While intrusive thoughts are associated with obsessive-compulsive disorder (OCD), they’re something that can happen to anyone. You ever go about your day when, out of nowhere, you get a sudden unsettling thought?

The contexts of these thoughts can vary, from an embarrassing memory to something immoral. They usually leave you in distress – especially if they occur frequently and get in the way of your daily life.

Luckily, there are ways to manage them. Throughout this article, we’ll look at intrusive thoughts and coping mechanisms you can incorporate.

What are Intrusive Thoughts?

An intrusive thought is a thought that suddenly enters your mind and portrays an image that is either upsetting, unsettling, and/or completely strange. ¹ Everyone gets them from time to time. However, some struggle with repeated intrusive thoughts, either of the same thought or a selection of thoughts.

If you struggle with these thoughts, you may face unique difficulties in life. These include: ²

• Difficulty maintaining personal connections (i.e. friends or family)
• Frustration with parenting
• Relationship complications
• Trouble with responsibilities (i.e. school or work)

Understandably, many don’t act upon an intrusive thought. Therefore, it may be assumed that living with intrusive thoughts is okay. Still, it’s unhealthy to let them fester in our brains. When unchecked, these thoughts can result in compulsive behaviors. ³

Why Do We Experience These Thoughts?

There are several different reasons intrusive thoughts appear, most of which correlate back to a mental health condition. ⁴ For example, if you have a social anxiety disorder, you may have these thoughts about embarrassing yourself in public.

Similarly, people with post-traumatic stress disorder (PTSD) are bound to have flashbacks from their traumatic experiences. Just like an intrusive thought, these flashbacks may appear at random. The only difference is they’re much more intense (sometimes realistic) and may show physical signs. ⁵

Still, it’s worth noting that intrusive thoughts aren’t always random. Sometimes, they appear through triggers. ⁶ For example, with PTSD, flashbacks may occur when you come in contact with a reminder of your trauma.

The most common trigger for intrusive thoughts is stress. This is why these thoughts can affect everyone. Mild stress can cause minor intrusive thoughts. Whereas major stress can cause severe intrusive thoughts (as seen in mental disorders). Stress can be brought about by several factors, including: ⁷

• Anxiety
• Disruptions to routine
• Hormonal changes
• Lack of sleep
• Major life changes

Treatment for Intrusive Thoughts

If your intrusive thoughts are severe, you must seek medical assistance. Intrusive thoughts can be dangerous to you and those around you. It may lead to violence or damage in relationships and its disruptions to daily life can lead to other consequences (i.e. job loss).

In most cases, severe intrusive thoughts can be attached to a mental health condition. The most common associated with these thoughts include:

• Anxiety
• Attention-deficit/hyperactivity disorder (ADHD)
• Bipolar disorder
• Depression
• Obsessive-compulsive disorder (OCD)
• Post-traumatic stress disorder (PTSD)
• Tay-Sachs disease (TSD)

Medication for Intrusive Thoughts

If you only have intrusive thoughts as a symptom of another condition, your healthcare provider may prescribe medication to directly target that condition. However, if you struggle with OCD, you’ll likely be prescribed one of the following antidepressants: ⁸

• Citalopram (Celexa)
• Clomipramine (Anafranil)
• Escitalopram (Lexapro)
• Fluoxetine (Prozac)
• Fluvoxamine (Luvox)
• Paroxetine (Paxil)
• Sertraline (Zoloft)
• Venlafaxine (Effexor)

Psychotherapy for Intrusive Thoughts

Alongside medication, you may also be recommended psychotherapy for your intrusive thoughts. The purpose of psychotherapy is to teach you how to manage negative thought patterns and develop healthy coping mechanisms.

The most common therapy for intrusive thoughts is cognitive behavioral therapy (CBT). This will help you understand where your unwanted thoughts come from (i.e. trauma) while giving you tools to manage these thoughts. ⁹ Two other types of CBT you may be recommended include:

• Acceptance and Commitment Therapy (ACT) – Focuses on accepting your thoughts and emotions rather than trying to change them. Through acceptance, the goal is to develop mindfulness and more adaptable thinking. ¹⁰

• Exposure and Response Prevention (ERP) – By exposing you to your fears, ERP aims to help you reveal their irrationality and allow you to develop coping mechanisms. This is a common form of treatment for PTSD. ¹¹ ¹²

People with intrusive thoughts have a habit of “spacing out” when these thoughts arise. As such, it’s believed that hypnosis communication may help relieve unconscious fears. ¹³ However, it’s unlikely your doctor will recommend this form of treatment.

What Can You Do About Intrusive Thoughts?

Beyond professional treatment, there are several things you can do for these thoughts. The first step is to devise a worksheet that lays out your intrusive thoughts. From what they are to when they happen to how you can improve.

To develop this worksheet, it’s recommended you take the following steps:

1. Categorize the thoughts as “intrusive thoughts.”
2. Remember you have no control of these thoughts (they’re usually an automatic response).
3. Accept these thoughts and allow them to take hold of your mind. It’s important not to push them away.
4. When these thoughts appear, try to let them pass rather than fight them.
5. Pause and remember to give yourself the time.
6. Understand that these thoughts will come back again.
7. When you feel these thoughts coming on, do whatever you can to let them pass with ease.

Therapy can help you with this process. Since your intrusive thoughts aren’t 100% understood, therapy will give you an outside perspective that may help you to understand.

References

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² Kühn S, Schmiedek F, Brose A, Schott BH, Lindenberger U, Lövden M. The neural representation of intrusive thoughts. Soc Cogn Affect Neurosci. 2013 Aug;8(6):688-93. doi: 10.1093/scan/nss047. Epub 2012 May 3. PMID: 22563007; PMCID: PMC3739913.

³ Warman DM. Decision-making about intrusive thoughts: Relationships to attitudes towards them. J Behav Ther Exp Psychiatry. 2020 Sep;68:101571. doi: 10.1016/j.jbtep.2020.101571. Epub 2020 Apr 8. PMID: 32325286.

⁴ Arnáez S, García-Soriano G, López-Santiago J, Belloch A. Illness-related intrusive thoughts and illness anxiety disorder. Psychol Psychother. 2021 Mar;94(1):63-80. doi: 10.1111/papt.12267. Epub 2020 Jan 20. PMID: 31957211.

⁵ Jones E, Vermaas RH, McCartney H, Beech C, Palmer I, Hyams K, Wessely S. Flashbacks and post-traumatic stress disorder: the genesis of a 20th-century diagnosis. Br J Psychiatry. 2003 Feb;182:158-63. doi: 10.1192/bjp.182.2.158. PMID: 12562745.

⁶ Arnáez S, García-Soriano G, López-Santiago J, Belloch A. Dysfunctional beliefs as mediators between illness-related intrusive thoughts and health anxiety symptoms. Behav Cogn Psychother. 2020 May;48(3):315-326. doi: 10.1017/S1352465819000535. Epub 2019 Oct 10. PMID: 31597585.

⁷ Ferreira S, Couto B, Sousa M, Vieira R, Sousa N, Picó-Pérez M, Morgado P. Stress Influences the Effect of Obsessive-Compulsive Symptoms on Emotion Regulation. Front Psychiatry. 2021 Jan 20;11:594541. doi: 10.3389/fpsyt.2020.594541. PMID: 33551866; PMCID: PMC7854917.

⁸ Pittenger C, Kelmendi B, Bloch M, Krystal JH, Coric V. Clinical treatment of obsessive compulsive disorder. Psychiatry (Edgmont). 2005 Nov;2(11):34-43. PMID: 21120095; PMCID: PMC2993523.

⁹ Freeston MH, Ladouceur R, Gagnon F, Thibodeau N, Rhéaume J, Letarte H, Bujold A. Cognitive-behavioral treatment of obsessive thoughts: a controlled study. J Consult Clin Psychol. 1997 Jun;65(3):405-13. doi: 10.1037//0022-006x.65.3.405. PMID: 9170763.

¹⁰ Vakili Y, Gharraee B. The effectiveness of acceptance and commitment therapy in treating a case of obsessive compulsive disorder. Iran J Psychiatry. 2014 Apr;9(2):115-7. PMID: 25632289; PMCID: PMC4300464.

¹¹ Song Y, Li D, Zhang S, Jin Z, Zhen Y, Su Y, Zhang M, Lu L, Xue X, Luo J, Liang M, Li X. The effect of exposure and response prevention therapy on obsessive-compulsive disorder: A systematic review and meta-analysis. Psychiatry Res. 2022 Nov;317:114861. doi: 10.1016/j.psychres.2022.114861. Epub 2022 Sep 25. PMID: 36179591.

¹² Markowitz S, Fanselow M. Exposure Therapy for Post-Traumatic Stress Disorder: Factors of Limited Success and Possible Alternative Treatment. Brain Sci. 2020 Mar 13;10(3):167. doi: 10.3390/brainsci10030167. PMID: 32183089; PMCID: PMC7139336.

¹³ Vickers A, Zollman C, Payne DK. Hypnosis and relaxation therapies. West J Med. 2001 Oct;175(4):269-72. doi: 10.1136/ewjm.175.4.269. PMID: 11577062; PMCID: PMC1071579.