Intrusive thoughts, compulsions, and anxiety are becoming overwhelming — last night felt like my breaking point

Hi everyone. I’m 25 and I’m looking for some advice because I’m starting to wonder if what I’ve experienced for years could be OCD. I don’t want to diagnose myself, which is why I’m getting a professional evaluation, but I would really appreciate hearing from people who have experienced something similar. Last night honestly felt like my breaking point. My thoughts were making me so nervous that I was shaking, felt extremely nauseous, and ended up throwing up three times and having diarrhea. I was supposed to be studying for a nursing test, but I couldn’t concentrate because my thoughts and anxiety were making me physically sick. I felt completely overwhelmed and exhausted. Looking back, I think I may have first noticed some OCD-like patterns when I was around 8 or 9 years old. At night, I would constantly worry about something bad happening to my family. Sometimes, if I forgot to pray or do what I felt I needed to do for them, I would become scared that something bad would happen. I never wanted anything bad to happen—I was actually trying to prevent it. As I got older, I’ve noticed different fears and behaviors. For example, sometimes I’ll take a water bottle with me to the bathroom, and afterward I’ll suddenly worry that someone may have tampered with it. Even though I have no evidence that anyone touched it or did anything to it, I can become so uncomfortable that I throw the bottle away instead of drinking it. I’ve also had different intrusive thoughts over the years. In 2024, I had a very disturbing sexual intrusive thought involving my younger brother even though nothing happened between us and I absolutely did not want the thought. It eventually went away and no longer bothers me. More recently, I’ve been having a new episode where the thoughts feel much more persistent. It started around September 1. I’m in nursing school and I’m in my last few classes before graduating. On my way to clinical one morning, I was listening to a song I’ve heard many times before and suddenly became emotional and cried because I realized how far I’ve come in nursing school. Later that day, I started having an unwanted harm-related thought involving a patient. That made me start thinking, “How am I going to be a good nurse?” and questioning why I was even having these thoughts. Then, during clinical, I witnessed a 40-year-old woman code. She was young and had children, and it really affected me. After that, my thoughts shifted toward my mom. I started thinking about what I would do if something happened to her and how I would function without her. Then I started getting horrible intrusive thoughts like “do something to your mom.” I do not want to hurt my mom. I love my mom, and these thoughts scare and upset me. I have no desire or intention to hurt her or anyone else. What makes everything worse is that I start analyzing the thoughts. I ask myself why I thought it, what it means, whether I secretly feel something, whether I’m becoming a different person, etc. Sometimes I feel like I need reassurance that the thoughts don’t mean something about me. The more I focus on them, the more noticeable they seem to become. I’m still functioning. I’m going to clinical, doing my schoolwork, studying, seeing people, laughing and doing normal things. I’m not isolating myself. From the outside I probably seem completely normal. Internally, though, I’m exhausted from constantly fighting with my thoughts. I’ve noticed that lack of sleep, caffeine, stress, and possibly my menstrual cycle can affect how intense my anxiety/intrusive thoughts feel. I’m not sure how much hormones actually play a role. I’ve also been seeing disturbing things online recently, including pop-ups about an upsetting criminal case involving a mother and children. I don’t seek this stuff out, but seeing it seems to make me anxious and can get the thoughts going. I’m seeing a psychiatric provider because I want a proper evaluation. I don’t want to walk in and tell them that I definitely have OCD. I want them to evaluate me independently and tell me whether this sounds like OCD, anxiety, something related to stress, or something else. I’m also really nervous about medication. I was prescribed fluoxetine previously but never took it because I was afraid it could make my thoughts worse, affect my memory/concentration, cause suicidal thoughts, make me lose control, or make me dependent on it. I’m finishing nursing school, so I’m especially worried about anything affecting my ability to study and function clinically. I’m open to discussing medication, but I really want to learn about ERP/therapy and all my options first. Has anyone experienced different OCD themes over time, such as fears about something bad happening to family, contamination/tampering fears, and then intrusive harm thoughts? Did you also find yourself analyzing the thoughts and trying to figure out what they mean about you? I’d really appreciate hearing from people who have experienced something similar. I especially want to know what helped you stop getting stuck in the thoughts and compulsions and feel like yourself again.

Amy B.

Date posted: 20h

I recommend seeing a NOCD therapist. They specialize in ERP, which is what is used for treating OCD. If you go to a talk therapist they can make your OCD worse. My themes have changed over time, that's super normal. Themes are a way to describe what you are experiencing, but it's all OCD, attacking what's important to you any way it can get a rise out of you. I put off ERP treatment with a peofessional for a lot of years for various reasons, and I regret it so much. OCD has stolen so much from me, but I finally have the right tools to fight back. I had tried talk therapy, doing ERP on my own, medication on it's own, or just toughing it out, but none of that worked. Now that I'm working with a NOCD therapist I have real hope for a better future.

Community AI...

User type: Staff

Date posted: 19h

Hi! I'm the NOCD Community AI assistant (currently in Beta). Would you like me to share some resources that might help? Just reply and let me know.

Happyfeet4@

Date posted: 11h

@Community AI Helper Yes

Community AI...

User type: Staff

Date posted: 11h

@Happyfeet4@ - Happy to share! One thing worth naming up front: the analyzing — asking why you thought it, what it means, whether you secretly feel something — is itself a compulsion, not a symptom. It feels productive because it briefly lowers anxiety, but that relief is exactly what teaches your brain the thought was worth checking, which is why the thoughts get louder the more you review them. Noticing when you've slipped into reviewing, and letting the question stay unanswered, is the single most useful thing you can practice before your evaluation. "OCD Rumination: How to recognize and treat it | NOCD" https://www.treatmyocd.com/blog/the-rumination-trap This covers the exact loop you described — mentally replaying a thought to figure out what it says about you — and what actually breaks it. "Why does my OCD keep switching themes?" https://www.treatmyocd.com/blog/why-does-my-ocd-keep-switching-themes Stacy Quick, LPC explains why the content can move from family safety to tampering fears to harm thoughts while the underlying mechanism stays the same, which answers the question you asked the community directly. "Is Prozac (fluoxetine) effective for OCD? | NOCD" https://www.treatmyocd.com/medication/posts/everything-you-need-to-know-about-using-prozac-fluoxetine-for-ocd Since fluoxetine is the one you were prescribed, this walks through how it's actually used for OCD, what side effects are common versus rare, and what to ask — useful background for the conversation with your psychiatric provider rather than a reason to decide either way now. Worth knowing too that medication and ERP aren't an either/or choice, and ERP is the treatment specifically shown to work for OCD — a general talk therapist often isn't trained in it. Are you working with a therapist who specializes in OCD and ERP specifically, or is the psychiatric provider the only person you're seeing right now? 💬 Was this response helpful? Reply with a rating from 1–5 (1 = not helpful, 5 = very helpful) — your feedback helps us improve!

Ocd;;;;;;

User type: OCD Conqueror

Date posted: 18h

I am NOT a doctor but there sounds like you might be having intrusive thoughts and stress and anxiety attacks. Give yourself grace, sleep, breaks and ask for help. Start seeing a therapist, I’d rec someone from NOCD but at the very least someone who understands ocd well. I’ve had anxiety that caused me to vomit before, or get what seemed like the flu. And those intrusive thoughts sound like ocd. It hit in college just like you and it was just so so much. OCD themes change, that’s very common. I had a therapist who told me she liked when they changed cuz it got boring, which sounded crazy to me at the time but I can find the humor in it now. I like the book called “needing to know for sure”. Does a nice job of talking about ocd and how treatment is accessible. While it can be so so so awful when you’re having ocd and anxiety, they can also be (generally speaking) extremely treatable in a way so many other health conditions are not. I find this hopeful and helpful.

☮️Better_Me☯️

User type: OCD Conqueror

Date posted: 18h

Hello, I completely understand where you are coming from. I'm very much stressed out and my intrusive thoughts are at the forefront right now. To answer your question about hormones, yes it can make OCD worse. I'm 52 and in perimenopause, but my hormone levels are at post menopausal range. I can tell you that my OCD has been at it's worst in the last year, and I think it's due to the hormone imbalance. I have listened to podcasts about hormone imbalance and OCD that's been helpful. As for medication, I wouldn't be able to function without it. I hope you find what works for you and things get better. Take care 🫶🏻

Anonymous

Date posted: 18h

Fellow nurse here! First of all, I am sorry you are experiencing all of these unwanted thoughts and feelings. That must feel so discouraging and exhausting. Secondly, thank you for your vulnerability. You should pat yourself on the back for starting the process to conquer what sounds like OCD. That is genuinely one of the harder steps and not to mention all during nursing school! Here is my (attempted) cliff notes version of my experience: when I was young (started at 5-6) I struggled with thinking family or loved ones would die if they left by car, plane, etc, and I would also really struggle with perfectionism in homeschool to the point I would just shut down. My mom had me evaluated by a specialist and he just said I had anxiety. Fast forward to my adolescence and young adulthood, I struggled a lot still with perfectionism, symmetry, and relationship obsessions. I would spiral constantly and nursing school? You guessed it, made it SO MUCH WORSE. Fast forward I am in my thirties now and had a recent severe reaction which caused me to obsess over my own mortality and my health. I then honed in on my loved ones and their mortality and their health. That’s when the harm intrusive thoughts set in. I recently got help and an OCD diagnosis. I was 1000% against taking meds because I genuinely thought it would kill me. I have found though that through consistent work with my NOCD therapist, my OCD has improved so so much and I noticed that only a couple of weeks in! All that to say, what you are experiencing is real and scary and it has a name. You DO NOT have to take meds if you don’t want to but I know it has been helpful for a lot of members here. A lot of people find a lot of relief in doing ERP alone. There is a light at the end of the tunnel and I am rooting for you. But like Amy said above, NOCD is definitely the best route for therapy. They are professionals who specifically train to do ERP and a lot of individuals have reported doing ERP through another therapist in their local community has proven to not be so effective. I hope this has been helpful and you have my full support. I’m very proud of you and if you can go through life…through nursing school, with OCD, then you can do anything you set your mind to. Last thing I will remind you before I end my novel, thoughts are just thoughts, they are NOT actions. Even though they are tough, uncomfortable, and overwhelming sometimes, these thoughts go against your value system and that is why they are so distressing. Try your best not to reassure yourself “omg I would never do that!” Or “I am a good person.” Those are considered compulsions to cut the anxiety from the obsessive thoughts and they feed the obsessive thoughts actually. When the thoughts pop up just try to sit with uncertainty. That sounds like “Ok maybe that will happen or maybe not. But I don’t need to figure this out right now.”

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