Intrusive thoughts are sudden, involuntary thoughts. They are often negative or scary, and people feel they have little control over them. These thoughts commonly occur in people with mental health conditions such as anxiety and obsessive-compulsive disorder (OCD).

Although everyone may occasionally experience sudden thoughts that can be distressing or uncomfortable, some individuals experience frequent, involuntary thoughts that cause great stress and anxiety. When intrusive thoughts are a common occurrence that disrupts a person’s daily life, they may be due to a mental health condition.

In this article, we discuss what intrusive thoughts are, some myths surrounding them, and how a person can get treatment.

Intrusive thoughts are unwanted thoughts that seem to come from nowhere. They can be disturbing and unpleasant. A person usually feels unable to control these thoughts and may find they distract from daily tasks.

Intrusive thoughts are among the symptoms of:

The thoughts can be explicit, which can lead to people keeping them secret. People may not seek help because they feel ashamed.

According to the Anxiety and Depression Association of America (ADAA), intrusive thoughts are involuntary and have no bearing on reality or a person’s desires. People do not act on these thoughts, and they typically find them shocking and unacceptable.

Intrusive thoughts can be persistent and cause significant distress. Often, the harder people try to rid themselves of these thoughts, the more they persist and the more intense they become.

There are many types of intrusive thoughts, including the following:

Intrusive thoughts about sex and sexuality

Intrusive thoughts that are sexual tend to revolve around a person’s sexuality or sexually harming others. Examples include:

  • fear of being sexually attracted to infants
  • fear of being attracted to members of their family
  • fears regarding their sexual orientation

Intrusive thoughts about relationships

People may worry about their relationships, and intrusive thoughts can place a strain on them. Examples of this type of intrusive thought can include:

  • analyzing the strength of their feelings for their partner obsessively and finding fault
  • constantly seeking reassurance from a partner
  • obsessive thoughts about a partner leaving the relationship
  • doubts regarding fidelity

Intrusive thoughts about religion

Types of intrusive thoughts about religion can include a person:

  • having negative thoughts in a religious building
  • repeating certain prayers continually
  • fearing they have lost touch with their faith or beliefs
  • constantly analyzing their faith

Intrusive thoughts about violence

A person may experience thoughts about being violent toward themselves or others. Common thoughts include:

  • harming loved ones or children
  • killing others
  • using knives or other items to harm others
  • poisoning food for loved ones

People experiencing these thoughts may avoid public places and contact with others.

Intrusive thoughts about eating disorders

Intrusive thoughts are common among people with eating disorders such as anorexia nervosa and bulimia nervosa. Some common themes include:

  • ideas about perfectionism, such as being unworthy of love if a person does not achieve a “perfect” body
  • obsessive fears about gaining weight
  • inaccurate and intrusive thoughts about appearance
  • a preoccupation with eating, avoiding eating, calories in food, or “earning” food

Some people with eating disorders may also have OCD. For these individuals, disordered eating may be a ritual they use to manage intrusive anxious thoughts.

Some myths surround intrusive thoughts. These include:

Myth 1: A person wants to act on these thoughts

Fact: People do not want to act on their intrusive thoughts

According to the ADAA, the opposite is true. The most dangerous myth surrounding intrusive thoughts is that they might lead to action.

People experiencing these thoughts typically work hard to fight them, which results in the thoughts becoming persistent. The thoughts are at odds with the desires or beliefs of the person thinking them.

Myth 2: All thoughts are worth examining

Fact: Thoughts do not always have a significant meaning

People do not have to see every thought as a sign or warning about something. Despite how these thoughts can make a person feel, they do not carry meaning or desire.

Anyone can experience intrusive thoughts, and not all people who do so have a diagnosis. Some potential causes include:

  • Anxiety: Temporary anxiety, such as a person might feel before a medical procedure, might cause them to experience a range of intrusive thoughts. These may include thoughts of dying or being injured.
  • Anxiety disorders: Anxiety disorders such as generalized anxiety disorder and OCD tend to cause recurring, frequent intrusive thoughts. People with OCD use compulsions, or ritualistic behaviors, to manage these thoughts.
  • Post-traumatic stress disorder (PTSD): People with PTSD may experience repeated intrusive memories of a traumatic event. They may re-experience some of the same symptoms they experienced during the trauma.
  • Eating disorders: People with eating disorders may have intrusive thoughts about their bodies, food choices, or the need to achieve perfection. They may feel preoccupied with thoughts of food.

A person does not have to live with intrusive thoughts. Various treatment options can help.

Healthcare professionals may advise cognitive behavioral therapy (CBT) to help someone change how they think and react to these thoughts.

Another option is medication. Medications for OCD might include selective serotonin reuptake inhibitors (SSRIs) or other antidepressants, such as clomipramine. Although people typically use SSRIs to treat depression, these drugs can also help with OCD symptoms. Antidepressants can take 8–12 weeks to start working.

The ADAA offers some tips for dealing with intrusive thoughts, including:

  • identifying the thoughts as intrusive
  • clarifying that they are involuntary and irrelevant to daily life
  • accepting their presence instead of pushing them away
  • continuing usual behavior
  • understanding that the thoughts may return
  • practicing meditation or mindfulness

A person should try to avoid:

  • pushing the thoughts away
  • trying to figure out what the thoughts mean
  • engaging with the thoughts

A doctor will ask the individual questions about the nature of the thoughts and their frequency. They will also ask whether a person has a family history of mental health conditions.

They may refer the person to a mental health specialist who will check for symptoms of a mental health disorder. For example, they may ask about compulsive behaviors that indicate OCD.

Many people will experience unwanted and sudden thoughts at some point. Occasional intrusive thoughts do not necessarily mean a person needs treatment.

However, anyone who experiences regular intrusive thoughts that cause distress should contact a doctor or therapist. A healthcare professional can help the person understand what is causing the thoughts and how to treat them.

Intrusive thoughts are unwanted and involuntary thoughts that are usually disturbing in nature. People experiencing these thoughts do not act on them and often find them distressing.

Intrusive thoughts are sometimes due to an underlying mental health condition. In other cases, their cause is unclear. Treatment for an underlying condition might help reduce the intrusive thoughts.