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How to deal with intrusive thoughts

How to deal with intrusive thoughts
Reviewed by:
Authored by:
Sumeet Singh, MD
Staff Psychiatrist
at Talkiatry
September 27, 2022
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Have you ever had a thought you didn’t want to have? It might’ve been something as simple as a flash of fear that you left the stove on, or an embarrassing memory from high school.

Most people experience unwanted thoughts, also called intrusive thoughts, from time to time. But for some people, the frequency or nature of the thoughts can be disturbing. They might think about doing inappropriate things in public or hurting themselves or someone else.

When you’re worried about your intrusive thoughts, you might be scared to tell someone about them. But disturbing thoughts that won’t go away can be a symptom of a mental health condition like an eating disorder or obsessive-compulsive disorder (OCD), depending on what other symptoms they come along with.

So how can you tell if your unwanted thoughts are a sign of a larger issue? We’ll talk you through it.

What exactly are intrusive thoughts?

If you think of your mind as an email inbox, intrusive thoughts are like junk mail. You didn’t ask for them, you don’t know why you’re getting them, but there they are.  

Like junk mail, intrusive thoughts are an unpleasant but common experience. In fact, a 2014 study published in the Journal of Obsessive-Compulsive and Related Disorders found that 94% of people deal with them.

If you’re able to simply push the thought out of your mind and move on with your day as easily as you’d delete an unwanted email, then your intrusive thoughts are probably nothing to worry about.

How do I know if I’m struggling with intrusive thoughts?

Even though occasional intrusive thoughts are normal, certain types of thoughts are more likely to signal an underlying issue. If a particular thought feels very out of character for you, disturbs you, and hurts your quality of life, it could be a sign of a problem. Examples of these types of thoughts include worries about being contaminated by germs, acting inappropriately in social settings like work or church, or committing acts of violence.

But what makes an intrusive thought a big problem isn’t the content of the thought, it’s how you react to it. People who struggle with intrusive thoughts can’t just delete these junk messages from their minds. Instead, they open them, pore over their contents, and sign up for more emails, even though they don’t like them.

In other words, you’ll know your intrusive thoughts have become an issue if you’re obsessing over them to the point that they’re getting in the way of your life.

What causes unwanted intrusive thoughts?

Eating disorders

People with eating disorders, such as anorexia or bulimia, can struggle with intrusive thoughts about their body or their diet. These can include unhealthy urges to restrict your food intake, or shame about the way your body looks. If you’re dealing with anything like this, you should talk to your doctor or a psychiatrist right away.

To make matters worse, intrusive thoughts aren’t just a symptom of eating disorders—they can also cause them. When you’re struggling with disturbing thoughts, obsessively tracking your eating habits can be an unfortunately effective distraction. That’s why it’s so important to take intrusive thoughts seriously if they’re bothering you, before they have time to cause even more havoc in your mind.

OCD

Intrusive thoughts are a key part of OCD, but it’s important to know the difference between intrusive thoughts (which nearly everyone experiences) and obsessions (which characterize OCD). If you’re able to put an unwanted thought out of your mind pretty easily, then it was probably just an intrusive thought.

But for people with OCD, an intrusive thought can easily become an obsession. That’s because people with OCD tend to believe their disturbing fantasies will become reality unless they take specific actions, called compulsions. You’ll know you’re dealing with an obsession if you’ve started upending your life to avoid or relieve a particular intrusive thought, like washing your hands repeatedly to stave off fears of infection.

PTSD

People with post-traumatic stress disorder (PTSD) sometimes struggle with intrusive thoughts related to a traumatic event in their lives, such as combat experience, a car accident, or a troubled childhood. Unlike other types of intrusive thoughts, which often have little to do with the person thinking them, these thoughts are usually flashbacks to your most unhappy memories.

PTSD flashbacks can be triggered by all sorts of things, depending on your particular experiences, and tend to bring with them other problems, like insomnia or substance abuse. That makes them an especially complicated problem to deal with on your own, so be sure to talk to your doctor or a psychiatrist if you’re relating to this section.

Stress or isolation

You don’t have to have a mental health condition to struggle with intrusive thoughts. Any major uptick in your stress level or the amount of time you spend by yourself can lead to increased intrusive thoughts, even if you don’t have an underlying condition.

Studies show that more isolation can often mean more unwanted thoughts, especially for people with social anxiety.

If this sounds a lot like what you’ve been experiencing over the last few years, you’re not alone. The rise of COVID-19 has left people across the world feeling more anxious and isolated than ever. If you’re feeling this way and need help, you can take our quick assessment to get matched with a psychiatrist who can guide you through it.

How do I overcome intrusive thoughts?

While there’s no cure for intrusive thoughts, there are plenty of ways to stop them from interfering in your life, including:

  • Mindfulness: Mindfulness is about being fully present in whatever you’re doing, without overreacting to experiences you don’t enjoy. In this case, that means recognizing an intrusive thought for what it is, an unwanted idea that doesn’t mean anything about you, without trying to make it go away or judging yourself for it. Then getting back to the task at hand, whatever that happens to be. It’s a lot harder than it sounds, but practice makes progress (because nothing’s perfect).
  • Therapy: One type of therapy that has helped people who struggle with intrusive thoughts is cognitive behavioral therapy (CBT). CBT involves working with a therapist to understand your thought patterns and learn coping strategies for the unpleasant feelings that can come along with unwanted thoughts. That can make intrusive thoughts less frequent and less bothersome when they do come along. If you have a therapist, try asking them about CBT. If you don't have a therapist, consider seeing one with CBT training.
  • Psychiatry: CBT helps you understand and manage your thoughts, but sometimes that’s not enough to improve your quality of life. A psychiatrist can work with you to figure out whether medication can help. For people with OCD, selective serotonin reuptake inhibitors (SSRIs) like Zoloft and Buspar can be especially helpful for curbing compulsive behavior.

When you’re concerned about a disturbing thought, you might worry that one day your unwanted fantasy will become reality. That’s a terrifying possibility, especially if you’re thinking about endangering yourself or hurting someone you love.

That’s why it’s so important to remember that the thoughts you have aren’t who you are. Your character is determined by the thoughts you choose to express, act on, and believe in. Your thoughts don’t decide who you are—you do.

If intrusive thoughts are preventing you from being the person you’d like to be, you have options. Talking to a psychiatrist is a great way to understand those options and identify the best next step. Get started today with our quick assessment.

Talkiatry is a mental health practice, and our clinicians review everything we write. However, articles are never a substitute for professional medical advice, diagnosis, or treatment. If you think you may need mental health help, talk to a psychiatrist. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.

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Dr. Sumeet Singh is board-certified by the American Board of Psychiatry and Neurology in General Adult Psychiatry. He completed his psychiatry residency training at Howard University Hospital and Saint Elizabeth's Hospital in Washington, DC., where he was voted as Chief resident. He went on to serve as Vice Chair of the Department of Psychiatry at Adventist HealthCare in Maryland where he worked in both an administrative and clinical role to treat adults in an inpatient setting. Additionally, he served as a Clinical Instructor of Psychiatry at Georgetown University School of Medicine, teaching medical students about the art of medicine. Dr. Singh received his undergraduate degree in Neuroscience from the University of Michigan and received his medical degree from Xavier University School of Medicine.

Most recently, Dr. Singh worked for Life Stance Health, an outpatient telehealth company, where he treated patients between the ages of 18-65 years old with both medication management and therapeutic interventions. Dr. Singh has years of experience treating the following disorders/diagnoses: depression, anxiety and panic attacks, bipolar disorder, PTSD, ADHD, and OCD.

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