How to cope with intrusive thoughts?

I feel like I'm up against an insurmountable mountain. I'm not new to OCD; I know I've had symptoms since at least the age of 8 (probably earlier to be honest, I just know things really took off when I was 8). I dealt with things with no outside help until I was 17, at which point I began seeing a therapist and began to take celexa. I stuck with that therapist for a couple more years before going about my life, though I continued to take the the celexa. Fast forward to 2018, age 29 - I once again began to see a therapist and had my meds adjusted once more, this time switching to Luvox. I also wound up switching therapists after a year or so, though not by choice - my therapist had a personal crisis come up that necessitated the switch. I still see the same therapist I switched to in 2019. Early 2020 brought with it a couple more med changes, going off the Luvox and onto Cymbalta and Intuniv due to concerns about previously undiagnosed ADHD. This was how things were for five years. I'm not going to say things were perfect- there were undoubtedly bumps in the road - but things felt doable, and I mostly found enjoyment in life. This came to a screeching halt recently. Again, as I said, there were bumps in the road. At first, I thought this was all that this was. When I spoke to my psychiatrist in early February, I started Ativan as I just wanted something to take the edge off a little bit. I also went off of Intuniv as we thought that might be contributing to things. It was Saturday, February 8th when things really started to go off the rails. My boyfriend and I were going on a short trip across the state. An intrusive thought popped up - What if I sleepwalked at the hotel and hurt or even killed my boyfriend? This fear stuck with me through the entire trip. I heaved a sigh of relief as we drove back. I'd soon be safe back at home and I'd put it all behind me. If only. On the ride home, my worries shifted to concerns that I would sleepwalk and do something to my parents, who I live with. I fretted for the majority of the trip back, already making up plans to research the subject and how unlikely it would be that something like that would happen, and I'd tell my parents for good measure. They, of course, assured me that I'd never sleepwalked in the past so it was unlikely I'd do so now. I should also note that this is not a new fear of mine, but one I experienced as early as elementary school, though it had essentially disappeared up until this point, decades later. If only it stopped there. I stopped taking the Ativan Sunday evening in the middle of the trip, my thought being that the Ativan might have contributed to this. My boyfriend, in fact, had a reaction years ago where Klonopin actually sent him into a panic, so it seemed possible that I might be experiencing some sort of paradoxical reaction. I also remained off of the Intuniv. Monday was the day I began experiencing loss of appetite. Monday was also the day when things really began to take off and my life began to truly feel like a waking nightmare. Another horrific image from my past reared it's ugly head - an image of my grabbing a knife from the kitchen and stabbing my mom. An image that has continued to haunt me since - and now its 2 weeks later. There's still a bit more to the story - The day after this began, I went to a local urgent care. I was now not only experiencing these horrible thoughts, but I could barely eat lunch, and my stomach was hurting. I also told my parents the latest turn in how things were going. From the urgent care, I was given a prescription for Omeprazole and Hydroxyzine. The following day, I went to my ordinary doctor's office, where the doctor suspected my increase in anxiety and the associated intrusive thoughts had to do with going off of the Intuniv I'd been taking for five years without tapering, and advised me to immediately resume the Intuniv. He also endorsed continuing the Hydroxyzine, which I was taking at night before bed at this point. I'd hoped that going back on the Intuniv would 'even things out' and I'd be back to normal in no time. The thoughts continued, unfortunately. I had an appointment with my therapist as well as my psychiatrist, who upped my dosage of Intuniv to 3mg instead of 2mg and advised on other medication options should this not help. Though I would like to see both of them more, it's difficult with my work schedule and their busy schedules to find time. As of right now, I'm seeing my therapist once every two weeks. My next appointment with her is this Wednesday. I've also made follow up appointments with my regular doctor's office. Last Wednesday (2/19), I had an appointment with an NP who advised I take the Hydroxyzine three times a day rather than just at bed time, so I've been doing that. I thought it might be helping the first time I took it in the afternoon, though this doesn't seem to be the case with subsequent dosages, unfortunately. I also see her again on Wednesday. I apologize for the long post, but I wanted to share how I got to this point. Things aren't great. I'm trying to enjoy life where I can - I recently played board games with my parents yesterday and went to a restaurant with my boyfriend the day before and felt almost normal, but even in those instances it felt like there was something lurking just beneath the surface. I'm going through life, but it feels like I'm barely surviving. I'm going to work but only because I think I'd be worse at home with absolutely no distractions. I wish there was a switch I could flip and things would be back to normal, where I didn't feel this way. In fact, more often that not, I want to be laying in bed asleep, because you can't think when you're asleep, and it feels like the only refuge at this point. It's hard because home was always my safe place, and my mom one of my safe people - and now this. Anyway, if you made it through this long post, thanks for reading. <3

Hi Everyone! I hope whoever is reading this is having a good day so far :) So for years now I’ve had very bad intrusive thoughts about things that I have done or embarrassing things that I’ve said or have happened and it’s mortifying and debilitating on a daily basis. Specifically these thoughts are mainly things that have occurred from 2018-2020 and some are more simple just as a stupid joke I made or being way too loud on calls while my family was trying to sleep and others being way more complex such as past relationships and how I’ve hurt some of the people I care the most about and when I have acted on intrusive thoughts and these thoughts will appear with no triggers at all I’ll just wake up and already have something I did just nagging me. I don’t want to live like this anymore and I’ve tried working through it with self compassion but sometimes the things I said or did back then it’s very hard to forgive myself for and I’ll reminisce on it for hours on hours, gaslight myself into believing that’s not how it happened and try to change the memory itself, or just suppress it entirely. I know those habits aren’t healthy and truly I want to get better but I don’t know how to overcome some of these thoughts. I have talked to my fiancé about this a few times and even today we talked about it and he fully supports me and is helping me work through it. I might also contact my sister too, I don’t talk to her overly too much but ever since I was little she’s thought I’ve had ocd and was one of the people who made me consider that I might have it (I’m still undiagnosed but I’ll try to when I have the money and time) and I know she could maybe provide some insight. Another thing that is troublesome about the situation is my other family members specifically my mom aren’t the most helpful and can trigger thoughts. To put it in perspective on how her thought process is and some background info she is an ER nurse and has been for 30 years due to this she believes she knows mainly everything there is about mental health and she gets extremely upset when I don’t take her advice or set boundaries. She’ll force me to talk to her about my problems and when I don’t want to she’ll pin me in a corner where I’m forced to and last summer I had a really bad episode and was really overstimulated and I just finished taking a shower and due to the water on me, my hair being wet (my hair is naturally curly and it takes forever to dry and it’s very draining taking care of even with a keratin treatment) and all the intrusive thoughts I was having and she forced me to talk to her and I did open up for the first time about my thoughts and brought up how sometimes I have thoughts of hurting my animals and it makes me physically sick. Her response to this was threatening to call the cops on me saying it was a behavioral thing and I was doing it for attention. I have never hurt any of my animals but later that day my cat came into my room and a few minutes later she comes up just gives me the death stare and after a few seconds just asks me “are you going to go kill snickers?” In the most condescending tone and she’s always like this daily where she’ll force advice onto me or get upset and yell and then reinforce thoughts I’m having. I just want to know first how to stop the thoughts from so frequently and how to heal in an environmental where it keeps reopening wounds despite trying to place boundaries? I’m sorry this is really long I usually do go really in detail about things and it’s just how I’ve always been. If anyone has any questions feel free to ask and I’ll answer them to the best of my ability. I really appreciate the time you took to read this and thank you for your help! 🥰

(Sorry for the long post!) So one of the OCD things that most affects me at times, and that I have not really found other people dealing with (in literature or in my work as a therapist working with people with OCD), is one that often relates to potential dating and people I am interested in. Typically, as a gay male, I meet people on chat apps or dating sites, so the first interactions are virtual. What I find often happens is that I sort of build an image of the person, and then if anything goes against that, I start to get anxious and the OCD kicks in. An example may work best. I started talking to a guy that I find incredibly attractive, and who seems to find me attractive as well, and when we became friends on instagram, I saw that he has done some amateur modeling for a friend who does pictures in various states of undress. There are a few in underwear, and a few with no clothes (no genitals are shown), and this started off the thoughts of "oh no, he must just want sex" or "I bet he is super promiscuous if he has pictures like these." This leads to me investigating the other photos on the site, and the guy who does the images to try and figure it out, what kind of work it is, etc. I even found a way to work it into a conversation with the guy, like "wow I don't think I could do that. You're braver than me," and he said he did it because the photographer is a husband of a coworker and expressed interest in doing the pictures, and he loves his body so didn't mind doing it, and they are really good friends now. OCD then gets triggered "he loves his body? That must mean he really IS promiscuous. What if he and the men also have threesomes?" This leads to intrusive thoughts of me having to picture this happening,or him having sex with other people, over and over until it "feels right." I'll recheck his dating profiles in which has said that he is "not into fast sex," and then think about and picture scenarios about how that could just mean he wants to talk to someone once before having sex. The OCD also affects conversations--if he doesn't get back to me quickly on WhatsApp, I scour the texts to see if I messed something up (ocd responsibility--it's always my fault). I texted him yesterday, and he hasn't looked at the messages (he has read receipts on WhatsApp), but I check and see that he has liked a post by someone on instagram or has posted a story, so I think "clearly he sees that I've messaged and is purposely ignoring it, because he hates me and wants nothing to do with me. That's it, I'm never going to hear from him again." We were supposed to hang out last week, but he asked to reschedule because he wasn't feeling well, so my OCD then said "he was at an event the night before, he probably met someone and is still at their house." He did text the next day to ask what my schedule was, and then said "perfect. I work in Lisbon until next Thursday" (I'm currently living in Porto, in Portugal, where he also lives), so he seems to be interested in hanging out, but then I think "he probably saw something that I did online or someone we both know in common somehow told him something and now he's done with me. Or maybe he met someone he's more interested in, and will just ignore me now." This type of experience has happened with several guys I've been interested in, and it has actually led to me pushing too hard and making them uncomfortable as I seek certainty, so I'm trying to be aware of that and not engage in that kind of behavior. I also realize that there are like a billion different OCD things in this post, and I'm writing another post as well related to how moral scrupulosity has been controlling my beliefs about sex, etc., something my new therapist identified after one session. Anyway, I just wanted to see if anyone has experienced anything along these lines, because when it happens it takes over and it is painful and I just want to rip it out of my head. Additionally, I never quite know how to manage exposure to this type of thing--there is the logical one of not checking social media, and not texting or re-reading texts, but it's also hard because I will actually force myself at times to think about him having sex with people, and then that makes me feel overwhelmed with anxiety, but I also can't suppress the thoughts, as that doesn't work, and am thus trying to do more of an ACT/acceptance approach. Unfortunately my therapist is out of town this week, so we can't work on anything surrounding this until next week. Thanks for taking the time to read this, and I apologize that it is so long, but it is just really sucks right now.