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Intrusive Thoughts?

Question:

I’m seventeen and have shown signs of Bipolar Disorder for the past five years or so. My family is not exactly well-off, so getting a therapist and an official diagnosis will have to wait. The thing is, whether I’m up or down, I get insanely violent intrusive thoughts. Some are directed towards myself–without any suicidal feelings. I get sudden daydreams of hacking myself to bits, jumping in front of trucks, hanging myself, etc. More often, though, it’s directed at other people. In the hallway at school, I get sudden mental images of slamming a hatchet into a student’s neck. At work, it’s beating people’s heads into the till. There’s drownings, hit-and-runs, shootings, stabbings, arson… I feel like a monster. What can I do?

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  • Dr. Schwartz responds to questions about psychotherapy and mental health problems, from the perspective of his training in clinical psychology.
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Answer:

Getting a diagnosis and seeing a therapist cannot wait. Even for families with little or no money there are ways to get psychiatric help. There are not for profit mental help agencies that provide psychiatric services and that can help you get medicare to pay the expenses. You cannot afford to wait. Perhaps you can speak to your guidance counselor. You can also speak to your medical doctor.

Pehaps you have a Bipolar Disorder or not. Only a full diagnosis can determine that. However, you most certainly do have suicidal thoughts. Those fantasies of wanting to hurt yourself are most definitely suicidal. The other fantasies are homicidal in nature. Are these mere fantasies or could you do these things? I do not know you and cannot say with any authority or knowledge. You feel like a monster for having these thoughts and that means that you may have a good sense of self control. I can only hope this is true.

Clearly, one thing about you that stands out is that you are very angry. That can stem from depression, including the type of anger that can go with a bipolar disorder. Regardless of the cause of this anger you need help with it. While I do not want to alarm you, at the same time, I want to alert you to the fact that anger can spill over into action even if you have a good sense of self control.

You need to get help now and not wait for some future time. To repeat, help is available to you even if you go to a hospital emergency room to ask for help. They can set you up for the proper type of help you need. In addition to the guidance counselor and medical doctor, this is another way to seek help. They can refer you to the proper help in your community and get your application for medicare started.

Best of Luck

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