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Elliot Ruff
Elliot Ruff, GP
Category: Medical
Satisfied Customers: 3868
Experience:  GP at Whitstable Medical Practice
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I've been having intrusive thoughts about harming my partner

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I've been having intrusive thoughts about harming my partner -she is scared -what can I do to reassure her these are just thoughts -Rose
JA: Have you spoken to a mental health professional about this?
Customer: Yes my psychiatrist and cpn -they have reassured me I am not a risk given my background
JA: Got it. How have you been sleeping? Any insomnia or other issues?
Customer: Yes my sleep has been disturbed for a few months I waken in the middle of the night and very early in the morning
JA: Thank you so much for your time. Finally, is there anything else in your medical history you think the Psychologist should know?
Customer: I have bipolar type 1 and am suffering from low mood at the moment -I was prescibed Lamotrigine and I don't think it helps -I also suffer from dissociation attacks

Good evening, I am Dr Ruff, thank you for contacting us today

I am very sorry to hear this. It is quite understandable they would be concerned if you have expressed this.

This is quite a challenge for you both, but I would suggest you discuss more about your mental state and these thoughts. Allowing your partner to be more informed is likely to allow them to feel they understand you more.

Elliot Ruff and 2 other Medical Specialists are ready to help you
Customer: replied 9 days ago.
Dear Elliot thanks for your reply. Suzanne (my partner) and I have been together for 8 years so she knows me well and has supported me through my mental illness -she is aware of my mental state and I have told her about my thoughts of harming her. At first these took the form of wanting to 'attack' her but in recent days these thoughts have evolved to thinking I might stab her with a knife. I find these thoughts very distressing as I love her and can't imagine doing such a thing. My cpn and psychiatrist have both told me these are just intrusive thoughts and I am not a risk but she is not reassured by this.I also suffer from dissociation attacks and our fear is I might do something while in one of these. I have had the initial thoughts for a few months and have not acted on them. I wonder if my Lamotrigine which I have been on for a year might be contributing to my current mental state ?

Good morning, I can understand how stressful these must be, and I can understand the concern you both would have. Lamotrigine is used more as a mood stabiliser. Have you been on an anti psychotic medication?

Customer: replied 9 days ago.
Thanks Elliot. I am on amisulpride 800mg a day for several years.

I do think reviewing your medication is wise. I would speak with your CPN and Psychiatrist again. They may be of the thought these will settle, however if these thoughts persist, then a change of medication or even dose is needed.

Customer: replied 9 days ago.
Thanks Elliot. Suzanne is also writing to my psychiatrist to express her concerns. My psychiatrist increased my Lamotrigine to 400mg daily but this made me feel worse so I went back to 300mg. I wonder if I need an increase in my amisulpride ? I will follow this up with my mental health team.

I think it may be an option. So yes, do chase them up to help you with this.

Customer: replied 9 days ago.
Thanks. Do you have any experience with dissociation attacks -I have had these for several years without finding a solution for them -diazepam helps as does zopiclone surprisingly. They can arise without triggers such as stress. I have tried grounding techniques with little result. My psychiatrist thought the lamotrigine might help but it seems to have made them worse.

I do not sorry, however the nature of this type of dissociation suggests psychotherapy may have some benefit.

Customer: replied 9 days ago.
Thanks. I am waiting to chat with a psychotherapist today and will now get on to my cpn and psychiatrist. Thanks again Elliot.

That is my pleasure, it sounds like you have a good plan in place.