Have you ever had a thought or image pop up in your head that made you feel anxious, uncomfortable, or even scared? You could be driving past some pedestrians and suddenly think, What if I just plowed my car into them? You don’t act on the thought, but it’s still disturbing. So what just happened? You’re dealing with what’s known as an intrusive thought.
Intrusive thoughts are ideas, sensations, feelings, images, and/or urges that are unwanted and distressing. The “intrusive” aspect of these thoughts means that they’re not something you really want taking up space in your mind. But they do anyway—and these thoughts can feel particularly loud and powerful.
While intrusive thoughts can be jarring—especially thoughts related to harming others—they’re a normal part of being human. Most people can move on from them rather quickly. However, if anxiety-provoking thoughts are repeatedly causing you distress, or they’re creating issues in your day-to-day life, it could be a sign of an underlying mental health condition like obsessive-compulsive disorder (OCD).
What causes intrusive thoughts?
The exact cause of intrusive thoughts is not fully understood—it’s believed that a combination of biological, psychological, and environmental factors contribute to their development.
While unwanted thoughts happen spontaneously, there are a variety of factors that can make them more frequent and intense, such as stress, illness, lack of sleep, and significant life changes (e.g., having a baby).
It’s also worth noting that intrusive thoughts tend to stick out more in our minds because they are unpleasant. Thoughts, feelings, and urges we view as negative may feel more significant than mental experiences we view as neutral or positive.
Are intrusive thoughts normal?
Having mental experiences that are unwanted and unpleasant is a normal part of being human. “We have so many thoughts daily,” says NOCD Therapist Monique Selman, MS LMFT. “Some are good, some are bad, and some make us uncomfortable.”
Your mind is constantly reacting to your environment, and the content of some of those thoughts will inevitably be weird, awkward, or make you feel uneasy. In fact, research suggests that people who have active internal monologues tend to have more frequent unwanted thoughts.
Do people act on intrusive thoughts?
Having an intrusive thought is not the same as having a desire to do something—a random thought about doing harm is not the same as having the intent to harm yourself or someone else.
Intrusive thoughts are ego-dystonic, meaning they go against your values, morals, and beliefs. In other words, they are not about things you want to happen. These thoughts cause fear and shame, and can even make you question if you’re a bad person.
When do intrusive thoughts become a problem?
Intrusive thoughts come and go for most people. However, if you frequently find yourself ruminating on your unwanted thoughts, it could be a sign of a more complex issue.
Mental health conditions associated with intrusive thoughts
Although the existence of intrusive thoughts doesn’t necessarily mean that you have a mental health condition, research shows that there are some conditions that tend to cause these thoughts more frequently. These include the following:
Anxiety
While there are many different types of anxiety disorders, generalized anxiety disorder (GAD) is characterized by intense worry or anxiety that you just can’t shake. There’s endless things to be anxious about, and these feelings can pop up in the form of intrusive thoughts: What’s going to happen in the future? What if I lose my job?
Of course, some amount of anxiety is normal—it allows you to think two steps ahead and keep you and your loved ones safe. But GAD is more about intense, severe anxiety that makes it difficult to focus, increases irritability, and causes you to lose sleep.
Post-traumatic stress disorder (PTSD)
Post-traumatic stress disorder (PTSD) can occur after going through something shocking, scary, or dangerous, such as war, an assault or abuse, a natural disaster—or being a witness to one of these events. With PTSD, intrusive thoughts can come in the form of intrusive dreams or flashbacks where you relive your trauma.
Obsessive-compulsive disorder (OCD)
Obsessive-compulsive disorder (OCD) is a cycle of obsessions (intrusive thoughts, images, sensations, feelings and/or urges that cause distress) and compulsions (mental or physical behaviors done to neutralize the distress or prevent something bad from happening).
But how can you tell if your intrusive thoughts are connected to OCD? Here are a few indicators:
- You believe intrusive thoughts mean something. People without OCD usually let their intrusive thoughts go quickly without much introspection. But those of us with OCD have a tendency to attribute meaning to whatever random thought appears in our mind. The logic being that these thoughts must signify that something is wrong, because why else would they appear?
- You perform compulsions. What characterizes an intrusive thought as a component of OCD is how much emotional distress the thought causes you, and whether you try to alleviate that anxiety via compulsions. Intrusive thoughts become unsettling to the point where you feel you must find a way to eradicate them through taking action. You get caught in an endless loop, believing you can neutralize intrusive thoughts and make them go away.
- Your thoughts interfere with your ability to function. The criteria for being diagnosed with OCD is that you spend at least an hour a day experiencing OCD symptoms, like intrusive thoughts. “You might engage with intrusive thoughts by asking yourself questions about them or trying to reason with yourself,” says Selman. If ruminating over intrusive thoughts is taking up huge chunks of your day, your work, school, and/or social life may be affected.
Examples of intrusive thoughts in OCD
In OCD, recurrent unwanted thoughts (known as obsessions) have a range of themes, including:
- Violence: What if I stab my friend?
- Relationships: What if I’m not actually attracted to my partner?
- Religion: Did I do something that angered God?
- Contamination: What if I use the public bathroom and catch a disease?
- Health: What if I die of cancer and ruin my family’s life?
- Public humiliation: What if I say something inappropriate in front of my co-workers?
- Existential topics: What if this is all a computer simulation?
Find the right OCD therapist for you
All our therapists are licensed and trained in exposure and response prevention therapy (ERP), the gold standard treatment for OCD.
Can you stop intrusive thoughts?
There’s no way to stop intrusive thoughts completely, but there is a way to change your reaction to them.
The problem isn’t having an intrusive thought—it’s your relationship to that thought. If you interpret your thoughts as a threat to your sense of self, place value on them, or try to push them away, you may actually cause yourself more distress.
Selman advises, “You’re under no obligation to take your intrusive thoughts seriously. These thoughts do not need to be evaluated or dug into deeper. They don’t deserve time, effort, or attention.” It’s okay to acknowledge the presence of an intrusive thought, just skip the self-judgment.
If your intrusive thoughts are part of a pattern of obsessions and compulsions, you’ll most likely need some extra help getting back on track. Fortunately, there are therapists who specialize in breaking the OCD cycle.
Treating unwanted thoughts in OCD
OCD is best treated with exposure response prevention (ERP) therapy, a specialized form of cognitive behavioral therapy (CBT). ERP therapy is divided into two parts: exposures and response prevention techniques.
During ERP, your therapist will teach you strategies to refrain from performing compulsions in response to intrusive thoughts. Instead of doing mental or physical behaviors to try and alleviate discomfort (e.g., counting, checking, asking for reassurance), you’ll learn how to sit with the doubt and uncertainty that your obsessions bring up. Over time, you’ll find that intrusive thoughts don’t have the same power over you.
Bottom line
Intrusive thoughts happen to most people at some point. While they can be disturbing, they don’t reflect your morals, values, or true intentions.
However, mental health conditions like obsessive-compulsive disorder (OCD) can cause intrusive thoughts to become unmanageable. If you’re experiencing significant distress from your intrusive thoughts, or you feel like they are taking over your life, reach out to a therapist who specializes in OCD. They can help you build a different relationship with your thoughts so that you can feel better without having to rely on compulsions.
Key takeaways
- Intrusive thoughts are unwanted ideas, images, sensations, feelings, and/or urges that pop into your mind. Having intrusive thoughts is a normal part of being human.
- If intrusive thoughts are causing distress in interfering with daily life, it could be a sign of an underlying mental health condition such as obsessive-compulsive disorder (OCD).
- Exposure and response prevention (ERP) therapy is a treatment for OCD that can help you better manage the uncertainty and doubt caused by unwanted thoughts.
