Need help breaking free from addiction?
1-888-993-3112
Call 24/7 for treatment options. Ad Info & Options

OCD

Question:

Hello I have some problems with obsessions since I was young. Now I am 19 years old and I have a crisis. My obsessions vary since have all right to murder and suicide. I recognize these thoughts as not mine and I don’t want to kill or die, but I have the compulsion to do some actions, like pick up a knife and ask me if I want really die or kill or go into someone and think that I will strangle him. I have anxiety if I don’t do that but I got even more anxious if I do. After that, I ritualize in order to not repeat these processes, but sometimes I can´t. I would like to know if an OCD person can be a murderer or if this is really OCD.

This Disclaimer applies to the Answer Below
  • Dr. Schwartz responds to questions about psychotherapy and mental health problems, from the perspective of his training in clinical psychology.
  • Dr. Schwartz intends his responses to provide general educational information to the readership of this website; answers should not be understood to be specific advice intended for any particular individual(s).
  • Questions submitted to this column are not guaranteed to receive responses.
  • No correspondence takes place.
  • No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Schwartz to people submitting questions.
  • Dr. Schwartz, Mental Help Net and CenterSite, LLC make no warranties, express or implied, about the information presented in this column. Dr. Schwartz and Mental Help Net disclaim any and all merchantability or warranty of fitness for a particular purpose or liability in connection with the use or misuse of this service.
  • Always consult with your psychotherapist, physician, or psychiatrist first before changing any aspect of your treatment regimen. Do not stop your medication or change the dose of your medication without first consulting with your physician.
Answer:

There is now way any mental help professional can determine the nature of your thoughts and urges without directly talking to you. However, the fact that what you report goes beyond thoughts into actually picking up a knife makes it very dangerous. At least, that is my opinion. Also, thoughts of harming yourself or others can turn into action if they are persistent enough.

I want to encourage you to go for psychiatric help immediately. It would even be a good idea to go to the nearest hospital emergency room and report exactly what you are experiencing.

I urge this so that you avoid running any risk of harming your self or anyone else. Without a full evaluation from a psychiatrist or clinical psychologist, there is no way anyone can tell you that you are safe.

Under the circumstances this is the best possible advice I feel comfortable giving you. If you are not comfortable going for help by your self, perhaps a close friend or loved one can accompany you.

Please act quickly.

Best of Luck

More "Ask Dr. Schwartz" View Columnists

Comments
  • Anonymous-1

    It seems to me you know nothing about OCD. Most therapist will tell you to pick up the knife you show that you will not do it and to relieve the anxiety. What kind of therapist are you.

  • Allan N. Schwartz, PhD

    There is no way of knowing whether or not the individual who wrote the original comment has OCD or something much worse and something much more serious and dangerous. In addition, there is absolutely no therapist whether a psychiatrist, psychologist, social worker or psychiatric nurse who can guarantee that once a knife is picked up it will not be used.

    Dr. Schwartz

  • Anonymous-2

    People with OCD do not follow through with their obsessive thoughts. That is not something that happens within that disorder.

    However, it is possible that the person may suffer from another mental health problem. If I was him, I would go see someone, just to get some peace of mind.

    Really, the therapist has no choice but to suggest the person goes to seek help, and I think it would benefit that person enormously, however to suggest someone with OCD will act on an obsessive thought is not correct.

    Editor's Note: This is one man or woman's opinion, which unfortunately happens to be quite incorrect and not borne out by clinical experience or observation. Many people dealing with OCD do act on their obsessive thoughts. When this happens, the resulting behaviors are known as "compulsions" hence the phrase "obsessive-compulsive". Obsessions are unwanted pressured thoughts, and compulsions are behaviors that are acted out so as to try to relieve the pressure of the compulsions.

  • Leah

    I can relate because I have extreme obsessive thoughts that I struggle to manage. But what has helped me is to come up with a phrase that say I to myself everytime I have the thoughts (such have faith, or keep hope).
    I can completely understand how frustrating it is when you have no desire to cause harm and yet these thoughts are there. From my experience I have learned that my suicidal ideations had become obsessive when they started to relieve stress as a sort of escape tactic, like knowing that if things ever did get too bad I still had options. But this can be very dangerous as these thoughts can get worse and hard to distinguish between what is a random thought popping into your head and feeling of desperation.
    I highly advise talking with a psychiatrist about ways to handle this, either through meds, hospitalization, or an intensive outpatient program. You need to learn how to slow the thoughts and urges down (like with a phrase) and then come up with new skills to handle stress and think of healthy escape plans (like I'll take a walk, or I'll take a break)."
    This can be managable with some hard work, but it is definately worth it. Once you learn your triggers you can learn how to manage the thoughts. They may not entirely go away but they become nothing more than a nuicance like a fly buzzing around your head. I still have a random "I need to shoot myself now" thought completely out of no where but I can now just kinda laugh and think its funny because I have complete confidence in myself that its nothing more than a thought.
    I wish you good luck in getting help and your treatment process. I hope you choose to get help because without help they will only get worse much harder to ignore.

  • Anonymous-3

    Pick up the knife to realive anxiety?? Do you live in farytale world? Do not strugle with the DSM name, that doesn't help. Think about the situation.

  • Anonymous-4

    Im sorry but i wouldnt come here again for help mate, but what ur thinking is normal for ocd sufferers ur just sensitive to the thoughts, thats why uve responded by looking for help on here. And he never said he actually picked the knife up. Duhhh, this doctor hasnt even read what u have said. It is possible u need to see a psychiatrist but ihave been suffereing from ocd for so long and have never been to see one. Make sure u talk to some1 u trust, family or a friend before u go see some stranger. Good Luck.

  • common-sense

    well well well, another worthless scam of a site, nothing new. To the 19 year old, never come to this site if you want any real help, go see a DOCTOR and THERAPIST who is trained in dealing with OCD, not this joke of a site. People with ocd, as you already know, but can't tell yourself, never commit the terrible acts that plague them, the mere fact that you are aware this is a problem is a big factor...Please, for your own sake, never come to this site, because in all honesty, the so called 'help' you seek here is far more destructive than you can imagine.

    Editor's Note: The reason it is called Obsessive Compulsive Disorder is because both obsessions can be present (which are the repetative pressured thoughts), and also compulsions which involve the act of carrying out the object of the obession something that tends to have a calming effect if only temporarily. People with OCD do, with some frequency, but not always, act out their obsessions.

  • Allan N Schwartz

    To : Ocdey:

    I am very impressed by how astute you are. You have determined, without ever meeting this young man, that he suffers from OCD only and nothing else!! Well, what if he is psychotic and responding to voices that he is halllucinating? What if these voices are telling him to murder someone or kill himself. Ooops, I forgot: you are all-knowing. The young man has been advised to see a psychiatrist who will then determine the nature of his problem, be it OCD or something else. Sorry, I do not have your immense powers.

    Dr. Schwartz

  • Ocder

    A compulsion is STARTED to mask an obsession. It then becomes the obsession. If a person has OCD with harm thoughts which are NORMAL FOR PEOPLE WITH OCD... they will find a compulsion to try and MASK the obssesive violent thoughts!! A person with OCD will do anything to avoid harm thoughts ...they do not carry them because they are infact terrified of them!!!!!!! Its when you are not afraid of something and it doesnt phase you to harm your self or others....or when your psychotic, and lack reality and insight is when acting out can occur.

  • Allan N Schwartz

    Ocder, or whatever your name is, you are amazingly misinformed and I do not know where you get the "nerve" to question experts in mental health. Obsessions do not hide compulsions. Compulsions are repetitive and ritualistic acts, such as tapping the stove a certain number of times. Obsessions are repetitive thoughts that are part of compulsions, as for example: "I fear the stove will explode unless I touch it a certain number of times." That is OCD.

    There is such a thing as an Obsessive Personality Disorder: A very rigid person who cannot get their work done because they are so focused on every detail that they lose the main picture. Its the old story of the person who can "only see each tree, but, not the forest." This is a personality disorder and, yes, sometimes, this can mask a psychotic disorder because the person is desparately trying to hold on so that they do not "Lose It."

    Dr. Schwartz

  • kristin

    what kind of therapist are you??? you clearly are not trained in anything other than how to be completely incompetent. I agree with the comment before mine...I have ocd and my therapist has ALWAYS told me to pick up a knife and think the WORST thoughts to counteract the ocd. So, you're bullshit response is horrible and will not help anyone with ocd WHATSOEVER! Please visit the ocd foundation website to get ACCURATE information on this disorder!!!

    Editor's Note: Lots of hostility in this thread for some reason and that is really unfortunate. Dr. Schwartz is essentially suggesting, I believe with much merit, that if someone has obsessions that involve knives, that this could be a situation which is highly dangerous and should be evaluated by a local doctor who is competent to evaluate and treat OCD or psychosis or whatever this happens to be. Please everyone keep in mind that diagnosis cannot be done over the net and that when knives and other weapons are involved it is better safe than sorry. As a variety of anxiety disorder, OCD can benefit from exposure treatments designed to foster habituation to the anxious obsessive thoughts. Exposure treatments might take the form of getting into the uncomfortable situation and then sitting there long enough for the fear to drain some and new learning to occur. This is probably what people are refering to when they report that their therapist is having them "think the worst thoughts" or to "pick up the knife". The intention is very likely that if these worse thoughts are thought, or if the feared knife is actually picked up and that these postures are held long enough for habituation to occur, that some learning will also occur that these things are not so dangerous. There is a big difference between someone who is in treatment and under the supervision of an experienced therapist being instructed to "pick up the knife" and some random if well intentioned person urging some other random person to "pick up the knife" in order to relieve symptoms. What if this is not OCD? What if it is OCD but this particular instruction is a bad one for this particular person? Because the true diagnosis is not known here, and neither is the particulars of this particular person (which are vital for treatment planning), urging someone to take a particular therapeutic course other than to get themselves evaluated and treated locally is simply unwise.

  • Anonymous-5

    I can understand this doctor being concered if the person does not have OCD, but if he does, he is judging him all wrong.

    As far as the editor's claim that people with OCD act on their thoughts with frequency, that is absolutely not true. People with OCD do not act on their thoughts. The editor infers that acting out the thought is the compulsion. It is not. The compulsion is the checking or the counting or doing whatever to make sure the thought it not real. OCD has NOTHING to do with acting out the thought. To tell people with OCD that it does is the worst thing you can do (and the most inaccurate thing).

    The compulsion is merely the checking. Thus, if you have a thought about stabbing your child, the compulsion IS NOT that actual act of stabbing your child. Rather, it is the CHECKING to make sure your child is okay. People with OCD are not violent. If they were, their violent thoughts would never bother them. They would do the exact opposite and give them pleasure. People who have OCD are more harmless than the general public, they just don't think they are.

    Dr. Dombeck's Note: Perhaps a bit of clarification is in order here. An obsession is an unwanted repetative thought. A compulsion is a repetative behavior designed to reduce the emotional impact of the obsession. It is true that people with OCD have obsessions and act on them with frequency, in the form of behavioral compulsions. The commenter seems to be suggesting that we editors believe and are suggesting to the world that a compulsion is an acted out obsession and that is not the case. Instead, as the commenter suggests, the compusion is a separate behavior designed to calm the frantic emotion associated with the obsessive thought - such as checking. It is instead, an act in response to the obsession.

    As I read through these comments today, I think I myself may have introduced some of this confusion with my Editor's Note of August 20th, 2008 where I suggested that people do respond to obsessions by creating compulsions. The author of that comment said, "people with ocd do not follow through on their obsessive thoughts...", and looking back at it now, I think I read the meaning wrong myself as my response was "people with ocd do act on their obsessive thoughts". But what I meant by action in that context was the development of compensatory behaviors such as checking - not the acting out of the deepest fear. Consider the present comment a retraction and restatment of the earlier one.

    What I see happening in this thread emotionally is similar to what I see in some other threads, and what I take is something that is easy to happen when you are communicating digitally such as by email. Some information gets misunderstood or stated without full context and suddenly everyone assumes the worst - that the people answering the question are completely incompetent - and anger flares. As it turns out, I think there is more shared understanding here than has been previously understood (at least as far as it goes with the understanding of what a compulsion is) and the anger is based on what I believe are misunderstandings. But people don't generally have the ability to look for the misunderstandings so that they can be resolved and instead just get angry - uselessly. It's kinda sad.

    The final thing I'll say tonight is that it really is not wise to assume that no person with OCD would ever act out an obsessive violent thought. As Dr. Schwartz points out, co-existing disorders or conditions (such as psychosis) can complicate the situation which cannot be properly evaluated online. Mental Illness - probably any form of illness - is tricky and variable. While many cases may always proceed in a particular way, there will always be an exception or several exceptions that proceed in another direction. Any therapist or physician who tells you that things always go a certain way or that a particular thing will never happen is probably oversimplying things for you. Anyone thinking that they can definitively diagnose someone over the internet on the basis of a few lines of text has a misundestanding of the complexities of the diagnostic process.

  • Fred

    I dont know whats wrong with me. I don't know how anyone can live with OCD?! its so hard to keep those thooughts out of your head. Can someone please talk to me.

  • Anonymous-6

    I have been struggling with suicide thoughts because of my ocd. I have tried reading the bible, but it hasn't helped me overcome my problems. I'd like to try magical mushrooms, does anyone know where I can get some? I'm desparate.

  • ed

    It seems that so many people have nothing better to do than to criticize others efforts agt helping people. Can people really be so inconsiderate, opinionated and generally full of themselves?

    The people who are providing this forum are not being paid for their time. They are trying to give to the community.

    To say that a person is NOT going to harm themselves without further diagnosis is incredibly shortsighted.

    If you don't like what the therapist says simply move on.

  • Anonymous-7

    Everyone has an interesting and good point of view.

Close

Call the Helpline Toll-FREE

To Get Treatment Options Now.

1-888-993-3112 100% Confidential

Get Help For You or a Loved One Here...

Click Here for More Info.

Close

Call The Toll-FREE Helpline 24/7 To Get Treatment Options Now.

100% Confidential
Get Treatment Options From Your Phone... Tap to Expand