What Do Intrusive Thoughts Feel Like
Intrusive thoughts can be distressing, but there are ways to help manage them

Intrusive thoughts are images or thoughts that pop up in your mind and can cause strange or unpleasant feelings of distress.

Although some intrusive thoughts are fear-based, they often feed off other ideas and accentuate unrealistic ones.

What are types of intrusive thoughts?

Intrusive thoughts tend to involve similar topics, such as:

  • Harming yourself
  • Intentionally or unintentionally harming others
  • Sexual attraction or behavior
  • Sacrilegious behavior or sinning
  • Getting sick
  • Existential crises

Common intrusive thoughts include:

  • Flashbacks of unpleasant memories of the past
  • Fear of contracting an illness or disease 
  • Inappropriate thoughts or images of sex
  • Thoughts of doing something illegal or violent
  • Impulses of doing something embarrassing or shameful 
  • Fear that if you don’t do something specific, it can cause something bad to happen

Some examples of what intrusive thoughts might sound like include:

  • Harm: “What if I stab that person?”
  • Responsibility: “What if my dog dies because I didn’t touch the wall three times?”
  • Religious: “What if I’m a devil worshiper because I read the number 666?” 
  • Suicidal: “What if I decided to kill myself right now?”
  • Contamination: “What if this paper cut gets infected and I get rabies?”
  • Somatic: “What if I never stop thinking about blinking?”
  • Existential: “What if everything is a simulation and people aren’t real?”
  • Metaphysical contamination: “What if a racist person entered that building, so if I enter, I’m racist too?” 
  • Pedophilic: “What if I inappropriately touched that kid and forgot, and now I’m a pedophile?”
  • Health: “What if I get a heart attack and die in my sleep?”
  • Incest: “What if I want to have sex with my parents?”
  • Relationship: “What if I don’t love my partner?”

Intrusive ideas can also include directives, desires, pictures, sensations, voices, and premonitions.

Are intrusive thoughts normal?

According to recent research, more than 94% of people experience unwelcome, intrusive thoughts and urges. However, intrusive ideas are just that—thoughts. To some extent, this is natural. Even if you don't have any major mental health concerns, you may be hit by random ideas, which is not something to be concerned about. 

As long as you're not obsessing over an idea or feeling horrible and guilty about it, intrusive thoughts may not be a serious issue. The real problem arises when you become stuck on an intrusive thought and want to act on it. 

Intrusive thoughts can become problematic if you start obsessing over them and experience feelings of guilt, anxiety, and self-hatred as a result. Signs that these thoughts may be indicative of a serious mental health disorder include:

  • Duration: May keep you pre-occupied for long periods of time
  • Intensity: Can lead to distress and anxiety 
  • Degree: May feel unmanageable or lead to a ritual or particular behavior
  • Impact: May affect relationships and your daily life 

If you experience intrusive thoughts on a regular basis, you should see a psychologist or psychiatrist.


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What causes intrusive thoughts?

It is unclear what causes intrusive thoughts, as they can occur randomly. Possible causes of intrusive thoughts include:

Coping mechanism

According to one theory, intrusive thoughts are caused by our brains "practicing" what we would do in dangerous or stressful situations.  From a survival standpoint, the brain may try to anticipate potential threats in order to avoid them.

Deficiency of certain neurotransmitters

One possibility is that people who struggle with intrusive thoughts have less γ-aminobutyric acid in the brain, an inhibitory neurotransmitter that helps suppress unwanted thoughts through unknown mechanisms.

Medical conditions

Some mental health conditions may cause intrusive thoughts. Intrusive thoughts often occur with other anxiety and mood disorders such as:

Intrusive thoughts associated with underlying mental health issues can be debilitating and anxiety-inducing, making daily tasks difficult and impacting a person's ability to contribute meaningfully to their personal and professional lives. 

How to manage intrusive thoughts

Almost all people encounter intrusive thoughts from time to time. Although most are harmless and fleeting, they can be distressing. The following strategies may help you manage these thoughts when they occur:

  • Recognize them for what they are: Understanding what intrusive thoughts are—momentary thoughts that you cannot control—may be occurring can help you move past them. 
  • Practice mindfulness: Mindfulness techniques can help relax and clear your thoughts, allowing you to recognize intrusive thoughts without assigning any value to them. Furthermore, mindfulness can help you minimize anxiety and find healthier ways to cope with it.
  • Stay positive: Positive affirmations can help you reclaim self-confidence and combat negative thoughts that are detrimental to your health and well-being. 
  • Talk with friends and family: Talking things out with someone you trust may help give insight into why the ideas are bothering you or where they may be coming from.

Dealing with intrusive thoughts may be difficult. If you feel that these strategies aren't working for you, talk to a mental health expert. Therapists can help you identify the source of your negative thoughts and find ways to overcome them.


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Can intrusive thoughts be treated?

Although intrusive thoughts may never completely disappear, certain therapies and treatments can help you cope with triggers and reduce anxiety, fear, and distress. Effective and evidence-based psychological treatment options for intrusive thoughts may include:

  • Cognitive behavioral therapy: This is a type of psychotherapy in which people work with a mental health counselor to address emotional challenges and painful experiences. The counselor may teach you breathing techniques and other relaxation strategies to prevent anxiety-related intrusive thoughts or to reduce the anxiety that the thoughts cause.
  • Exposure and response prevention (ERP): ERP is an effective treatment that helps people gradually and intentionally expose themselves to situations that trigger intrusive thoughts so that they can recognize that the thoughts are not harmful and learn how to reduce the anxiety caused by them.
  • Medications: Medications may be used to treat underlying mental health conditions that are the source of intrusive thoughts. The effectiveness of treatment varies from person to person and may be determined by how much the thoughts interfere with the quality of life.

When combined, these therapies can help reduce the frequency and intensity of intrusive thoughts.

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Medically Reviewed on 10/13/2022
Image Source: iStock image

Managing intrusive thoughts: https://www.health.harvard.edu/mind-and-mood/managing-intrusive-thoughts#:

Unwanted Intrusive Thoughts: https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/unwanted-intrusive-thoughts

5 Ways to Free Your Mind from Intrusive Thoughts: https://www.rtor.org/2020/05/18/5-ways-to-free-your-mind-from-intrusive-thoughts/

How to Manage Intrusive Thoughts: https://www.manual.co/health-centre/daily-health/how-to-manage-intrusive-thoughts