What Are Intrusive Thoughts?

Medically Reviewed by Jabeen Begum, MD on April 23, 2024
Written by Keri Wiginton
10 min read

Have you ever had an unwanted thought or image stuck in your head? Usually, you can ignore it and move on. But sometimes, it just keeps popping right back up.

You don’t want to have these sticky, uncomfortable thoughts. So why do they happen to you? They're called “intrusive thoughts,” and nearly everyone has them from time to time. They can range from random images to disturbing and violent ideas such as punching someone in the face or hurting yourself.

They're usually harmless. But if you obsess about them so much that they interrupt your day-to-day life, this can be a sign of an underlying mental health problem. Intrusive thoughts can be a symptom of anxiety, depression, or obsessive-compulsive disorder (OCD).

Intrusive thoughts can come in many forms.

Sexual thoughts. It’s natural to often have sexual thoughts. When you feel uncomfortable with or shocked by such thoughts, you may fixate on them and try hard to push them away. Experts say it’s best to remind yourself that these are just passing, automatic thoughts. They don’t define you in any way.

Violent thoughts. Your thoughts may have dark or violent themes such as hurting yourself or someone else. Often, they're just harmless, repetitive thoughts that you have no intention of acting on. You don’t even want them in your head. And they'll pass in time. But if you find yourself planning to follow through on your aggressive thoughts, you need professional help to manage your emotions. Talk to a doctor or a therapist.

Negative or self-doubt thoughts. Sometimes, when things don’t work out as planned, you might think of yourself as a “loser” or feel you’re not good enough. These thoughts should fade as your situation changes. But if they become overwhelming, you could have depression or anxiety. Talk to a mental health professional about how to control your symptoms.

Health-related thoughts. Contamination fears are a common type of intrusive thought. You may think about coming into contact with germs that can make you sick such as when you have to touch a doorknob in public, have sex with someone, or when you’re around dirt or other things out in nature.

Religious thoughts. You may constantly worry that the way you think is impure or sinful. Your thoughts may include doubt in your beliefs or fear that you may anger or offend your higher power in some way. Sacred images or phrases may pop into your mind all the time.

Public humiliation thoughts. You may have thoughts that you’ll do or say something embarrassing or inappropriate in public, such as swearing, having sex, or exposing yourself.

Death or suicidal thoughts. You may think about ways you might die or see flashes of suicidal behavior (such as cutting yourself). Intrusive thoughts of self-harm may often be the opposite of how you actually feel. But if you think you might hurt yourself, call or text 988 Suicide & Crisis Lifeline right away.

Thoughts about the safety of yourself and loved ones. You may think about all the ways you or your loved ones might get hurt. This may include situations in or out of your home.

Trauma-related thoughts. Images or memories of bad things that have happened to you in the past may pop into your mind. These thoughts and emotions may be unpleasant enough to interrupt whatever you’re doing.

Other types of intrusive thoughts. You can also have bizarre, weird, or paranoid thoughts that are basically “junk” thoughts. You have no control over them, and most of the time, they have no meaning or relevance in your life. It’s best not to take them personally or pay much attention to them. But if they last a long time, or you keep having episodes of them, talk to your doctor to rule out an underlying mental disorder.

Yes. According to one global survey, 93% of participants reported having at least one intrusive thought over 3 months. This holds true for folks with or without a diagnosed mental health condition. They only become a problem when they interrupt your daily life or cause a lot of anxiety.

At the end of the day, most intrusive thoughts are just thoughts. They're not a red flag or a signal that you actually want to do those disturbing things. If they bother you, you can take steps to cut down on their frequency and intensity.

You can:

  • Recognize and label them for what they are -- intrusive thoughts that you can’t control.
  • Just let them stay, instead of trying to push them away.
  • Accept that they will pass eventually.
  • Give yourself time for them to fade away.
  • Prepare yourself for unwanted thoughts to come back.
  • Continue to do whatever you were doing when the intrusive thoughts flooded your head.

Don’t:

  • Act or engage with these random, repetitive thoughts.
  • Try to question why you’re having them in the first place.
  • Look for meaning behind them.
  • Try to stop them. If you do this, you may fixate more on them.

This can be hard to do. But over time, being less sensitive to intrusive thoughts can reduce the emotional effect they may have on you. It also helps you feel more in control of them.

Your brain thinks all the time, and you may have intrusive thoughts for no clear reason. But they often pop up due to stress, anxiety, lack of sleep, or after big changes in your life or body. For instance, people who’ve recently given birth often have an increase in intrusive thoughts about the safety of their baby.

Some experts think intrusive thoughts are a kind of warning signal from the brain, which may help explain why these thoughts tend to be about scary, violent, or embarrassing things. The idea is that your brain brings dangerous things to the forefront of your mind so you can prevent them. Take the new parent example. A mom may see a disturbing flash of harm coming to her baby precisely because she doesn’t want that to happen.

Sometimes, intrusive thoughts can be a symptom of a mental health condition, such as:

Obsessive-compulsive disorder (OCD). With this type of anxiety disorder, you may have repeated, unwanted thoughts that are difficult or impossible to ignore. You may repeat certain behaviors to relieve the anxiety around your intrusive thoughts. These compulsive acts or “rituals” may disrupt your life.

Depression. You may have the same kinds of intrusive thoughts as anyone else, but you may randomly think more about negative things such as self-doubt, the worst-case scenario of any situation, or what someone is thinking about you.

Postpartum depression or OCD. New parents with postpartum depression or perinatal OCD may notice a rise in intrusive thoughts. Examples include disturbing flashes of hurting your own baby or harm coming to your child in another way. Note: These are different from psychotic thoughts where you have a strong desire to hurt your baby.

Posttraumatic stress disorder (PTSD). People who have PTSD often relive traumatic memories. These flashbacks may be so vivid that you can see, taste, smell, or hear sounds related to your trauma. Certain people or situations may trigger these intrusive thoughts or images.

Other mental health conditions. Delusional thoughts, such as thinking that someone is always watching you or wants to hurt you, can be a sign of schizophrenia or bipolar disorder. If you have these thoughts, talk to a psychiatrist for diagnosis and treatment options.

All these disorders can be treated with medications, behavioral therapy, or a combination of the two.

Other health conditions that may lead to intrusive thoughts include:

Brain injury. Rarely, traumatic brain injury (TBI) may change the way you think and act in a way that causes symptoms associated with OCD.

Parkinson’s disease. Brain changes linked to Parkinson’s disease may be associated with OCD and vice versa. More research is needed to know for sure.

Alzheimer’s disease and other dementias. These can affect how your brain works and may raise your chances of getting intrusive thoughts, OCD, or other mental health conditions later in life.

Other neurological conditions. This includes people who have brain changes from conditions such as Tourette’s syndrome or epilepsy.

If intrusive thoughts take up a lot of your energy, cause you distress, or make it hard to go about your day, don’t be embarrassed to tell your doctor about them. Your health care provider can help you figure out what to do next, which may include talking to a behavioral therapist, psychologist, social worker, or psychiatrist for further diagnosis and treatment.

To get you to the right specialist, your doctor will give you a physical exam and ask about your symptoms. Your provider may give you a mental health questionnaire or other tests to learn more about how you’re feeling.

Expect to answer questions such as:

  • Do your thoughts get in the way of your social life, work, and family responsibilities?
  • How many times a day do you have intrusive thoughts?
  • Do you do things to relieve the anxiety around your thoughts?
  • Do your thoughts take up a lot of time during the day?
  • Do you use substances such as alcohol or other drugs?
  • Have you been diagnosed with a mental health condition before?

If necessary, your regular doctor may refer you to a psychologist or psychiatrist. These are mental health specialists trained to diagnose disorders causing intrusive thoughts and help guide you toward the best treatment to manage your symptoms.

If you feel like acting on your intrusive thoughts in a way that could cause harm to yourself or someone else, get medical help right away.

If you’re thinking of hurting yourself, call the National Suicide Prevention Hotline at 800-273-TALK. Or you can text “MHA” to 741-741. This will connect you to a trained counselor from the Crisis Text Line.

No matter how serious your symptoms are, there are ways to manage intrusive thoughts. You may need medication, talk therapy, or a mix of both.

Treatment for intrusive thoughts may include:

Cognitive behavioral therapy (CBT). This is a type of talk therapy that helps you identify and change unhelpful thoughts and behaviors, such as those that fuel intrusive thoughts.

The two main types of CBT for intrusive thoughts may include:

  • Exposure and response prevention (ERP). In a safe space, your therapist gradually exposes you to whatever is triggering your intrusive thoughts. For example, they may have you touch something dirty and not let you wash your hands afterward if you have a fear of germs.
  • Acceptance and commitment therapy (ACT). A therapist helps you see your thoughts as a natural part of your life that you can’t control. ACT may not get rid of your intrusive thoughts, but it may help lessen your anxiety and distress around them. 

Medications. Your doctor may prescribe antidepressants, including selective serotonin reuptake inhibitors (SSRIs). These drugs are used to treat conditions such as depression and anxiety, but if you have OCD, you may need a higher dose than what’s recommended for other disorders.

Mindfulness techniques. These are exercises that help you sit with your thoughts without judging them. Certain techniques teach you how to relax, focus on the present moment, or engage with your senses, including:

  • Meditation
  • Yoga
  • Being kind to yourself
  • Diaphragmatic breathing
  • Grounding techniques

With the 5-4-3-2-1 grounding technique, you may lessen the anxiety around your intrusive thoughts. This technique requires you to find and focus on:

  • 5 things you can see
  • 4 things you can touch
  • 3 things you can hear
  • 2 things you can smell
  • 1 thing you can taste

Ask your doctor or therapist if there are other steps you can take to manage the stress and anxiety stemming from your intrusive thoughts. They may suggest more advanced techniques such as brain stimulation.

Intrusive thoughts happen to almost everyone at some point. These random thoughts or images can be confusing, disturbing, or scary, but they’re usually nothing to worry about. But you should tell your doctor if they bother you or get in the way of your daily life. A mental health professional can help you find the best treatment to manage your symptoms.

What are examples of intrusive thoughts?

Thoughts about jumping off a rooftop when you’re standing on top of a tall building, driving your car off the road, or doing something embarrassing such as swearing in public. You may also have violent thoughts about hurting yourself or other people, such as pushing a stranger in front of a train or harming your baby if you’re a new parent.

How do I get rid of intrusive thoughts?

Recognize them and try to figure out what they mean, but don’t try to control them. Remember that unsettling or troubling thoughts (or images) pop into everyone’s head from time to time. Talk to a mental health professional if you’re having trouble getting rid of intrusive thoughts or if they scare you. Treatment with cognitive behavioral therapy or medication can help.

What causes intrusive thoughts?

Pretty much everyone has intrusive thoughts now and then. These thoughts may show up for no obvious reason. But you may notice them more often (or be bothered by them) when you’re stressed or if you have a mental health condition such as anxiety, depression, or obsessive-compulsive disorder.