OCD and Intrusive Thoughts: Signs, Symptoms, and Treatment
Intrusive "Bad" Thoughts
Do you sometimes have embarrassing, frightful thoughts that just pop into your mind for no apparent reason?
Do these thoughts contain imagery of harming yourself or someone close to you?
Are you ashamed of these thoughts and afraid to talk about them because you fear being judged?
If you answered yes to these questions, you may suffer from a condition called intrusive thoughts.
If You Need Help
If you are concerned that you may hurt yourself or someone else, please call 800-273-TALK, dial 911, or go to your local emergency room.
What Are Intrusive Thoughts?
In plain-speak, intrusive thoughts are a series of words or images (or both) that enter into your mind against your will. They sometimes come rapidly and often in flashes.
If you are experiencing a great deal of anxiety or are under unusual stress, intrusive thoughts can become exacerbated. These symptoms are commonly explored as part of anxiety counseling and therapy.
Intrusive thoughts can come in a variety of themes. Generally speaking however, these themes fall into one of three distinct categories, according to the most recent research:
Note: You may have some or none of these thoughts. Each person experiences intrusive thoughts differently. Think of these in categories in broad terms.
Categories of Intrusive Thoughts
Category I: Violence
Category II: Sexual
Category III: Spiritual
Violence against others
Violence against God
Violence to Self
Violent sexual behavior
Violence/Intimacy with Saints
Violent "Bad" Thoughts
1. Thoughts involving violence
Under this category, violent thoughts can pop into your mind about harming someone close to you. This could mean striking the person or using an object to inflict pain.
Violent thoughts can also involve something bad happening to someone close to you in the form of an accident.
An example might be your child being hit by a car or your spouse slipping on ice.
Here are some common themes researchers found when surveying college students:
- Harming elderly people
- Wishing harm to someone close
- Strong impulses to harm a child or animal
- Impulses to verbally and/or physically abuse someone.
2. Thoughts involving sexual behavior
This category in particular brings a great deal of shame to the person suffering from intrusive thoughts.
Words and imagery connected to this category usually involve some type of sexual aggression or inappropriate behavior with others. An example might be touching a stranger.
Here is what researchers found as general themes for some people under this category:
- Kissing parents, strangers and other inappropriate people
- Intercourse in different forms with the above mentioned
- Violence involved with intercourse
3. Anti-Spiritual Thoughts
Anti-spiritual thoughts are also called Blasphemous thoughts. These thoughts run counter-intuitive to a person’s spiritual beliefs. If you identify with or were raised in the Christian faith, your intrusive thoughts may center on violations against God.
If you identify or were raised in the Jewish or Muslim faith, your intrusive thoughts may involve compliance issues with laws or rituals.
The research is somewhat scarce here but generally speaking, anti-spiritual thoughts can contain the following imagery:
- Sexual thoughts about the identified creator, saints or religious leaders
- Thoughts of being possessed by an evil force
- Repeated thoughts of blasphemous behavior during religious activities
Note: The important consideration here for all three of these categories is the thoughts come during odd or inappropriate times and simply “appear” in the mind. If you have a phobia, you may experience a momentary image of the object/situation you fear.
Intrusive Thoughts Comes in Waves
What causes intrusive thoughts?
There are a number of different conditions that can cause you to have intrusive thoughts. Obsessive compulsive disorder is considered to be the main cause of this problem in most people. Many famous people have OCD and have struggled with some of the “bad thoughts” described above.
It is important to state however that intrusive thoughts can also happen if you struggle with depression, suffer from different forms of body dysmorphic disorder or have another type of anxiety disorder.
Let’s walk through several of the more common mental health issues where we see intrusive thoughts.
Note of caution: A medical issue and/or prescription medication can act as the source behind intrusive thoughts and other behaviors.
Five Main Causes: Intrusive Thoughts
Fear of embarassment
Fear of Dying
There can be other causes for intrusive thoughts not mentioned here. It is important that you get evaluated by your physician to rule out medical causes.— Dr. John D. Moore
Intrusive Thoughts: Causes
Intrusive Thoughts Poll
My intrusive thoughts:
Intrusive Thoughts Video
Mental Health Causes
If you have OCD, you are more likely to have intrusive thoughts. Here, we are talking about having obsessive thoughts that are repetitive in nature. As a coping mechanism, you may feel a compulsion to engage in a certain activity. An example might be tapping a spoon against your teeth five times to purge the thought. Many adults with OCD had lived with this disorder since childhood.
Post-Traumatic Stress Disorder (PTSD)
If you have PTSD, it is common to have “flashbacks” to the traumatic event. This causes you to relive that moment in a way that seems like the event is happening “in the here and now”. You may have nightmares or day-dreams about the event which can be terrifying. The mental imagery of the event can be overwhelming and hard to shake. Intrusive thoughts associated with PTSD are often triggered by something or someone and can strike without notice.
If you suffer from a panic disorder, your intrusive thoughts can take on a variety of forms. Generally speaking however, you may have worries about having an “attack” and consumed with difficulties breathing. The mental imagery involved for those with panic disorders often contain visuals of not being able to breath. Paradoxically, these thoughts can act as a trigger for an actual panic attack.
Generalized Anxiety Disorder
This disorder is also referred to as “GAD”. If you have GAD and suffer with intrusive thoughts, the essential characteristic is likely over-powering worry about the health and well-being of someone close to you. An example might be a parent having a stroke as a result of not taking prescribed medication. The only way to calm the worry for the person with GAD is to telephone the loved one or physically visit them to check on their well-being.
This disorder is also known as social anxiety disorder. If you are a person who as social phobia, your primary fears relates to being in a situation where you embarrass yourself and are unable to escape. Intrusive thoughts usually focus on these kinds of scenarios. An example might be walking through the mall and urinating on yourself in front of others.
Intrusive thoughts can also occur as a result of other mental health issues. These include but are not limited to:
- Major depressive disorder (not the same as suicidal ideation/thoughts)
- Schizophrenia (usually involve delusions of thoughts being “inserted” from elsewhere.
- Post-Partum Depression (usually a thought about harming newborn baby)
Healing from Intrusive Thoughts
Mental Health Links
- National Institute of Mental Health
Website that is filled with everything you ever wanted to know about different mental health issues.
Treatment for Intrusive Thoughts
In order to be treated for intrusive thoughts, you must first visit with your physician to rule out potential medical causes. Assuming there are none, treatment for intrusive thoughts can occur through a variety of therapies.
These therapies include:
Cognitive Behavioral Therapy (CBT)
CBT for intrusive thoughts involves challenging irrational thinking. CBT is one of the primary forms of treatment for people who suffer from various anxiety disorders, including OCD. It is important to find a therapist trained CBT in order to gain the maximum benefit.
This particular treatment approach involves directly facing a given fear and remaining with the associated feelings (i.e. anxiety, shame, fear) until the intensity of the feelings subside. Research shows this to be an effective treatment approach for intrusive thoughts however, many people do not opt for this approach because it means being “exposed” to the fear trigger.
People who have severe instances of intrusive thoughts benefit from medication therapy. Specifically, this means taking anti-anxiety or anti-depression pills (or both). There has been enough clinical research to suggest that certain types of anti-depressant medications work well at combatting OCD; the primary causal condition for intrusive thoughts.
Summing Things Up
If you suffer from intrusive thoughts, you know just how difficult it can be to talk about some of the things you are thinking. This is particularly true if some of the mental imagery involves forms of violence. One of the best things you can do is to speak with your medical doctor about these issues. You can also talk to a mental health therapist. They will not judge you, and anything you say must be legally kept confidential.
The good news is that your intrusive thoughts can be treated so that they ultimately stop. Why not make a call today to your healthcare provider and create positive change?
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.