Expert: Ivan Goldberg, M.D. - 8/11/2011

Question
I am a gay woman of 48.I have been diagnosed with both bipolar and OCD. I am tormented by obsessional thoughts of my partner's past she was married for 20 odd years and I drive myself insane thinking about them. What did they do together? both sexual and non sexual. I want to get over it and just enjoy being with her but it wont stop and I find myself either desperately depressed convinced I will lose her or filled with rage wanting to hit out at things and/or hurt myself. is it the OCD or Bipolar making me like this. I am an medication and have CBT but I just can't stop the unwelcome thoughts.

Any help or advice I feel like I am about to totally flip out

Answer
Hello Ju . . .

I am sorry for the delay in answering your question but because of some technical problem I never received it.

What you describe is a process ss known as obsessive rumination. You go over the same material; again nd again in your mind. The thoughts are unwelcome and you are powerless to stop them.

There is a kind of psychotherapy that teaches "thought stopping." Such psychotherapy is often highly effective in treating people with depressive ruminations.

You can read about this sort of therapy at:

http://bjp.rcpsych.org/content/166/4/444.abstract

http://psychcentral.com/disorders/sx25t.htm

http://www.neuroticplanet.com/forum/viewtopic.php?t=8622

While there are medications, clomipramine and fluvoxamine, that are often used to treat people with OCD these medications are relatively contraindicated in people with bipolar disorder because they increase the probability of inducing mania, irritability or rapid cycling.

Best regards . . .

Ivan
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