For about two years now ive been leaveing with random violent thoughts thoughts of me or those close to me dieing in violent and terrible ways, and to not make anyone sick, a thought i had was actually me opening up my owe stomach with a box cutter and smile while i do then proceeding to pull out fat and acid and throwing it on the wall. others involve stabbings, shootings, falling to my death, and being killed by fictional or demonic family seems more worried of my sudden acts of anger which seem to happen over the simplest things, i am also suffering from what i believe is paranoia, it just always seems like someone is watching me or something is going to come out of the woods and kill me. the thoughts get worse and worse and i do worry i will try and hurt someone like my friends or family if you need any other info please just ask i do not know what else to put.

A. There seem to be three main issues. The first is that you are experiencing violent thoughts and images. I’m wondering how often this occurs (i.e., daily, weekly, monthly?) and how you handle these images when they arise. I’m also wondering what you are doing when they occur. Do they occur on the verge of sleep? During the day? Only in times of stress? After ingesting drugs or alcohol?

Secondl your family is worried about your “sudden acts of anger” which seemingly occur over the “simplest thing.” It would have been helpful to know how often these sudden acts occur. It also would have helped me to understand this issue better if you had provided an example of a “simple thing” that angers you. Even without that information, your anger is concerning. It frightens and endangers your friends and family.

Third, you are feeling paranoid. The paranoia is focused on someone watching you and your belief that someone is trying to kill you. Your paranoia seems to exacerbate your mental instability which as you said, has left you worried that you might hurt someone. This is yet another sign that you may be on the verge of losing control.

The most responsible course of action is to seek professional mental health treatment. Your symptoms are concerning and they should not be ignored. Ask your primary care physician for a referral to a therapist or seek the services of a therapist directly. Clicking on the “find help” tab, at the top of this page, will assist you in accessing mental health treatment in your community.

Your symptoms are clearly not well controlled and require professional intervention. Do what you can to seek the proper treatment. It would be irresponsible and ill-advised to ignore your symptoms and to continue living on the verge of losing control. I hope my letter convinces you to seek the proper intervention. Please take care.

Dr. Kristina Randle