What Are Intrusive Thoughts?

Sometimes, an absolutely shocking thought crosses your mind, seemingly out of nowhere, like envisioning punching someone or letting your car veer into traffic. Understandably, such thoughts catch you by surprise, causing alarm and concern.

You need to know: Why would these horrible scenarios even enter your head?!

They’re called intrusive thoughts, says psychologist Lauren Alexander, PhD, and they’re not uncommon. Here’s what they can look like and where they may stem from.

What are intrusive thoughts?

“Intrusive thoughts are thoughts, images or urges that are unwanted but pop into your mind anyway,” Dr. Alexander reports. “They’re often violent, disturbing or unnerving in nature.”

Though intrusive thoughts are often discussed in relation to obsessive-compulsive disorder (OCD), anyone can have them.

Here are some of the ways they may appear:

• Specific thoughts can crop up at random or in response to other situations. For example, if your parent gets ill, you might persistently worry about them dying.
• Images are scenes that play out in your mind, like if someone cuts you off on the highway and you vividly envision running them off the road.
• Urges are pressing thoughts that you should do something you don’t actually want to do, like if you dislike your job and feel compelled to walk out the door and never return.

Importantly, the more you try to ignore an intrusive thought or push it away, the more likely it is to stick in your mind. Per the American Psychological Association’s definition, intrusive thoughts “interrupt the flow of task-related thoughts in spite of efforts to avoid them.”

Examples of intrusive thoughts

Though this certainly isn’t a comprehensive list of types of intrusive thoughts, it may help you better identify and label your own.

Doubts

This is the most common category of intrusive thoughts and includes persistent worry about relationships (“My friends all secretly hate me”), as well as tasks (for example, “Am I sure I locked the garage door?” or “I could’ve bumped into the stove accidentally turning it on before I left home”).

Embarrassment

You might experience persistent worries about doing something humiliating in front of other people, like falling down the stairs, blurting out something inappropriate at work or farting during yoga class.

Hurting yourself

These intrusive thoughts can arise even if you’ve never had suicidal ideations or seriously considered hurting yourself. For example, you could be cutting vegetables and suddenly imagine stabbing your hand. Or while standing over a beautiful scenic overpass, you imagine what it’d be like to jump.

Hurting someone else

Violent intrusive thoughts can be deeply distressing and at odds with your values and intentions, making you think about things you’d never do, like slapping a stranger or committing a terrible crime.

One study found that 70% to 100% of new moms had intrusive thoughts about something bad happening to their baby; half envisioned being the one to cause that harm.

Health concerns

Intrusive thoughts about “contamination” can cause you to obsess over germs or illness, even when the risk is low — for example, “If I touch that elevator button, I might get sick” or “The doctor says I just have a cold, but what if it’s actually cancer?”

Negative self-talk

Negative self-talk like “I’m such a loser” and “Nobody even likes me” are types of intrusive thoughts that can both stem from and contribute to low self-esteem.

Unwanted sexual thoughts

This especially upsetting category of intrusive thoughts can cause you to think about sexual activities that are taboo, violent, harmful or otherwise upsetting. These thoughts can be especially difficult to discuss with others, including a therapist, because of the stigma associated with them.

Traumatic memories

If you’ve experienced a traumatic event in your past, like a car accident, deployment, sexual assault or natural disaster, intrusive thoughts can appear as flashbacks, memories or little blips of thoughts or mental images. These thoughts are common with post-traumatic stress disorder (PTSD).

Sin and immorality

Cultural and faith-based intrusive thoughts can include persistent fears that you’ll upset God or accidentally do something that goes against your religious beliefs.

What causes intrusive thoughts?

Because intrusive thoughts can be so surprising and upsetting, it can feel like there must be a reason for them. But that’s not always the case. “Sometimes, they’re completely random, and you go, Wow, where did that come from?” Dr. Alexander shares.

Ever wondered what it would feel like to fly or what you’d look like with rainbow-colored hair? These out-of-the-blue thoughts are harmless, so they don’t stop you in your tracks like intrusive thoughts do. But they don’t really originate anywhere either, illustrating the fact that sometimes, unexpected thoughts simply appear.

But intrusive thoughts can stem from other conditions, too:

• Stress. Disruptive events like work stress, a breakup or a move can prime you for intrusive thoughts. “If you’ve got any variety of stressors in your life, you may be more prone to getting stuck on these thoughts,” Dr. Alexander says.
• Anxiety. Anxiety can complicate your ability to regulate your emotions. “Intrusive thoughts are often related to something you’re already anxious about,” Dr. Alexander confirms. “And anxiety is a sticky emotion. If you’re anxious about one thing, it’s very easy to get anxious about other things.”
• OCD. This condition is characterized in part by obsessions, which are unwanted, intrusive thoughts that are lasting and repetitive.
• Other mental health conditions. Intrusive thoughts are also associated with mental health conditions, like generalized anxiety disorder, ADHD, major depressive disorder and eating disorders. “Having multiple mental health issues can make it harder to manage intrusive thoughts,” Dr. Alexander notes. “Just like we all have a finite amount of money and time, our mental and emotional resources are the same way.”
• Lack of sleep. The less sleep you get, the more likely you are to experience intrusive thoughts, probably because you’re too mentally depleted to rationalize, focus and stay on task. Ultimately, this can increase your risk of developing an anxiety disorder or other mental health conditions.
• Hormonal imbalances. Shifting levels of estrogen and progesterone can cause issues like sleep disruptions and mood changes, which some people say bring intrusive thoughts during ovulation, menstruation, pregnancy, perimenopause and menopause.

Are intrusive thoughts normal?

Yes. One study found that nearly 94% of participants experienced at least one intrusive thought within the past three months!

And having intrusive thoughts doesn’t say anything about your character or your values. In the moment, thinking something scary or disturbing can make you feel deeply ashamed. But having a thought doesn’t mean you want to act on it. Remember: A hallmark of intrusive thoughts is that they’re unwanted. They’re thoughts you don’t want to have, about actions you don’t want to take.

“People often believe that if they have a thought, it’s true — and that if they keep thinking it over and over again, then it’s especially true,” Dr. Alexander acknowledges. “But just because you have a thought doesn’t make it true. Unless you act on it, it doesn’t have any bearing on reality.”

Fortunately, there are steps you can take to stop intrusive thoughts and let them pass you by. Strategies like mindfulness and grounding techniques, along with psychotherapy, can help.

“You can’t change anything that’s led up to the moment you’ve had this intrusive thought,” she continues, “but you can respond differently to it so that it doesn’t become more of an issue than it actually is. It’s just a matter of finding and using the right strategies to help you cope.”

If you’re worried for your safety or the safety of others, seek immediate help by calling 911 or your local emergency hotline. In the U.S., you can also call or text the 988 Lifeline.