for OCD (as opposed to the psychotherapy approach called cognitive behavioral therapy (CBT)), is antidepressants.  And antidepressants can make bipolar disorder worse.  But "mood stabilizers" we use for bipolar disorder don't make OCD worse, generally.  So most mood expert psychiatrists I think would start by treating the bipolar side of things first and hope that got the whole collection of symptoms, which in my experience is clearly possible much of the time.  You need to hook up with a doc' (obviously; I hope things allow you to do this pronto) who can learn about the role of mood stabilizers and their combinations and see if that's the right thing now (somebody thought that 4 months ago).   Good luck getting to such medical care quickly. 

Dr. Phelps

Published September, 2001


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