Intrusive thoughts are ones that people do not want to have and feel they have no control over. These thoughts may cause a person anxiety, distress, or shame.
Intrusive thoughts may be recurring thoughts that are sexual, violent, socially unacceptable, or paranoid in nature.
Various conditions may cause intrusive thoughts, such as OCD, anxiety disorders, or post-partum depression.
In this article, we look at the type of intrusive thoughts a person may have, medications and therapies to treat intrusive thoughts, and other steps a person can take to help manage unwanted thoughts.
Intrusive thoughts are thoughts that come into the mind and cause distress or anxiety to the person thinking them.
Intrusive thoughts may include thoughts that are:
- socially unacceptable
- doubts or fears about relationships, decisions, body image, sexual orientation or identity, safety, or other issues
- about death, religion, or unanswerable questions
People who have intrusive thoughts may feel shame around these thoughts, or fear that these thoughts make them a bad person.
People may also worry that something bad will happen to them, or that they will carry out the acts they are seeing in their mind.
Certain health conditions can cause intrusive thoughts:
- Obsessive-compulsive disorder (OCD): Recurring intrusive thoughts that people feel they have no control over
may be a signof OCD.
- Post-traumatic stress disorder (PTSD): PTSD
can causepeople to have recurrent intrusive thoughts and memories.
- Eating disorders: An eating disorder
may causepeople to have intrusive thoughts about body image, food, and eating.
- Anxiety disorders: An anxiety disorder may make people have persistent worries or intrusive thoughts that will not go away.
- Post-partum depression: People with post-partum depression may have intrusive thoughts about harming their child.
- Psychosis: If intrusive thoughts are bizarre or paranoid, it may be a symptom of psychosis. Schizophrenia, bipolar disorder, and some medications may cause psychosis.
Certain medications may help to treat intrusive thoughts by altering chemical messengers, called neurotransmitters, in the body:
SSRIs are a type of medication people
SSRIs block the reabsorption of serotonin to increase serotonin levels in the brain.
Benzodiazepines are drugs that slow down the rate at which messages travel between the brain and the rest of the body.
Benzodiazepines are mild tranquilizers, which means they can help to relieve stress and anxiety.
TCAs may have more side effects than other medications for intrusive thoughts, so may be an option if other medications do not work.
|Generic (brand) name||Type||Description||Possible side effects|
|Diazepam (Ducene or Valium), oxazepam (Alepam, Murelax, or Serepax), nitrazepam (Alodorm or Mogadon) temazepam (Euhypnos or Normison), alprazolam (Xanax, Kalma, or Alprax)||Benzodiazepines||Diazepam is long-acting, nitrazepam is intermediate-acting, and oxazepam, temazepam, and alprazolam are short-acting. Short-acting benzodiazepines may be more addictive and cause stronger withdrawal symptoms.||depression, confusion, changes in mood and memory, headache, drowsiness, fatigue, dry mouth, slurred speech, vision changes, impaired coordination, dizziness, nausea, loss of appetite, diarrhea, constipation|
|Fluoxetine (Prozac), Sertraline (Zoloft), Paroxetine (Brisdelle, Paxil, Paxil CR, Pexeva), Fluvoxamine (Luvox), Citalopram (Celexa), Escitalopram (Lexapro), Vilazodone (Viibryd)||SSRIs||SSRIs are ||sexual dysfunction, sleep issues, anxiety, changes in weight, dizziness, dry mouth, headache, gastrointestinal issues|
|Clomipramine (Anafranil)||TCAs||Clomipramine may be ||constipation, dizziness, dry mouth, blurred vision, confusion, urinary retention, increased heart rate|
Other treatments include the following, which people may use as a stand-alone treatment or in combination with medication:
Cognitive behavioral therapy (CBT)
- anxiety disorders
- eating disorders
- psychiatric disorders
CBT works to change thinking patterns by helping people to:
- learn to recognize distorted thoughts that are causing problems, and then see them in reality
- learn problem-solving strategies to deal with difficulties
- learn techniques to calm the mind and body
- develop coping skills
CBT may provide significant improvement in how people are able to function and their quality of life. It may be as effective or more effective than other types of therapy or medication.
Exposure and response prevention therapy (ERP)
ERP is a type of CBT, that may be particularly beneficial to people with OCD.
With ERP, rather than trying to ignore or suppress an intrusive thought, people will learn to notice the thought and work with a healthcare professional to prevent any compulsive behavior that may result from it.
According to the
Other steps that people may find helpful in managing intrusive thoughts include:
- learning to notice any intrusive thoughts and label them as “intrusive thoughts”
- remembering that these thoughts are not of their choosing and occur automatically
- letting the intrusive thoughts float through the mind without trying to push them away
- pausing and taking time to accept and allow the thoughts
- expecting the thoughts to return
- continuing with whatever was happening before the thought occurred and allowing any feelings of anxiety or worry to be present
It may also be helpful to avoid:
- engaging with the thoughts in any way
- trying to push the thoughts out of the mind
- trying to work out any meaning to the thoughts
People can contact a doctor if they have intrusive thoughts that are interfering with their everyday life, causing them distress, or that they think could be a sign of a mental health condition.
Working with a therapist or healthcare professional may help people to understand that their intrusive thoughts are separate from them and help them work on reducing the impact the thoughts have.
If people have any thoughts of self-harm or suicide, they will need to seek help straight away from a medical professional or call 911. People can also call the Suicide and Crisis Lifeline at 988.
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
CBT and ERP may be effective treatments for intrusive thoughts and may be
Learning to allow intrusive thoughts and any feelings they may bring up without trying to push them away may be an effective way of reducing the frequency and intensity of intrusive thoughts.
Intrusive thoughts are thoughts that may feel disturbing, distressing, or uncontrollable to the person having them.
The more people try to suppress intrusive thoughts, the more frequently they may occur.
Learning techniques to notice and allow intrusive thoughts, such as through CBT, may help reduce the impact of intrusive thoughts.
Medications and ERP may also help, particularly for conditions such as OCD.
If people are experiencing intrusive thoughts, they can speak with a healthcare professional for advice and treatment.