Intrusive thoughts are a symptom of obsessive-compulsive disorder (OCD), a mental health condition in which a person experiences involuntary obsessions and compulsions that may cause distress.
Intrusive thoughts repeatedly and automatically enter one’s mind. They may consist of feelings, mental images, memories, or urges to do something. They can be distressful and upsetting and make a person feel ashamed or scared.
Almost everyone may experience intrusive thoughts occasionally. The thoughts that pop into one’s mind may have no meaning or significance and result from the brain producing thousands of thoughts daily. The concern with OCD develops when the intrusive thoughts are involuntary and cause negative emotions.
This article explains what intrusive thoughts are and why they may happen. It also details treatment for OCD and intrusive thoughts.
An intrusive thought is an unwanted thought that enters someone’s mind. It may be an unwanted mental image, a feeling or sensation, a memory, or an urge to do something someone may not want to do.
Intrusive thoughts can result from specific causes or happen randomly. They may make the person feel ashamed, scared, or unhappy and go against the person’s values or beliefs.
Intrusive thoughts that frequently occur and cause stress, anxiety, or upset are usually symptoms of OCD. Mental health conditions that can involve intrusive thoughts include:
The thoughts can be unsettling due to their nature, such as being explicit, socially unacceptable, or offensive. In reality, they have no power at all. They are simply thoughts someone’s brain produces.
However, when they result from OCD, intrusive thoughts can become obsessions. The obsession can then become a compulsion, such as doing a particular action to eliminate the thought.
It is important to remember that a person cannot control intrusive thoughts. A thought entering does not make it significant or worth examining.
It does not mean the person agrees or wants the thoughts to become realities. Thoughts can come and go without bearing on a person’s beliefs or desires. If someone does not pay attention to them, they will eventually disappear.
Learn more about intrusive thoughts.
What is OCD?
OCD is a
- Obsessions: Obsessions are intrusive thoughts that become anxiety-inducing and disturbing, causing the person undue stress. Common obsessions include having thoughts about harming oneself or others despite having no desire to do either.
- Compulsions: Compulsions are actions a person feels like doing to control intrusive thoughts or obsessions or relieve the anxiety they cause. An example includes constantly washing hands due to obsessions regarding cleanliness and germs.
Treatment for OCD includes certain medications such as antidepressants, psychotherapy, or both.
A person with OCD may ruminate on a particular intrusive thought. The thought can become repetitive, and the anxiety with the thought may lead a person to believe that it says something about who they are.
Intrusive thoughts can also be unsettling and stressful because they:
- cause a person to worry about what the thoughts mean or why they are thinking such thoughts
- involve explicit, socially unacceptable, or offensive topics
- make a person feel there is something wrong with them
- result in a person indulging in compulsions to try and soothe or remove the thoughts or rumination with no end, known as pure O
OCD can capture deep insecurities a person feels, which is why the obsessions or intrusive thoughts are so distressing. A person can feel they want to do the things they imagine. Otherwise, they would not have the thoughts at all. The thoughts feel threatening and take much effort mentally or physically when ruminating on them.
Intrusive thoughts do not reflect a person’s personality, beliefs, or desires. Not all thoughts are worth examining, but a person with OCD can do just that to get rid of the “stickiness” of the thought.
Two things are essential to remember with intrusive thoughts:
- Just because a person has the thought does not mean they want to act on it or desire it.
- Not all thoughts need examination. The brain can make up random thoughts with no meaning behind them.
Intrusive thoughts due to OCD can include:
- self-harm thoughts
- ideas of harming people close to someone, such as family members
- unwanted sexual thoughts about others
- violent thoughts
- thoughts of harming children or animals
- doubt-causing thoughts, such as in relationships
- recurrent thoughts, reminders about painful past events
- concerns about doing something embarrassing in front of others
- worries about exposure to diseases, germs, or becoming seriously unwell
- taboo thoughts about religion or sex
- weight- and appearance-related thoughts
Almah’s story: Intrusive thoughts and OCD
“My experience with intrusive thoughts has been rather hellish. I’ve felt afraid of being a horrible person because of the thoughts that haunt and hound me. At its worst, I was a nightmare-riddled brain, nothing else.
“Medication helped me for years, as did individual and group therapy. Although I still see a therapist who specializes in OCD, I also rely on a variety of strategies. I use immersive storytelling podcasts to redirect my intrusive thoughts, especially when trying to fall asleep at night.
“I remind myself that I am not my OCD and talk back to it when it tries to convince me that my intrusive thoughts mean that I am a latent serial killer. I am not buying what my OCD is selling.
“More than anything, active artistic practice helps me shunt my obsessive tendencies into something more generative and life affirming.”
This table details how intrusive thoughts or obsessions can result in compulsions.
| Obsession or intrusive thought | Resulting compulsion |
|---|---|
| I frequently think about harming others. | isolating oneself and staying away from people, including loved ones, or repeatedly checking to see whether they are fine |
| I am full of germs and feel sick. | excessive cleaning of spaces, or themselves, frequent or over-washing |
| I frequently think about sexually taboo subjects. | deliberately thinking certain thoughts to “cancel” out the intrusive ones |
| I fear losing or forgetting things. | repeatedly checking they have not forgotten anything, to the point it becomes a hindrance |
Types of OCD
Subtypes of OCD can result in different intrusive thoughts, such as:
- harm OCD
- sexual OCD or SO-OCD
- relationship OCD
- contamination OCD
Intrusive thoughts may cause negative emotions, such as fear and anxiety. To relieve them, people perform compulsions, believing they can get rid of them by performing a certain action.
However, the act’s reassurance and relief are only temporary, and eventually, the need to relieve it becomes more severe, along with the intrusive thought.
Intrusive thoughts become stronger when a person experiences worry, stress, overthinking, and compulsive reassurance.
The way to reduce intrusive thoughts is to lower sensitivity to them, not by reassurance through compulsions.
Although many people experience intrusive thoughts, those with OCD may find them more severe and anxiety-inducing, resulting in compulsions.
Some potential causes of intrusive thoughts and OCD include:
- PTSD: PTSD is an anxiety disorder that stems from experiencing traumatic events, resulting in flashbacks, severe anxiety, and nightmares. Some events from the trauma may appear as intrusive thoughts that a person feels they cannot escape from, or they relive it.
- Anxiety disorders: Anxiety disorders such as generalized anxiety disorder can result in frequent intrusive thoughts.
- Eating disorders: Eating disorders may result in frequent
negative thoughts about a person’s body, appearance, weight, or eating habits. - Genetics: The International OCD Foundation says that research shows that OCD can run in families. If a person has a close family member, such as a parent or sibling, with OCD, then they may be more likely to experience it.
- Biology: Brain structures in people with OCD may be different from those without it. The structures that help manage behavior and emotional responses may relate to OCD and how the brain processes fear, anxiety, obsessive thoughts, and compulsive behavior.
- Temperament and personality: The National Health Service says those more likely to get OCD may appear more neat, careful, and focused on organization and structure than usual. They may also set high standards for themselves more strictly. These personality traits may develop from a strong sense of responsibility for themselves or having negative emotions during childhood, such as anxiety or depression.
Treatment for OCD and intrusive thoughts
- Psychotherapy: Psychotherapy can include cognitive behavioral therapy (CBT) or exposure and response prevention therapy. CBT aims to help a person recognize harmful ways of thinking and question negative and intrusive thoughts.
- Medications: Serotonin is the chemical in the brain involved in mental health conditions such as OCD or depression. Some medications usually prescribed for depression may help with OCD and intrusive thoughts, such as selective serotonin reuptake inhibitors.
- Transcranial magnetic stimulation: This is a noninvasive therapy in which a magnet delivers low intensity pulses to stimulate particular parts of the brain that link to OCD.
Steps for changing intrusive thoughts can include:
- labeling the thoughts as intrusive and not as believed
- remembering the brain produces meaningless, automatic thoughts
- accepting the thoughts as they are, just harmless thoughts
- avoiding engaging with the thoughts
Treatment like CBT can help a person recognize harmful intrusive thoughts as meaningless, automatic products of the brain, as well as learn to manage the anxiety that may accompany them.
Support groups for OCD can help by providing resources and a sense of community with others who may experience OCD and intrusive thoughts.
Intrusive thoughts are ones that repeatedly and automatically enter the mind, causing feelings of anxiety and distress about their subject matter. Although almost everyone may experience them, intrusive thoughts that repeatedly return link to OCD.
Treatment for intrusive thoughts ranges from medications to psychotherapy, which can help a person understand that intrusive thoughts are harmless and bear no meaning on what the person truly thinks, feels, or desires.