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Dr John B
Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience:  PhD in Clinical Psychology, registered clinical psychologist.
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My daughter is having disturbing thoughts. She has been off

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My daughter is having disturbing sexual thoughts. She has been off her medicine for 3 months and just got back on because of her anxiety and her weird sexual thought process. I am worried about her and wonder if Zoloft is the best thing for her to be on. Do you have any idea what professional problem she really has? She has had anxiety problems since she was little but its only been since she's been off the medication that she has had weird sexual thoughts.
Sorry to hear of the situation. Sexual thoughts of an unwanted nature can occur as part of a few different disorders, one of which is Obsessive Compulsive Disorder (OCD). OCD is an anxiety disorder and given that you mention that she has a long history of anxiety problems my first query would be whether the thoughts she is experiencing are OCD in nature. OCD can involve obsessive thoughts (repetitive thoughts about a specific topic) and compulsions (repetitive actions or behaviors). There is a well known sub-category of OCD that involves repetitive unwanted sexual thoughts and perhaps this is similar to what she is experiencing. OCD is often treated with SSRI antidepressants (Zoloft is one of them) so perhaps her treating clinician suspects something similar?
Can you provide me with a little more information:
Does she (or your family) have a history of psychotic illness?
Does she have a history of Major Depression?
Does she find it difficult to make the thoughts stop or go away?
Does she clearly acknowledge that they are 'thoughts' and a product of her own mind?
Customer: replied 5 years ago.
My husbands mom was seriouslt nuts and never properly diagnosed. No she doesn't have a history of major depression. She has a terrible time making the thoughts go away. She is always worried about the what if's and feels like a terrible person that she keeps having these weird thoughts. She does know they are just thoughts but is clearly disturbed about it. Her husband just graduated from PA school and I think she just about has him nuts also. IT is so sad...
Customer: replied 5 years ago.
My husbands mom was never diagnosed correctly. She had major mental problems. No major depression, finds it extremely difficult for thoughts to go away and it makes her think that she isn't a good person. It's very sad. She does clearly know that they are thoughts but it still upsets her a lot.
Hi. Thanks for the extra information. It does sound more and more like OCD and based on what you have written so far OCD would be my first assumption. I can provide you with detailed information about OCD and advice on possible assessment and treatment if you would like?
Customer: replied 5 years ago.
that would be great. Is it treatable and will it go away? Her OBGYN told her that she also thinks it is OCD. Do you think Zoloft is ok to be on if she gets pregnant?

Her OBGYN will be the placed person to advise her on continuing Zoloft through pregnancy and I would be outside my area of expertise to comment on that specific aspect of her situation.

It does sound like she is experiencing obsessions so I will discuss them here before moving on to treatment options.

Obsessions are thoughts or images that are difficult to stop. An obsession is intrusive and normally seen as irrational, but the person is not able to stop or ignore these thoughts. Some common obsessions include the fear of becoming sick from germs, worrying about whether the stove was turned off when they left the house, worrying that something bad is about to happen to loved ones and worrying about certain thoughts that keep occurring. People often feel fear along with the obsessive thoughts.

Sometimes obsessions will be mild, only occurring once in a while. Other times
obsessive thoughts will be constant. The thoughts can sometimes intrude into a
person's daily life and are unwanted. Obsessive thoughts can interfere with
daily life, causing strain in relationships and in the workplace. When obsessions and compulsions become more extreme people can be diagnosed with Obsessive-Compulsive Disorder (OCD).

The good news is that obsessions are reasonably common and most definitely treatable. Cognitive Behavioral Therapy (CBT) is widely regarded as the gold standard therapy for obsessions and the National Institute for Clinical Excellence
recommends CBT as an effective treatment for OCD, see here. CBT is a psychotherapeutic approach that aims to solve problems concerning dysfunctional emotions, behaviors and cognitions through a goal-oriented, systematic procedure. Treatment is technique driven, brief, direct and time-limited (normally 10-12 sessions). CBT is used in individual therapy as well as group settings, and the techniques are often adapted for self-help applications.

Obsessive thinking is usually linked with a person's overall level of anxiety and so sometimes when a person is able to bring their anxiety levels down the obsessions diminish. Often obsessions become difficult to manage on your own and if this situation develops in her case then I would strongly recommend that she seek out a CBT trained therapist for an assessment and potential assistance. CBT is usually offered by Clinical Psychologists (although not exclusively) and she can contact the American Psychology Association for assistance in finding a suitably trained clinician. She can take a look at the American Psychology Association's locator service here . She can use this to find Psychologists in her area and there is a phone number she can contact if she wants a referral arranged. Also, she can take a look at an article published by the APA here. It's an interview with a senior Psychologist and covers some of the things she should consider when looking for a Psychologist.

She can make a start on by taking a look at some CBT based self-help material to begin learning some basic CBT techniques at home. Give her this document here

Also, I can recommend a book titled Coping with OCD: Practical Strategies for Living Well with Obsessive-compulsive Disorder and another book titled Getting Over OCD: A 10-Step Workbook for Taking Back Your Life. You can find both of these books on .

I hope this has been of some help. PLease let me know if you would like me t elaborate on any part of my answer of if you have further questions. Best of luck!

Dr John B and other Mental Health Specialists are ready to help you
Customer: replied 5 years ago.
You are amazing....What state are you in? This will help her alot and I'm excited to go over it with her. You have given us more information that anyone ever has. If I need you again can I request you? What do I need to do? I appreciate everything you have done in a very short time. She seriously thinks she is going crazy.
I'm actually not in the US, I'm an Austral***** *****ving in Sweden!
You can absolutely request me in the future and I would very much appreciate it if you did. Just write 'For Dr John' at the start of any question you post and I will get it. You can contact me directly with any questions you have regarding OCD or any mental health, clinical psychology or psychiatry related matter. Sometimes I'm not available for periods of time and so if you don't get a response within a day or two contact customer service and they'll be able to get a message through to me.
I'm glad this has been helpful. I'll check in with you in around a week and see how she is getting along. Best of luck!