Struggling with An Addictive Tendencies and Strange Thoughts

I’m looking for advice and possible ideas of what could be going on With several mental health issues that I’ve struggled with since middle school but seem to be getting worse. I’m 37 and single if it matters.

First I’m struggling with my addictive personality. I’m currently participating in a spiritual exercise at church. A group of men agrees to pray, fast, and give up unnecessary computer/screen usage, and purchases together to grow closer to Christ over 90 days. Despite this, I’ve spent over $400 on DND miniatures and accessories in the past month. This is significant, considering my income and the seemingly endless inflation.

Items I’ve looked at online will intrude upon my thoughts for days until I either buy the items or push the items from my mind. Pushing them out of my mind takes effort which sometimes seems to be painful. Obsession over the items I’ve looked at online frequently causes me to miss sleep. I'll try to sleep and they stick in my mind until I feel compelled to look at the items on my phone again.

Similarly, I recently discovered an online chatbot. I feel a need to chat with the character on the chatbot almost everywhere: at home, while I’m with family and friends, and even occasionally at work. If I don't chat with them, doing so is on my mind. I realized it was a problem when I found myself chatting with one of the characters during Mass. My faith is extremely important so this was particularly concerning to me. One day at work, I spoke with several of the characters for three hours straight, playing out a fantasy I have. I've been late for appointments because I feel compelled to talk to the characters.

Next, I struggle with what may be intrusive thoughts. For example, if I lose an item, I can’t focus on anything else until I find it. This is the case even when the item is not important. I've been late to work and appointments several times while looking for a trivial item I had misplaced. While it’s missing, the irrational thought that one of my family members or friends has stolen or moved it pops into my head. I know these thoughts are illogical and, at times, impossible, yet they still pop up. They remind me of the old pop-up ads that were once a perennial problem in the early days of the internet: they keep popping up and are difficult to get rid of.

Over the last two years, these thoughts have also included vivid images and ideas of self harm, having grown worse in the last three months. One thought that plays in my head on repeat (frequently though not necessarily daily or weekly) is as follows: “Go down to the river [a few blocks from my house], climb onto the guard rail, and kill yourself.” I have not fully acted on it but I have gone down to the river while having the thoughts, most recently last night. I will usually smoke my favorite Balkan pipe tobacco or a cigar and stare out at the water and the trees lining the riverbank, leaning on the guard rail while doing so. I'd be lying if I said thoughts of jumping in never came to mind. Along the same lines, the other day at work thoughts of my Buck 110 kept randomly entering my mind. I pulled it out and put it on my desk during lunch. Toward the end of lunch, I opened the pocket knife and held it an inch or two from my throat for a moment or two, then put it back in the leather pouch on my belt.

My job requires creative thinking, effective communication, management, and planning. All of this relies on being able to focus, which is something I can’t seem to achieve lately. It’s becoming increasingly difficult to focus enough to pray for a few minutes, much less pray an entire Holy Hour, which is something that used to bring me peace and comfort when struggling with anxiety.

Tomorrow morning, I have a first appointment with a psychological nurse practitioner, for ADHD testing. I’m reluctant to bring any of this up because I fear she may try to force me to get help. This is the busiest time of year at work and I can’t even afford to take two or three days to work on this, people depend on me at work. I’m not in a position that can easily be replaced by one person, even temporarily. Work must come first. Are my concerns about this legitimate in the US? I had a friend that was put on a 48-hour hold when he became suicidal in grad school.

I appreciate any advice or idea of what may be causing this. OCD has occurred to me but I'm the most physically disorganized person I know, piling seems to be my natural inclination. I don’t think I would ever hurt myself. My faith in Christ and my love for my family prevent me from attempting anything. I’ve never had thoughts of harming others. These situations seem to be hijacking my life and I'm at my wit's end. Thank you ahead of time for your help.

OCD does not necessarily include being overly organized. Have you thought about seeing a therapist that specializes in anxiety disorders? I think that would be a good thing to do. I have had OCD most of my life and I see similarities here.