Q. A few months ago, I started having thoughts of harming (killing) family members and friends, and even animals. Some of the thoughts are quite graphic and detailed. It oftens happens in their presence, but not always. I don’t mean to be nonchalant about it, but I don’t know how else to phrase it. Please understand, I would never, ever hurt anyone, least of all my family or friends. In fact, I have a stong aversion to violence, blood, gore, and thoughts about death/dying in general. It pains me so much just to imagine doing the things that I imagine. Sometimes I know that I will be thinking these thoughts before I do so; in other words, I think about what I will be thinking when I do meet a relative. I don’t why this is happening. I did not have these thoughts as a child or teenager (I am now 21). I have absolutely no history of mental illness and neither does any body in my immediate or distant family. I have never been molested, and I am not overly aggressive, moody, or depressed, although I am under severe school-related stress. Are low Seratonin levels to blame? I fear that it may be something more grave. I am worried about seeking pyschiatric help because doing so could preclude me from certain career aspirations that I have. Please advise.

A. These types of thoughts might be insignificant however I am in no position to evaluate this from a short e-mail. Someone [mental health professional] should evaluate what is happening to you. Additionally, you may be wrong about being excluded from a career because you have sought counseling. I am aware of no careers where simply having gotten counseling, excludes you from membership and this would include President of the United States.