What Causes Intrusive Thoughts and How to Stop Them

July 6, 2021

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woman working at her laptop experiencing intrusive thoughts Chances are, you’ve experienced intrusive thoughts. I’m talking about those odd or disturbing thoughts that pop into your head seemingly out of nowhere. Usually, they involve imagining yourself, just for a moment, doing something dangerous, harmful to others, or socially inappropriate. It’s not that you want or intend to do so, but you realize that you could stand up and yell obscenities in church, kiss a stranger on the bus, or ram your car into the car in front of you at the stoplight.

We don’t talk about intrusive thoughts all that much, probably because the content is often violent or sexual in nature. Yet, research suggests that intrusive thoughts are a near-universal human experience.¹ More often than not, people simply dismiss them because they’re so “out there.” A particular thought may make you pause long enough to ask yourself, “Whoa, where did that come from?!” but then you move on.

For some folks, though, intrusive thoughts become incredibly disruptive because they arise with great frequency, or because the person finds them so disturbing that they have a hard time letting them go. Sometimes both.

People who struggle with intrusive thoughts can become sidelined by shame, guilt, or anxiety. They worry that these thoughts reflect who they “really are” deep down. They believe that friends and loved ones will reject them if they knew. When the same intrusive thoughts run on a loop in their heads, they may fear that they are willing those bad things to happen or creating self-fulfilling prophecies.

Often, these individuals are reluctant to seeking help despite their profound distress. Intrusive thoughts are incredibly normal, but they shouldn’t interfere with your quality of life. While banishing them is easier said than done, some techniques show promise for helping people deal with unwanted thoughts and the angst they cause.

What Are Intrusive Thoughts?

Intrusive thoughts pop into your head unbidden, flooding your mind with upsetting content or imagery. You might suddenly picture yourself doing something you find abhorrent because it is violent, sexual in a way that you find unappealing, or just plain wrong according to your moral standards. Some intrusive thoughts involve memories of past traumatic events or incidents you’d rather forget. Others have to do with fears or phobias.

The thoughts themselves are disturbing enough on their own, but the follow-up can be worse if you start to ruminate on them:

“What does this thought mean about me?”
“What kind of person thinks these things?! I must be terrible.”
“If I’m thinking about this, does it mean that I actually want to do it? That I will do it?”

Some people even worry that they have already committed those acts without remembering.

Anxiety and self-doubt become the bigger problem in many cases. (This isn’t necessarily true for folks who have PTSD or otherwise experience intrusive thoughts related to past trauma.) Most effective treatments for problematic intrusive thoughts focus on how you respond to them rather than the thoughts per se.

Common Intrusive Thoughts

Intrusive thoughts tend to organize around common themes, such as:

Harming yourself
Intentionally or unintentionally harming others
Sexual attraction or behavior
Sacrilegious behaviors, sinning
Getting sick
Existential concerns²

If you are having thoughts of harming yourself or others, immediately call SAMHSA’s National Helpline, 1-800-662-HELP (4357).

Importantly, the content of intrusive thoughts is ego-dystonic, meaning that it’s inconsistent with how you see yourself and your closely held values. For example, you might worry that you’re attracted to someone whom you wouldn’t consider an acceptable or desirable partner, even if others would. The thoughts and images you find disturbing might not bother someone else.

One of the most distressing things about intrusive thoughts is that they make people feel so isolated. Embarrassment and shame prevent people from talking about their intrust thoughts, so it’s easy to assume—incorrectly—that you’re the only one who has them. However, there are almost certainly other people out there who experience the same thoughts as you, no matter how bizarre they may seem to you. For instance, most new parents imagine harming their baby or fear that they will do so, despite a strong desire to keep their newborn safe.³ Despite how common it is, I don’t recall ever being asked or counseled about intrusive thoughts after having my babies, nor talking about it even with my closest friends.

What Causes Intrusive Thoughts?

Nobody knows exactly what causes intrusive thoughts, nor why some people seem to get stuck on them but not others.

One theory is that intrusive thoughts come from our brains “practicing” what we will do in dangerous or stressful situations. From a survival perspective, it behooves us to anticipate potential threats and avoid doing things that would get us kicked out of the social group. Intrusive thoughts may be your brain’s vigilance system turned up to haywire, imagining extreme situations in an attempt to circumvent them. Thus, although it feels counterintuitive, intrusive thoughts could be your brain’s misguided attempt to help you navigate the world.

Even if that’s true, it still doesn’t explain why intrusive thoughts disrupt some people’s lives tremendously while others experience them only infrequently. One possibility is that individuals who struggle with intrusive thoughts make less GABA, an inhibitory neurotransmitter that helps suppress unwanted thoughts through mechanisms that aren’t fully understood.⁴ ⁵

Mental Health Disorders Associated with Intrusive Thoughts

Again, let me emphasize that intrusive thoughts are very normal. Most people, probably all people, have intrusive thoughts at least occasionally. Intrusive thoughts are not necessarily a sign that you have a specific mental health issue, any more than feeling very sad sometimes means you have clinical depression.

As with the sadness-depression spectrum, it’s a matter of degree—how frequently the thoughts occur and, in particular, how much distress they cause you. Intrusive thoughts that cause you significant distress or anxiety, or that otherwise detract from your day-to-day quality of life, might signal a bigger issue. That said, your intrusive thoughts don’t have to feel severe in order for you to seek help.

Certain mental health disorders are characterized by frequent intrusive thoughts. The obsessions in obsessive-compulsive disorder (OCD) are types of intrusive thoughts. Compulsive behaviors attempt to mitigate the negative arousal they cause. People diagnosed with a subtype of OCD called “Pure Obsessional” or “Pure O” experience obsessive thoughts without stereotypical compulsive behaviors (though they might exhibit less obvious compulsions).⁶

Intrusive thoughts frequently occur with other anxiety and mood disorders as well, including:

Generalized anxiety disorder
PTSD
Phobias, including social phobia
Postpartum depression
Bipolar disorder
Eating disorders

How to Stop Intrusive Thoughts

Note: Before taking a particular course of action, consult your healthcare provider, especially if you have been diagnosed with (or suspect you have) a concurrent mental health condition. While the treatment options listed below are generally considered best practices, individual needs vary. For help finding services, contact SAMHSA’s National Helpline, 1-800-662-HELP (4357).

Intrusive thoughts are outside our conscious control, so we can’t really stop them from happening. Sometimes, treating any associated mental health issues with targeted therapy and medications like SSRIs will alleviate intrusive thoughts. However, many people find that the thoughts return after stopping medication.

Although your instinct might be to try to push away intrusive thoughts, that rarely works. If “just don’t think about it” was an effective strategy, nobody would need treatment in the first place. Furthermore, psychologists widely agree that trying to shove down and ignore unwanted thoughts is actively counterproductive. Suppressing thoughts actually makes them more likely to stay in conscious awareness.⁷

Likewise, self-soothing actions like seeking reassurance that you’re a good person or compulsive behaviors in the case of OCD may provide short-term relief for the discomfort, but they aren’t effective long-term strategies. Plus, they can become debilitating in their own right.

Cognitive Behavioral Therapy

Since there’s no good way to prevent intrusive thoughts altogether, the preferred treatment paradigms help people learn to live with their intrusive thoughts.

According to the Cognitive-behavioral Therapy (CBT) approach, it’s not the intrusive thoughts that cause a person to suffer, it’s how they react. With CBT, people learn to change their responses—their thoughts about their thoughts—so they don’t cause as much distress. Over time, intrusive thoughts may become less frequent as they become less impactful.

One popular CBT technique is Exposure Response Prevention (ERP). With ERP, individuals are encouraged to face their fears head-on so they become desensitized to them. ERP has proven to be effective especially for OCD. However, it might be triggering for individuals with PTSD, which is why it’s important to work with a trained professional.

Mindfulness and Self-Compassion

Mindfulness practices teach us to observe our thoughts without becoming too wrapped up in them. Some people successfully use mindfulness meditation to separate themselves from their intrusive thoughts so that they aren’t so upsetting. In a similar vein, self-compassion exercises can help you process your intrusive thoughts without getting stuck in a cycle of self-recrimination.

A branch of CBT called Mindfulness-based Cognitive-behavioral Therapy aims to help people accept intrusive thoughts rather than being dragged down by them.⁸ Specific approaches that draw from mindfulness and CBT are Acceptance and Commitment Therapy (ACT) and Dialectical Behavioral Therapy (DBT).

Take Care of Your Overall Health

You might have already noticed that intrusive thoughts pop up more often when you are tired, stressed, or otherwise not taking very good care of yourself. That’s probably because your brain has fewer resources to keep unwanted thoughts at bay.⁹ Recognizing these patterns allows you to work on good self-care practices.

Thyroid imbalances—both hyperthyroidism and hypothyroidism—are also prevalent among folks with anxiety, depression, bipolar disorder, and other mental health issues associated with intrusive thoughts.¹⁰ ¹¹ ¹² Despite the well-known correlations, many doctors don’t screen people seeking mental health care for thyroid issues. Ask your doctor about getting your thyroid hormone levels checked.

Don’t Let Shame Prevent You from Seeking Help

Many people are reluctant to seek help because their thoughts feel so despicable. Surely if they tell anyone, the other person will think they’re horrible, right?

The likelihood that your intrusive thoughts are the worst, most socially unacceptable thoughts that have ever been thought by any human ever is exceedingly small. Even if they are, you still deserve to feel better. Any competent therapist should be able to listen without judgment. Frankly, they’ve probably heard it all before. If you somehow manage to come up with something new, it’s their job to listen and offer the help you need.

There are books and workbooks you can start to work through on your own if you’re not ready to talk to anyone yet. Online therapy could be another great option if face-to-face therapy feels too daunting.

If you take nothing else from this post, know that you are not alone. Intrusive thoughts do not make you a bad person. Thoughts are not actions, and thinking about something is very different from actually doing it. It might not be possible to stop intrusive thoughts, but with help, you can learn to live in peace, which you deserve.

Intrusive Thoughts FAQs

What are intrusive thoughts?

Intrusive thoughts are thoughts that pop into your head, seemingly from nowhere, that you find disturbing or distressing. Often, they are violent or sexual in nature, or they involve things you are afraid of. Some intrusive thoughts are memories of past experiences or trauma you’d rather not think about.

Are intrusive thoughts normal?

Yes! Nearly everybody experiences intrusive thoughts, at least occasionally. Intrusive thoughts are not a sign that anything is “wrong” with you, nor that you have a more serious mental health problem. However, if you find your intrusive thoughts upsetting, it’s a good idea to talk to a professional.

What causes intrusive thoughts?

One theory is that intrusive thoughts come from our brains “practicing” what we will do in dangerous or stressful situations. Intrusive thoughts are characteristic of anxiety and mood disorders, though it’s not clear whether they lead to or are caused by these disorders, or possibly both.

What are some common intrusive thoughts?

Intrusive thoughts tend to follow a few common themes: fear of hurting yourself or others; engaging in behaviors, including sexual behaviors, you deem undesirable or inappropriate; getting sick or contaminated; or existential concerns. It’s important to note that thinking about these things doesn’t mean you want to act on them.

How do I stop intrusive thoughts?

You can’t control the thoughts that pop into your head, but you can learn to manage your response to them using cognitive-behavioral therapy and mindfulness techniques. Psychopharmacological treatments might be useful in some cases. Take care of your overall health as well.