[18O] With compulsive behaviors, anger outbursts, and self-destructive tendencies

What might be happening

Based on the symptoms and history you've provided, here are some possible explanations:

1. Obsessive-Compulsive Disorder (OCD)

• Rationale: Your description of obsessive thoughts about people who show you kindness and compulsive decision-making aligns with symptoms of OCD. OCD is characterized by unwanted, persistent thoughts (obsessions) and repetitive behaviors (compulsions).
• Typical Treatments: Treatment often includes cognitive-behavioral therapy (CBT), specifically exposure and response prevention (ERP), and medications such as selective serotonin reuptake inhibitors (SSRIs) like Zoloft.

2. Depression and Anxiety

• Rationale: Your history of depression, feelings of sadness, hopelessness, and self-destructive behaviors suggest that your depression may not be fully managed. Anxiety can also manifest as irritability and anger outbursts.
• Typical Treatments: Adjustments to your current medication, additional therapy sessions, or exploring other medications might be necessary. CBT is also effective for managing both depression and anxiety.

3. Attention-Deficit/Hyperactivity Disorder (ADHD)

• Rationale: ADHD can contribute to impulsive behaviors and difficulty managing emotions, which might be exacerbating your current symptoms.
• Typical Treatments: Behavioral therapy and medications like stimulants or non-stimulants can help manage ADHD symptoms.

What you can do

Self-Destructive Behaviors and Anger

• Seek Professional Help: It's crucial to consult a mental health professional as soon as possible. They can provide a comprehensive evaluation and adjust your treatment plan.
• Coping Strategies: Practice mindfulness and relaxation techniques such as deep breathing exercises, meditation, or yoga to help manage anger.
• Journaling: Use MDandMe to journal your symptoms, track your progress, and share insights with your healthcare provider.

Obsessive Thoughts and Compulsive Decisions

• Therapy: Cognitive-behavioral therapy (CBT) and exposure and response prevention (ERP) can be very effective. Discuss these options with your therapist.
• Medication: If your current medication isn't fully effective, your doctor might adjust the dosage or try a different medication.
• Mindfulness: Engage in mindfulness practices to help manage obsessive thoughts.

Sleep Issues

• Sleep Hygiene: Maintain a regular sleep schedule, create a restful environment, and avoid caffeine or electronics before bed.
• Melatonin: Continue taking melatonin as prescribed, but discuss any ongoing sleep issues with your doctor.

What you should look out for

Given the severity of your symptoms and the potential for self-harm, it's important to seek medical care as soon as possible. Reasons to seek care even more urgently include:

• Worsening Thoughts of Self-Harm: If you have any immediate thoughts of harming yourself or others, seek emergency help immediately.
• Increased Impulsivity: If your compulsive behaviors become more frequent or severe.
• Changes in Mood: Any significant changes in your mood, such as increased sadness or hopelessness.

Remember, while I can provide information and suggestions, it's essential to consult with a healthcare professional for a formal diagnosis and treatment plan. If you have more questions or need further assistance, feel free to continue the conversation.