Advice

[jimbododdy]

Hi everyone,

I wonder if anyone can help me out. I have suffered with Generalised Anxiety Disorder (GAD) since I was assaulted in the street in an unprovoked attack some years ago. I take an anti-depressant drug and at the moment my GAD is (sort of) better than it was.

However, for the last year or so I have been having intrusive thoughts. I have these thoughts very frequently, but they are more intense and more prevalent in certain situations. For instance, when I am in a car on a Motorway these days (I don't drive but my brother does), I begin to think "What if I open the car door and throw myself onto the Motorway?" and I become almost convinced that I am actually going to do that. I then have a full blown panic attack that seems never ending. I now completely avoid motorways. Also, if I stay in a hotel room that is a few floors up, I become terrified, literally terrified, that I might throw myself out of the hotel window.

I am due to begin cognitive therapy next month, but before then I have to attend the funeral of my uncle in a completely different part of the country. It will involve a very long car journey and several hours of Motorway travel. It will also entail an overnight stay in a high rise hotel. What can I do? I would be so grateful for any suggestions.

Thank you.

[MyNameIsTerry]

Hi Jimbo and welcome to NMP :welcome:

I've had these issues myself over the years with OCD and I'm clear of them now. I still get them but my reaction has changed to be non judgemental by learning Mindfulness so I always encourage this. It is also used to treat anxiety as well and is NICE approved in its MBCT form for reoccurent depression. Your CBT therapist will be aware of itand mine actually started me off on it. MBCT is a blend of Mindfulness and CBT anyway so it can be easily used alongside CBT as long as your therapist is ok with it.

See Tish's recent "Mindfuless Apps" thread on the Therapy board for the free resources. Professor Mark Williams from Oxford uni co-created MBCT based on the US version, MBSR, that has been round longer and has loads of clinical studies about it treating more than just mental health issues.

I think I've probably explained a lot about intrusive thoughts and beating them in a couple of threads so I've attached them for you:

http://www.nomorepanic.co.uk/showthread.php?t=168238

(this next one is about POCD, paedophilia thoughts, its not graphic but not everyone is OK reading about it)

http://www.nomorepanic.co.uk/showthread.php?t=163847

I would also encourage you to read this medical professionals articles about OCD as they are very detailed and discuss aspects that are not always discussed on the OCD charities websites.

http://www.steveseay.com/ocd-unwanted-impulse-cursing-harming-killing/

Avoidance is a bad one with OCD because it acts as a confirmation the same as a compulsion/ritual does. Breaking this will be key but do it in micro steps by creating a hierarchy of things you could try from easiest to hardest. I don't know if you are familiar with Exposure and Response Prevention (ERP) which is a CBT technique? This uses this approach to get you to habituate to anxiety in situations and it can be a useful way to conquer a problem by taking it in smaller chunks. Like a ladder. Its very commonly used in things like agoraphobia but also in OCD as its about graded exposure.

I would also advise relaxation techniques bacause you could use these in those situations.

[Davit]

As this is a one off thing (the funeral) and as you are beginning therapy you will need time to do it and what Terry suggests also will take time. Your other option is just enough of your doctors favourite Benzo to get through this. Beware though, you may want to stay on it and that would be a mistake. It is only bandaid and a dangerous one. But it does work.
If it wasn't a one time thing I would have kept my mouth shut and got another cup of tea.
Terry knows more than anyone here about OCD and intrusive thoughts. I never had either.

[jimbododdy]

Thank you so much for your advice guys, particularly you Terry.