Why do I mentally repeat conversations and feel restless?

Question

Hello doctor,

I have been taking 3 mg of Risperdal for two years and 40 mg of Fluoxetine for the past two weeks. Sometimes when I speak, I say one thing but mean something else. The sentence I say sounds normal, but internally, I have lustful or violent thoughts.

When people speak to me, I mentally repeat or follow along with what they are saying, but with anger. I feel restless when people around me are talking. In my mind, I respond as if everyone speaking is addressing me directly, so if two people are talking and I can hear them, I mentally reply to their conversation or have a parallel conversation mimicking them in my mind, while they continue talking out loud.

Sometimes my mind just will not stay quiet when people are talking to me. When I watch a video of people speaking or a television anchor speaking with the sound off, I mentally mumble words as they speak instead of staying silent. I try to communicate with people through my mind and thoughts.

Please advise me on how to stop this.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understand your concerns.

Based on the available description, there is clear evidence that you may be dealing with obsessive-compulsive disorder (OCD). This disorder is characterized by recurrent thoughts, actions, or images that the individual cannot fully control. To counteract these intrusive thoughts, the person often tries to neutralize them by doing the opposite. Your description suggests the presence of intrusive thoughts and efforts to undo them, which aligns with the criteria for diagnosing OCD.

There are two main approaches to controlling these thoughts. The first involves the use of medications from the SSRI (selective serotonin reuptake inhibitor) group. You are already taking 40 mg of Fluoxetine, which is expected to bring about positive changes over time.

However, I would like to clarify that most individuals with a similar profile require 60 mg of Fluoxetine or more. Therefore, discussing a potential increase in dosage with your doctor is advisable. The other method for managing these thoughts is psychotherapy. The first option in this category is cognitive-behavioral therapy (CBT), which is typically delivered over 10 to 12 sessions for most individuals, though it is beyond the scope of our current discussion.

Another technique is the "stop" technique. Whenever you experience these intrusive thoughts, you can shout "stop" loudly to yourself. This simple but effective technique can help you interrupt these random thoughts. It is also important to maintain an optimistic attitude, as this can aid in controlling these thoughts.

Lastly, engage yourself in productive activities and allow a specific amount of time for these thoughts. While this is a temporary measure, it can provide some relief until the medication or other methods begin to take effect.

I hope this helps.

Feel free to reach out if you have more questions.

Thanks and regards.