Q. I became obsessed with it and thought about it all the time. It kept me up at night. I began to think that all children were in danger and would have images of my own children being killed. In my head I could feel the fear of the children. It makes me feel physically ill. It subsided over the past few months. I started taking medication and the thoughts went away but I stopped taking the medication because of all the side effects. Now the thoughts have returned again. The thoughts pop into my head at any given time and I can tie anything that comes up in my head to those murders. I have tried everything I can to get rid of these intrusive thoughts. They fill me with such a sense of dread and despair and affect my outlook on life. I have struggled with depression and anxiety since I was 15, but this is something new. I do not want to take medication but I can’t seem to fix this.

A. I am glad that you recognize that this fixation is a problem. I believe that you are going to need medication in combination with professional help to remedy this reoccurring intrusion. I know that you do not want to take the medication because of the side effects. I understand this but you should go back to your doctor and ask if he or she is willing to prescribe you another medication. Keep trying different medications until you find one with side effects that you can live with.

Maybe the medication you are currently taking (that seems to lessen these intrusive thoughts) can be reduced. If reduced, maybe that medication will not produce side effects. It is at least possible that a medication reduction will produce less intense side effects.

Please consider meeting with your doctor about this fixation. Explain to the doctor that you are bothered by the medication side effects and that you wish to lower the dose. Or if you do not like this idea, ask your doctor about trying a different medication. Whatever you decide, please do not let this problem go untreated. Be proactive and seek help for your invasive and scary thoughts. If nothing else, do it for your children. They need a mother who is mentally stable, compliant with her needed medication and able to properly care for her children. Let me know how your medication changes go. Good luck.