I can’t tell what I have. I feel frustrated sometimes because I have little control over my thoughts. I will often get very stressed out because of some horrible thing I think, like saying bad things about people in my mind. I never mean it. My brain seems to just be ‘daring’ me to think the words, knowing that it’s awful. I get very sad when this happens, because I would never say those things out loud, but it feels just as bad to think it. I usually try desperately to sing a song in my head or think about anything else to make it stop. Also, I’ve been experiencing some mild tics all my life, nothing major, just a slight jerky movement or I’ll randomly raise my eyebrows, but they have gotten worse lately and I don’t know what that’s all about. Any suggestions would be appreciated, as my own research turned up nothing.

A. The feeling that you have “little control over your thoughts” is clinically, in the realm of anxiety disorders, referred to as intrusive thoughts. Intrusive thinking is associated with a specific type of anxiety disorder called obsessive-compulsive disorder (OCD). Generally speaking, intrusive thoughts are unwanted, unpleasant and seemingly uncontrollable thoughts of a disturbing nature. Some common themes include: having mental images of killing a family member, friend or spouse; excessive fears of accidentally harming another person; accidentally hitting a pedestrian with a moving vehicle; or the fear of harming or molesting a child.

You also mentioned that you have tics and that lately they have been getting worse. One plausible theory is that your anxiety is making the tics worse. If I were interviewing you in person, I would inquire about whether or not you have been experiencing an increase in stress and anxiety. It is possible that a stressful event or an overall increase in anxiety, is directly affecting your tics.

It is difficult to know with certainty what may be wrong. With such limited information I can only provide a speculative answer. It would be best to have both a psychiatric and a medical evaluation. A medication evaluation is especially important to rule out a physical cause. A psychotherapist can assist you in reducing your anxiety, if that is a part of your problem. Please take care.

Dr. Kristina Randle