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She is sick. She needs to see a doctor. It doesn't matter if someone is physically ill or has a mental illness. I wish there was no stigma in catching a "brain flu" so people would just go get medical help whether they catch a cold or come down with something that effects behavior.
I can't diagnose the issue, but there are medicines for people with all kinds of illnesses and I bet this young lady could get great help by seeing a doctor who specializes in illnesses that impact behavior. They are called psychiatrists.
Of course, no one can diagnose a person without a complete evaluation. But if this were presented to me as a hypothetical, or in a classroom setting I would explore first the possibility of OCD, and next the possibility of a delusional disorder.
People with OCD can come up with obsessive thoughts that sound very bizarre, almost like a person with schizophrenia, but the thoughts are organized and fit into the overall focus of the person's obsessions. The obsession that you've harmed someone and that you might harm someone is very common among people with OCD. I think the general public only knows about the "germ-phobic" or "counting" forms of OCD, but the fear of harming others is very common.
If it turned out that these thoughts were more bizarre and paranoid than obsessive, it might point more toward a delusional disorder. With delusional disorders, people might have paranoid ideas and delusions like in schizophrenia, but they otherwise function in a more organized way. Schizophrenia will usually effect functioning in all areas of a person's life, but a delusional disorder consists of a persistent delusion that affects behavior and functioning, but usually only in some areas of life.
But my gut says it's more likely OCD, just going by what is presented here. I've had clients with very severe OCD, with symptoms very much like described above, and they did very well in treatment (meds and therapy).
Either way, this person needs a good psychiatric evaluation, if these symptoms are causing her distress or negatively affecting how she functions in life. Remember, it's only a "disorder" if it's causing significant impairment in functioning or significant distress. If it is causing distress and problems functioning, the sooner she gets help, the better her prognosis.
Agree evaluation is required in any case but one question which you may need to consider. Are these symptoms sudden onset and is there any precipitating event prior to symptom onset. Recent pregnancy, auto accident, new medications or stopping old ones. This is information your care provider will need.
A young woman who is 18 - 21 years old starts experiencing strange symptoms that she never had before.
Symptoms:
She convinces herself that she tells people to touch her menu when out in restaurants so that the germs from the menu will kill them.
She convinces herself that she puts stuff in her hair intentionally to kill others before going to the hairdresser.
Convinces herself that she spits on people intentionally when out in public.
Constantly stopping while walking to check her shoes because she is afraid that she stepped on something that will kill her.
Constantly stopping whenever she hears a noise to see if it is someone's dying.
She does NOT drink alcohol or does drugs.
She is NOT doing this for attention.
She does NOT have any known mental illness.
What is wrong with her?
Yes, she definitely has "mental health issues". She needs a thorough medical examination, in order to rule out the possibility of an underlying PHYSICAL health issue/issues, which could be causing this. Good grief, it could even be dietary issues.
The issue here? This is way, way beyond "normal" behavior. For some reason, the girl is having a psychological breakdown, which is resulting in delusions and obsessive compulsions. She needs help in finding out why this is happening to her. Thinking hopeful happy thoughts for your friend.
She certainly has mental health issues and should see a psychiatrist and get evaluated.
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