Why do I keep talking to people in my mind?

Question

Hello doctor,

I am taking 3 mg Risperdal for two years and 40 mg Fluoxetine from the last two weeks. Sometimes when I speak, I say one thing and mean something else. The sentence which I say is good, but I mean something lustful or violent inside. When people speak to me, I repeat or say along with them in my mind what they are saying, but angrily. I get restless when people around me are talking. In my mind, I respond as if everyone talking around me is talking to me, so if two people are taking and I can hear, I mentally reply to questions or have a parallel conversation mimicking them in my mind, as they continue to talk outside. For example, if someone says to someone, 'you want water?,' internally I think 'you want to get hit?' And then I wait for their reply. And if they say yes, I either start laughing that I said something else in my mind or I get angry. At times, my mind is just not quiet when people are talking to me. When watching a video of people speaking or a TV anchor speaking with no sound on, I mumble words in my mind as they speak instead of keeping quiet. I try to talk to people with my mind and my thoughts. Let me know how to stop this. Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and understand your concerns. From the available description, there is clear evidence that you are dealing with obsessive-compulsive disorder (OCD). The disorder is characterized by repeated thoughts, actions, or images without proper control of the individual. To counter the effect of these intrusive thoughts, the person tries to overcome them by doing just opposite of it. Your description suggests intrusive thoughts and undoing on your part and meets the criteria for the diagnosis of obsessive-compulsive disorder. Regarding control of these thoughts, there are two main ways. The first is SSRI (selective serotonin reuptake inhibitor) group of medications. You are already taking 40 mg of Fluoxetine from this group, and it is expected that you will see positive changes over a progress of time.

However, I like to make it clear that most individuals with similar profile need 60 mg of Fluoxetine or more. So, talking to your doctor for increase dose of Fluoxetine is warranted. The other method of controlling these thoughts is psychotherapy. The first among them is cognitive behavior therapy, which is often delivered over 10 to 12 sessions for most individuals and it is beyond our discussion here. The second in this line is stop technique. In this method whenever you feel that you are having these intrusive thoughts, shout loudly to yourself "STOP." This simple but effective technique will help you in stopping these random thoughts. At the same time, it is important to have an optimistic attitude, as this helps you in controlling these thoughts. Last but not least, engage yourself in productive work and allow at least some amount of time for these thoughts. I understand it is a temporary method, but till the medication start working or other methods kick in, you can get some relief by remaining busy and active. I hope this helps you. Feel free to write back to me if you have more questions. Thanks and regards.

Why do I keep talking to people in my mind?

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