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OCD or actual thoughts (tw for sui id)


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It's kind of embarrassing that I've had OCD for so long and I can't tell the difference but anyway.

I'm having a hard time distinguishing between OCD thoughts and actual suicidal ideation. The thoughts are mostly just repetition, things like 'you need to die' or 'you will die', with some intrusive thoughts as well. I can't really tell if I'm actually suicidal and the OCD is just repeating it, or if this is something the OCD is throwing at me for some reason. BPD kind of makes me switch between wanting to live/not wanting to live, so it's just really confusing. I don't want to, and have to real plans in place, but the thoughts are quite noisy. 

Anybody else ever experience this? How were you able to tell the difference/know when to take the thoughts seriously? (Not taking meds nor am likely to get any if thats helpful information?)

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yes, absolutely I've experienced this. it's super scary, and I'm sorry to hear you're experiencing these thoughts. I had trouble telling the difference at the time too, but in hindsight it's clear to me that I was having OCD-like intrusive thoughts. the primary tell: I didn't really want to follow through on any of the plans that I was obsessing over. I was just worried that I would, or should. in other words, I found the thoughts distressing rather than ego syntonic. when I was going through this it helped a lot to label these thoughts as OCD rather than real urges (tdoc's advice, and I found it helpful). 

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I think mine are a little more ego-syntonic (being depressed and borderline can do that to you) but still not really bad enough to actually want to do anything. But yeah, pretty sure it's the OCD. Did you find yours came and went sporadically, or was it more an intense episode?

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I was rapid cycling between mania and depression at the time, after taking an SSRI intended, ironically, to treat my OCD. It started with intrusive thoughts (OCD) of self harm and escalated to the point of intrusive thoughts about suicidal acts. I was so out of it at the time that I couldn't tell the difference between OCD and not-OCD. So I guess yea, it happened during a period of intensity. I also have bipolar and my OCD tends to change in terms of intensity and focus alongside my moods. My mood is stable right now and I don't have any self-harm intrusive thoughts.

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That kind of makes sense... BPD mood swings (albeit, far shallower than bipolar swings) can influence the OCD. Maybe it's because I was kind of elevated when I wrote this. Although, being depressed can also make me have suicidal OCD thoughts... This is so damn confusing. But thank you for sharing your experiences. Especially since being deep into one mood or another can make differentiating the illnesses confusing.

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I have this problem as well. I have intrusive thoughts of self harm/suicide due to OCD, but I also get suicidal ideation due to depression. I'm not very good at telling the difference. Usually, the intrusive OCD thoughts are more distressing to me than genuine suicidal ideation. Which sounds backwards, I know. But when I have an intrusive suicidal obsession, I get really anxious and scared that I'm going to follow through and I engage in compulsions/mental rituals to try and stop myself (even though I know intellectually that obsession doesn't equal action). When I have suicidal ideation, it's more I can't take this anymore, I need a way out, and I'll make plans for how I could do it. Thinking about suicide in that context doesn't make me anxious like the intrusive thoughts do - in fact, the idea of it is almost a relief. 

I don't know. Sorry if this isn't very helpful. I still get very confused. I usually need by tdoc to help me sort it out.   

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I know what you mean, there's a big difference between worrying about what you are capable of and starting to feel like it's a relief? Your tdoc sounds good, I hope they help you figure this stuff out. Obsession doesn't mean action, but it's hard when your own thoughts are trying to do bad things/make you do bad things.

There's another level of confusion here (for me anyway), in the sense that I've started to indulge the thoughts? I don't want to die (hooray) but I'm very happy thinking all sorts of messed up stuff about my own demise. But I never indulge OCD thoughts. Aside from the fact that I've done a bit of CBT/thought training/etc, my first impulse is always to reject intrusive thoughts because they are usually pretty disturbing? Throwing my phone off of a balcony is bad, punching pedestrians is bad, setting myself on fire, fine? 

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