Resolved question:
Dear Dr.
About a month ago, I started experiencing a very intrusive thought that I cannot shake off. When I was younger, I used to play with many feral cats. Now many years later, I am worried about having caught rabies from one of them, even though none of them showed any sickness symptoms. The reason I am worrying is because 1) In rare yet possible cases, rabies can incubate in humans for 20+ years, 2) Cats can be hosting/transmit the virus without any visually apparent symptoms. I have been scratched before. Although I have been reassured and told that the chances of any exposure are low, my issue is that I cannot deal with the uncertainty and maybes and what ifs considering the fatality rate of this disease.Fortunately, I have found out that there is a test that can accurately determine if rabies is present and I will try to find a hospital that can do it. I am just worried that the compulsive thoughts could stay or be hard to shake off even after the test. As specialists, can you please provide advice on how to deal with an obsessive compulsive thought practically? Please keep in mind that I dislike taking anti depressants and have no history of doing so. This issue just came out of thin air and has been very frustrating. Thank you for your time.
Submitted:
4 Days
Category:
Psychiatrist
Hello,
Thanks for posting your query at DoctorSpring.com
I have gone through your question in detail and I can understand what
you are going through.
I understand that these intrusive thoughts can be sometimes very
troubling. I cannot be very certain but probably you have started an
illness called obsessive compulsive disorder. There is a very very
rare possibility of the occurrence that you will get rabies, and
more-so you don not have any symptoms of rabies at present , but
recurrent thoughts about the same can impair your daily life. Now
that, its in the initial stages, it can be controlled well.
Anti-depressant medications like fluoxetine, fluvoxamine and
clomipramine are good medicines for the treatment of OCD and I
generally prefer starting my patients on fluoxetine 20mg and then
gradually increasing it to 60mg per day. However if you are averse to
taking medicines then there is an option of cognitive behavioural
therapy (CBT). This therapy is taken by either a psychologist or a
psychiatrist in which the therapist identifies impaired cognitions
(Thoughts) and try to correct them. They are 15-20 min weekly session
and there should be around 8-10 sessions to help you with your
illness.
You can opt for either of them, but let me assure you that fluoxetine
is a very safe option. Do meet your doctor and discuss these options.
Hope this helps.
In case if you need any further clarifications, do let me know.
Kind regards
Wish you a good health.
Dr. Srikanth Reddy MD