What Are Intrusive Thoughts—And Is It Normal To Have Them?

“They can occur to you, and you might not be terribly upset about them and then they drift away, or they may be very upsetting and you have a reaction or try to suppress them or get them out of your mind, which actually intensifies them and makes them stick further,” Dr. Saltz says.

Meet the experts: Gail Saltz, MD, is a psychiatrist and member of the Group for the Advancement of Psychiatry. Lauren Cook, PhD, is a clinical psychologist and the founder of Heartship Psychological Services.

And while intrusive thoughts are not always something to worry about, they can become increasingly disturbing or begin to take over your daily life, says Lauren Cook, PhD, a clinical psychologist and the founder of Heartship Psychological Services. “If you start to pathologize your thoughts and freak out about it, that’s when it becomes super distressing and it’s time to get help.”

Read on to learn more about the examples of intrusive thoughts, what causes them, and how you can learn to keep them from affecting you negatively, according to mental health professionals.

What are intrusive thoughts?

Intrusive thoughts are often involuntary, but they become repetitive and obsessive, with the same feedback loop playing repeatedly in your head, says Cook.

“Every thought that we have, to some degree, is automatic, and we can’t actually control our thoughts that much, but we can control our perspective and how we approach our thoughts,” she explains. “Where intrusive thoughts differ is when people get down the rabbit hole and start blaming themselves for having certain thoughts or freaking out over why they’re having these thoughts.” Fear, shame, and guilt are common emotions associated with these thoughts.

These are the typical signs of an intrusive thought.

• The thought is disturbing. It’s incredibly upsetting and you want to push it out of your mind.
• The thought is unusual for you. An intrusive thought is usually very different from your typical thoughts that come and go, so it may feel new, unexpected, or alarming, says Cook.
• The thought feels hard to eliminate or manage. Intrusive thoughts are often repetitive and stick in your mind, so they can be difficult to control or eliminate, says Dr. Saltz.

An important note: You don’t always want to act on these thoughts. “Someone may have an intrusive thought about harming themselves, but if you ask them if they actually want to hurt themselves, they would say no and that they’re terrified. Most of the time people don’t want to do that intrusive thing that they’re thinking,” says Dr. Saltz.

Examples Of Intrusive Thoughts

There are several types of intrusive thoughts and they vary from person to person, but some of the most common ones include the following.

• Germs, infections, or getting sick. This often presents itself as taking obsessive measures to protect your health by washing your hands too frequently and seeing a doctor many times in a year, Dr. Saltz explains.
• Violence, aggression, or harm to yourself or others. You may question if you’re a bad or dangerous person, says Dr. Saltz. These thoughts are also very common for new mothers experiencing postpartum depression who may have intrusive thoughts about harming or neglecting their baby.
• Sex or your sexuality. This could be anything that you could possibly think of sexually, “including any body part or any sexual act with anything or anyone,” Dr. Saltz explains.
• Completing tasks or doing them correctly. You doubting whether you’ve completed a task or assignment. This can lead to obsessive checking behavior where you keep checking your work email or constantly research a topic to make sure you have done it correctly.
• Blasphemy or fear of being an immoral person. Intrusive thoughts may surround religion and questions about whether you’ve committed a sin or will be punished. You may pray all the time or feel the need to talk to elders or spiritual leaders in your community. Note that this comes from an obsessive checking lens to make sure you are not (or will not) be punished rather than typical spiritual practice, Cook says.

Are intrusive thoughts normal?

Intrusive thoughts are incredibly normal, and most people experience them from time to time, says Dr. Saltz. In fact, almost 94 percent of participants identified as having at least one intrusive thought in one study published by the American Psychological Association.

“We can all have unpleasant thoughts, and sometimes we start to obsess over a particular situation that we may have gone through, but the difference really is how much we’re able to control,” says Cook.

When intrusive thoughts become problematic, you cannot let them go and they can occupy your mind for days, weeks, or months, to the point where they affect your sleep, says Cook.

If your intrusive thoughts are causing you a lot of distress, taking up every inch of your headspace, or making it harder for you to focus on work, school, and other obligations, then it’s time to check in with a mental health professional, says Cook. If you feel shame or embarrassment or like you can’t talk about these thoughts with anyone, it’s better to connect with a pro sooner rather than later, she adds.

If you or a loved one has intrusive thoughts that involve self-harm, call the 988 Suicide and Crisis Hotline or head to the closest emergency room immediately.

What triggers intrusive thoughts?

Technically, anything can bring on an intrusive thought, but a common cause is “ambiguous situations,” says Cook. For example, if someone is not overly friendly toward you or didn’t reply to your text, that could cause intrusive thoughts to spiral. Most of the time this causes internal dialogue such as “Did I do something wrong?” “Am I in trouble?” “Do they not like me anymore?” or “Did I make someone mad?”

That said, intrusive thoughts can also be triggered by stress or anxiety, according to Cook. For example, getting into an argument with your partner or having a disagreement with someone at work.

“Naturally, certain situations are upsetting for us, and you’ll probably replay the tape of that conversation, but after a day or so, you’re typically able to let it go and move on after you process it with the person,” she explains. If the thought becomes intrusive, you may not be able to let it go.

Intrusive thoughts are also linked to the following mental health conditions:

Obsessive compulsive disorder (OCD): OCD is a very common condition that includes intrusive thoughts, says Dr. Saltz. This typically involves “physical compulsions,” or repeated behaviors or habits, such as hand washing, but it can also present as obsessive thoughts like making sure you locked the door, she explains.

Post-traumatic stress disorder (PTSD): A prominent sign of PTSD includes intrusive thoughts, says Dr. Saltz. You may replay images and memories of trauma or abuse you’ve gone through.

Eating disorders: People with eating disorders often experience intrusive thoughts about specific foods and parts of their body, says Dr. Saltz. For example, this may include obsessive thoughts about your body image, weight loss, or fear related to food.

Depression: Depression negatively affects the way you think, feel, and react to situations, and repetitive intrusive thoughts are common among people with this condition, says Cook. Those who suffer from depression may ruminate on sadness, hopelessness, worthlessness, or low self-esteem, she explains.

How do you calm down or stop intrusive thoughts?

Therapy is one way to help you break that feedback loop in your head. Cognitive behavioral therapy (CBT) teaches you to shift your approach to your thoughts, and in turn, start to change your feelings and your behaviors, Cook explains. You’ll learn ways of thinking that can desensitize you to intrusive thoughts, while picking up more realistic and less distressing ways you can react to them.

Another therapy approach that could be helpful is exposure and response prevention therapy (ERP). Instead of suppressing unwanted intrusive thoughts, you sit with the anxiety that they provoke. You face your fears and process them instead of running away or avoiding them, adds Cook. In turn, this will reduce your anxiety over time.