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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10547
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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I have a friend who thinks/feels she gonna hurt someone

Customer Question

I have a friend who thinks/feels she gonna hurt someone constantly, does that mean shes going through possible psychosis or something else if so what? What advice would you give..also she is isolating herself and finding it hard to eat just regular dail functions as one would?
Submitted: 7 months ago.
Category: Mental Health
Expert:  Dr. Z replied 7 months ago.

*This website DOES NOT constitute treatment and only provides information and advice in a Q&A format. For treatment (therapy and/or medications) you must go to a licensed professional in your area. Please note that anything said here is not private or confidential, as this is a public forum.

Hello and thank you for using JustAnswer. May I ask are these thoughts intrusive and repetitive? Does your friend ever act on these thoughts?What are the details of these thoughts? How long has your friend had these thoughts? And lastly how old is your friend?

Customer: replied 7 months ago.
From what she has told me it's intrusive and repetitive, no... no real specific besides she feels that way, according to her the past few weeks she says that its just making her feel crazy cause never was she like that, 25 its just stopping her from doing everything she loves, its almost like shes so depressed or maybe anxious shes cutting off the world, hardly eats and wants to talk
Expert:  Dr. Z replied 7 months ago.

The good news is that there is a good chance this is not a psychosis as she is not displaying delusions, hallucinations, and/or a disorganized speech pattern/thought process. But she may have a form of Obsessive Compulsive Disorder (OCD) known as Harm OCD. This can cause a person to have repetitive and intrusive thoughts of harming others or one's self. Most people never act on these thoughts, but they do get quite distressed by their constant presence and fear they may act on them at one point, even though they never do. If your friend has a history of anxiety, obsessive/ruminating thoughts, and/or depression than the chance for acquiring OCD is more likely. Tell your friend to go to a psychiatrist and explain the thoughts and how they are repetitive and intrusive, and ask if Harm OCD is likely and the psychiatrist will prescribe an effective antidepressant lie Luvox to help lessen these thoughts. In addition, he/she may refer your friend to get treatment with a psychologist, namely a combination of Cognitive Behavioral Therapy (CBT) and Exposure and Response Prevention (ERP) as this the standard and best therapy modality for treating all OCD disorders.

Expert:  Dr. Z replied 7 months ago.

I hope this helps to provide you some guidance on this issue. Please let me know if you have any other questions or concerns as I would be happy to continue assisting you regarding this issue.

*Please do not forget to leave a positive rating at the top of the page so that I can get credit for helping you. Thank you, ***** ***** appreciate it.

Customer: replied 7 months ago.
Shes never had anxiety until now because of those thoughts shes so scared cause there so constant everday a few times a day, wouldn't it be ahrd to tell a psychatrist that they would put her away she feels like she a harm to others and won't do a thing she's constantly crying cause its so much to process , i guess the antidepressant or any would work
Expert:  Dr. Z replied 7 months ago.

She has never acted on these thoughts and they are not very specific, like "I want to harm John Doe by using this weapon, etc..." so most likely she will not be considered a threat to others. Like I said most people with Harm OCD tend to have recurring, repetitive, and obsessive thoughts about hurting others or themselves, but they never act on them. She needs treatment or these thoughts are just going to cause her more and more distress. Here is a good link on Harm OCD if you want to show her to try to explain to her the symptoms:

If your friend had a psychotic disorder, it would cause hallucinations, delusions, and/or disorganized speech/thought process and that is not the case here, so most likely Harm OCD is the cause of these symptoms and this is very treatable with the right combination of medication and therapy

Customer: replied 7 months ago.
I just contacted her if she can be specific on those feelings she says that she kind of feels the urge to scream or that a person not a particular one but wants to hurt and that she avoids beign in the kitchen because of her thoughts im not sure if that would clarify anything about this
Expert:  Dr. Z replied 7 months ago.

I cannot diagnose her over the internet obviously, but everything you are stating points to this being Harm OCD given that these thoughts are repetitive and intrusive. Again the likelihood of this being a psychotic disorder is near non-existent and it is very unlikely she will ever act on these thoughts. With proper treatment, she will be able to overcome this, but she needs to go to a psychiatrist for medication management and a psychologist for therapy as soon as possible

Expert:  Dr. Z replied 7 months ago.

Well I am going to sign off, if you have any other questions please feel free to ask. If not, I hope that you will provide me with a positive rating as this is the only way I am credited for my time in helping you. Thank you

Customer: replied 7 months ago.
Ok thank you, ***** ***** is worried cause she took a test and said that it seem to be psychosis
Expert:  Dr. Z replied 7 months ago.

Online tests are notoriously unreliable and invalid. A true psychological assessment is done face to face. Your friend has no symptoms of psychosis, so it is unlikely she is experiencing a psychotic disorder. To have a psychotic disorder you need hallucinations, delusions, disorganized speech, disorganized thought process, and/or negative symptoms (flat affect, no emotion, no motivation, lack of hygiene, etc...). Your friend does not display these symptoms at all, which is why a psychotic disorder is likely non-existent for your friend.

*Please do not forget to leave a positive rating at the top of the page so that I can get credit for helping you. Thank you, ***** ***** appreciate it.

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