What are intrusive thoughts, and are they normal?

Young woman sitting on the couch looking out the window

Have you ever had a thought or image pop into your head that surprised or even disturbed you? If so, you’ve had an intrusive thought, and they are more common than you might realize.

Intrusive thoughts are ideas and images that come to mind uninvited and typically unwanted.

“They can range from a thought that makes you feel a little bit uneasy to being wholly disturbing,” says psychiatrist Lauren Edwards, MD.  “And usually, it's the last thing you want to think about.”

Intrusive thoughts may be:

  • Violent or sexual in nature
  • Frightening
  • Related to a phobia or deep-seated fear
  • Disgusting
  • Embarrassing or shameful
  • Amoral or blasphemous if the person having the thought is religious

Are intrusive thoughts normal?

The good news is many intrusive thoughts can be considered normal and pass through a person’s mind without leaving an imprint.

However, Dr. Edwards says some intrusive thoughts may begin to stick in people’s minds and bother them. They may ruminate on the idea and start to feel anxious.

If you are having a bothersome thought, rather than immediately trying to push it away, Dr. Edwards suggests taking a moment to identify it as such.

“You can just say to yourself, ‘Oh, there's that thought again,’” she says. “Acknowledge it and then consciously refocus your mind on the present moment without ruminating on it.”

Over time, this technique may help remove the intrusive thought’s power. With practice, you may find your intrusive thoughts drifting away more quickly.

Are intrusive thoughts associated with any mental health conditions?

When intrusive thoughts begin to crowd out other thoughts and make it difficult to think about anything else, they may be a symptom of a mental health condition, such as:

  • Obsessive compulsive disorder, or OCD
  • Post-traumatic stress disorder, or PTSD
  • Eating disorders
  • Postpartum depression or anxiety
  • Generalized anxiety disorder

The good news is, if intrusive thoughts are part of a mental health condition, they're a symptom that can respond to treatment, Dr. Edwards says.

What causes intrusive thoughts?

The most common trigger for intrusive thoughts is stress. Stress that may lead to intrusive thoughts can be exacerbated by:

  • Disruptions to normal routines
  • Lack of adequate sleep
  • Hormonal shifts

“Many people experience intrusive thoughts when things happen that make them feel vulnerable, like a big life change of a new baby or a move,” Dr. Edwards says. “Reading about daily mass shootings in the news, a global pandemic or a doctor's appointment are things we're all facing every day.”

Are intrusive thoughts harmful?

In a word, no. Dr. Edwards says researchers studied people with OCD and violent, intrusive thoughts and found no increased risk of acting on the thoughts.

Having a disturbing thought does not mean you want to do what has popped into your head.

“Intrusive thoughts tend to reflect our greatest fears or most unwanted scenarios, so you can treat it as a signal of something important to you,” Dr. Edwards says. “If a new mother is having the intrusive thought of drowning her baby in the bath, which is not uncommon, it's a manifestation of her connection to this little vulnerable creature who is so fragile and dependent upon her for safety.”

According to Dr. Edwards, a 2017 study showed almost half of all new parents experience violent, intrusive thoughts toward their babies. She says fathers, not just mothers, may experience hormonal shifts and intrusive thoughts after a new baby arrives.

“I've seen a lot of fathers in my practice who come in after having a new baby with an exacerbation of OCD or intrusive thoughts,” she says. “I wish that were better recognized, and we could give a term to it so they can be seen and get help.”

Should I get help for my intrusive thoughts?

Dr. Edwards suggests seeking professional help for intrusive thoughts when they:

  • Are a daily occurrence
  • Are disruptive to your life

“If they make you feel like you can't go certain places, or do certain things, or are really sticking in your head, then get help sooner rather than later,” she says. “They can be treated very effectively and sometimes very quickly.”

How are intrusive thoughts treated?

Therapy can help you learn to manage intrusive thoughts. Cognitive behavioral therapy, or CBT, is a therapy approach that helps take power away from unwanted thoughts.

“I think people worry that if they go to see a therapist, they will have to see them indefinitely,” Dr. Edwards says. “But with CBT, you don't have to do the therapy forever for it to work. You can learn the techniques and use them on your own to prevent thoughts from becoming a problem in the future.”

When the thoughts remain especially “sticky,” medications, such as SSRIs, may be prescribed to treat underlying mental health conditions.

Regardless, Dr. Edwards advises anyone who might need help to reach out sooner than later. She says, on average, it takes 14 years from the onset of symptoms to treatment for people diagnosed with anxiety disorders.

“People tend to suffer for a long time before they seek treatment,” she says. “So I would say, it never hurts to get help, and therapy can be a really good place to start. It can be so empowering. In our anxiety disorders clinic, we don't just try to medicate your anxiety away. We aim to give people mastery over their anxiety so they can use it when they need to, but it doesn't bother them as much when it’s not useful.”

If you are experiencing anxiety and would like to learn about the CBT for Anxiety Disorders Group, which meets on Zoom via telehealth, call 402.552.6007.

For additional resources or to be connected to a therapist, visit nebraskamed.com/connection.