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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 constant harm thoughts towards myself and strangers.

Customer Question

I have constant harm thoughts towards myself and strangers. I keep geting mental images of me shooting someone using a knife and animal pictures. I have constant thoughts of alligators and i dont know why i have had mri of braiin and it was negative. i have tried multiple medications with no good effect currrently i take risperadal and klonopin and they do not control ny thoughts, Any suggestios as to what this is.
Submitted: 7 months ago.
Category: Mental Health
Expert:  LeahMSWuofm replied 7 months ago.
Hello: Thank you for writing to us. i am so sorry you are struggling with this. Since you describe these thoughts as constant and I would assume, unwanted, it is likely you are suffering from OCD. There are variations of OCD that result in compulsive thinking and/or ruminating. When you have obsessive thoughts without obsessive behaviors, it is termed Pure-OCD. In your case, there is even a more specific term for your pattern of thoughts which is called "harm OCD" where one ruminates on thoughts of harming themselves or someone else. Treatment for you condition is available but can take time. What have you tried so far in the way of treatment beyond the Risperdal and Klonopin? Therapy called "cognitive behavioral therapy (CBT)" and more specifically, "exposure and response prevention (ERP)" is indicated to help rid you of these intrusive thoughts and can be very successful. Have you ever tried this form of support?
Customer: replied 7 months ago.
i see a psychologist every week for erp and cbt. It doesnt help. I have tried every ssri and tricilic antidepressant nothing helps me
Expert:  LeahMSWuofm replied 7 months ago.
I am sorry to hear that. It sounds like you re being offered all of the right courses of treatment at this time. There may be some hope in trying to find an inpatient hospital setting that can work on your problem with a greater intensity/frequency and also provide a safer setting for medication adjustments. There may also be more breakthrough/advanced therapies of which i am not informed. I can opt out of this question and let others offer their ideas for what treatment options may remain for you given your OCD has been resistant to treatment thus far. I wish you all the best. -Leah
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, what medications have you tried in the past? Also what are your current doses for the Risperdal and Klonopin?
Customer: replied 7 months ago.
klonopin is 1mg and risperadal is 8mg a day. I have tried all the ssris and anafranil none of them helped with the thoughts.
Expert:  Dr. Z replied 7 months ago.
Thank you for your response. Usually an antipsychotic medication alone and a benzodiazepine are not going to be effective for treating OCD symptoms, which it appears you most likely have. I would recommend looking into Lamictal as the mood stabilizer has been shown to be very effective for treating OCD. In addition, your doctor may want to try some overdoses of the SSRI antidepressants as studies have shown this to be effective for resistant OCD (e.g. 300mg/day of Zoloft). The other option would be try older TCA antidepressants outside of Anafranil as these may be effective for treating resistant OCD as well.

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