Assessing Thought Content: Part 2
The purpose of this post is to help you determine when you should be concerned by your thoughts, and ideally seek treatment. The following are a few scenarios that are good indicators that you should seek help for what is occurring in your mind. First, when your thoughts and reality are not aligned. The most common representation of this occurs when we think things about ourselves, others, and the world that are not entirely accurate. This often occurs amongst people that have negative core beliefs about themselves. For example, someone has a negative experience at work. One might dismiss the experience and chalk it up to bad luck, or at least not a good representation of what they are capable of. Others might interpret this experience as proof they are not good enough, others do not like them, and the world is an unsafe place. When these thoughts lead to depression, anxiety, social isolation, or excessive distress, that is a good sign that treatment can be helpful. There are other times when thoughts depart dramatically from reality. It’s one thing to believe that you aren’t good enough, it’s another to believe you are the second coming of a popular deity. These thoughts are referred to as delusions, and they are resistant to any proof that would confirm that these thoughts are false. Delusions also require treatment, as those who possess delusions are often unable to function in the world.
Second, when you become overly fixated on certain thoughts. Some people become obsessive about certain things, and their mind becomes consumed by their obsessions. This keeps them from being able to focus and pay attention to other important parts of their lives. Additionally, obsessive thoughts can become problematic when they represent deviant actions. For example, someone that thinks obsessively about hurting others, taking advantage of minors or non-consenting individuals, or committing actions that are against the law. I express concern for this type of obsessive thought, because these thoughts can easily transition into action. The consequences of these actions can range from maladaptive compulsive behavior, to illegal behavior that has serious punitive consequences. These obsessive thoughts also require treatment in order to avoid the realization of these thoughts.
Third, when your thoughts are rapid and overwhelming. Most people have had thoughts that they cannot stop, or ruminative worry. The thoughts that I am referring to are representative of a manic state. Those in a manic state have thoughts that occur so quickly, they overlap one another and are so rapid that the individual struggles to make sense of what they are thinking. I once had a person describe this experience as changing the channel to your television every second, but you are unable to make sense of what you have heard, and when you try to make sense of it your brain has already moved on ten other thoughts in rapid succession. A manic state requires immediate treatment, and this treatment may require medication for the mania to abate.
Lastly, when you have thoughts about wanting to hurt yourself or someone else. It is common to react angrily to a situation and to have a thought or desire to behave aggressively towards another person. This thought becomes dangerous when the thought is so strong the person so longer just thinks about behaving in an aggressive manner, they intend to act upon the thought and cause serious harm to another person. If you have a plan to hurt someone, or you know someone in your life that is planning to hurt someone, it is best to seek treatment or to alert law enforcement in an effort to protect the safety of others. Similarly, many people have thoughts of what it would be like “if I wasn’t here anymore.” These thoughts can be harmless, and they can be a reaction to being hurt by those that you love. These thoughts become signals for the need for treatment when the person transitions from passively thinking about not being here anymore, to actively wishing they were dead. You should seek treatment if you actively have these thoughts, intend to act upon these thoughts, or have a plan to hurt yourself.
Overall, I hope you can see the distinction between normal thoughts and thoughts that require treatment. If you are ever concerned about the implications of your thoughts, it is better to err on the side of caution and seek the advice of a mental health professional.