Most of us have intrusive thoughts from time to time. These are thoughts that you don’t want to have. They can be images or urges that cause you a lot of distress, anxiety, fear or discomfort. They might be violent, aggressive, sexual or blasphemous. They could make you afraid you’ll do something inappropriate or embarrassing. Perhaps you feel as though you can’t control them.
Some examples of intrusive thoughts are:
- Excessive worries about being exposed to germs.
- Picturing yourself hurting a child or animal.
- Thoughts about sexual acts that you don’t think are appropriate.
- Imagining that you would hurt yourself when you don’t want to.
“These thoughts are often unsettling to people. The more you try to push them from your mind, the more they persist. They cause guilt and shame, and people do not want to admit to them,” said Varun Monga, MD, a psychiatrist with Banner Health.
Some people think intrusive thoughts are something you unconsciously want to do. “This is not true. In fact, the opposite is true,” he said. “People fight with these thoughts because the thoughts are alien to them.”
People also think that intrusive thoughts must be meaningful. “Not all thoughts are worth examining. Your mind can create junk thoughts. As long as they are short-term and not distressing, it’s better to leave them alone,” Dr. Monga said.
He explained more about why we have these thoughts, how to cope and when to seek treatment.
Intrusive thoughts are common
“Intrusive thoughts are a normal part of human life and many people have them,” Dr. Monga said. Up to 90% of people may have intrusive thoughts at times. Having them doesn’t mean you will act on them.
An occasional intrusive thought isn’t anything to be concerned about. “As long as you recognize they are just thoughts and you have no desire to act on them, they are not harmful,” Dr. Monga said.
When to be concerned about intrusive thoughts
Persistent intrusive thoughts that interfere with your life can be problematic. Dr. Monga said signs that there could be an underlying problem include intrusive thoughts that:
- Last longer than a brief moment.
- You spend a lot of time trying to fight.
- Continue to pop up in your mind even after your best efforts to stop them.
- Cause distress and make you feel that you need to control them.
What causes intrusive thoughts?
Dr. Monga said there are a lot of factors that can cause intrusive thoughts:
- Trauma, stress and major life events. For example, women may have intrusive thoughts after the birth of a child.
- Past traumatic experiences such as an accident or an assault.
- Abnormalities in the regulation of neurotransmitters in the brain such as serotonin, dopamine or glutamate.
- Brain structure abnormalities.
- Neurological disorders such as dementia and Parkinson’s disease.
Some mental health conditions may also make intrusive thoughts more likely:
- Obsessive-compulsive disorder (OCD). “Intrusive thoughts (in this case, obsessive thoughts) are a core OCD symptom,” Dr. Monga said. These thoughts often center around fear of germs or contamination, fear of forgetting or misplacing something, fear of losing control, aggressive and violent thoughts towards others or unwanted thoughts involving sex, religion or harm.
- Post-traumatic stress disorder (PTSD). “Intrusive thoughts in PTSD are tied to memories of traumatic events,” Dr. Monga said. “They may be a flashback of the event itself.”
- Generalized anxiety disorder (GAD). These thoughts can include worrying about all aspects of life, including the safety of family members.
- Eating disorders. With eating disorders, these thoughts typically focus on your self-image.
- Depressive disorder. These intrusive thoughts can involve evaluating yourself negatively, expecting the worst to happen, ruminating over a bad experience and generalizing it to the future and overanalyzing or assuming other people's behavior towards you is negative.
- Certain phobias. You can worry excessively about the specific thing you fear.
How to cope with intrusive thoughts
To start, remind yourself that these thoughts are just thoughts. They are not real and having them does not make you a bad person. “They do not predict the future and having them does not mean something bad will happen,” Dr. Monga said.
When it’s hard to stop intrusive thoughts, don’t try to suppress them. Instead, examine them, confront them and work through them. Focus on the present moment, label these thoughts as intrusive, and allow them into your mind without trying too hard to push them away. Try not to reason with them and anticipate that they will come again.
These strategies can help:
- Mindfulness techniques such as deep breathing and meditation can help you acknowledge and examine your thoughts without getting overwhelmed by them.
- Self-care activities such as regular exercise, good sleep, eating healthily and engaging in activities you enjoy can make it easier to cope with intrusive thoughts.
When to see a professional
Dr. Monga said you should talk to a mental health professional about your intrusive thoughts if they are:
- Causing significant distress in your life.
- Disrupting your daily activities or making it hard for you to function.
- Forcing you to spend most of your time resisting them.
- Affecting your relationships.
- Progressing to thoughts of self-harm or suicide.
“Professionals can provide a combination of medications and therapy that can give you good results,” Dr. Monga said. Common medications which can treat intrusive thinking include selective serotonin reuptake inhibitors (SSRIs), benzodiazepines, and tricyclic antidepressants.
These types of therapies can be effective:
- Cognitive behavior therapy (CBT) techniques can help with intrusive thoughts caused by depression or anxiety. They help you challenge your thoughts and reframe them positively and realistically.
- Exposure and response prevention can be effective for OCD. “In this therapy, you are exposed to the situation or stimuli that trigger the intrusive thoughts and you are taught to resist the urge to engage in compulsive behaviors,” Dr. Monga said.
- Acceptance and commitment therapy can teach you to accept that you have these thoughts and must work on them mindfully. “You don’t necessarily stop them, but you accept that they are intrusive and stop them from consuming your mind,” Dr. Monga said.
The bottom line
Intrusive thoughts—thoughts that you don’t want to have and that you find distressing—are common. Examining these thoughts mindfully can help you cope with them. If you have intrusive negative thoughts that are impacting your daily life, professional care can help.
Are intrusive thoughts impacting your quality of life?
Call the Banner Behavioral Health Appointment Line at (800) 254-4357.
