Please, Gayle, could you post about what advice your dr gives you? I have just popped into the SI forum because I'm in a similar place to you right now. However it is not mood related nor is it trigger related as far as I can tell. The urge itself is just SOOO overwhelming, it is consuming all my thoughts. I see no need to up my antidepressants as my mood isn't really low at the moment. I wish you much strength and also congratulate you on your 6 year achievement.