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Why can’t I get gross images out of my head?

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Summary

A peaceful bedside table in soft morning light.

A fifty-two-year-old woman experiences persistent anxiety and revulsion after seeing or hearing disturbing descriptions. She wonders whether menopause, insomnia or medication for migraines and sleep may be contributing to this new sensitivity.

The response describes the pattern as potentially obsessional but notes that a new onset at this age warrants attention to physical changes and medication effects.

It recommends returning to the doctor with a clear description of the symptoms so possible causes and treatment changes can be considered, rather than confirming Obsessive-compulsive disorder (OCD) from the letter.

Question

Reader · Identity withheld

I never use to be this way but find that I am increasingly anxious over images that I witness first hand or from descriptions relayed to me.

I never use to be squeemish but I now find that I am hypersensitive to things such as the following. The description of an injury to a person’s face from a bad car accident; a photograph of what should’ve been a cute furry mammal with some sort of insect on it; things that are clustered which brings to mind clusters of bugs.

These images make me so anxious and angry and I get frustrated by it. When I see something that sets me off, it takes days and weeks for the effects to diminish – but then again I see something else that sets me off again.

I am a 52 year old woman, am going through menopause and wonder if that plays into this. Plus it doesn’t help that I’ve developed very bad insomnia, which caused daily migraines and so now am taking Amitriptyline to stop the migraines and to help me sleep.

The meds help a little but I am still only getting about 4-5 hours of sleep each night during the week.

At any rate, I am really struggling with my revulsion over images which never use to bother me before. It would be great to hear your opinion about this and to learn if there is something I can do to make this stop.

Thanks very much.

Answer

Mark Vigil Dombeck, Ph.D.

The symptoms you’re describing would probably be classified as obsessional, as in obsessive-compulsive disorder obsessional.

However, it would be odd if you were just developing an OCD-like condition at age 52, as the vast majority of OCD starts in childhood, or at least during early adulthood (e.g., by age 30).

You are wise to suspect that physical changes in your body may be playing into this sort of anxious condition. Many medical conditions can cause anxiety symptoms to occur, and medications can cause anxious symptoms as side effects as well.

Amitriptyline, an old-school tricyclic anti-depression medication, is known to sometimes cause anxious or activating symptoms, although not specifically OCD like symptoms.

It’s worth looking into, anyway.  It would be a good idea for you to go back to your doctor, describe the obsessionality and associated anxious symptoms you are experiencing, and see what he or she recommends. A medication change may be in order.

Subject matter expert

Carlos Protzel Psy.D.

Integrative mental health care

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Author

Mark Vigil Dombeck, Ph.D.

Mark Vigil Dombeck, Ph.D. is a trauma-informed psychologist with over 30 years of experience helping people navigate mental health challenges.

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Medical reviewer

Jesse Hanson, Ph.D.

Jesse Hanson, Ph.D., is a clinical and somatic psychologist with over 20 years of experience in neuropsychology, specializing in integrative, mind-body…

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