Intrusive Thoughts: Why They Occur and How To Deal With Them

Ever walked near a cliff and thought, what if I just jumped right now? Or have you ever had a random, uncomfortable past memory or strange, dark scenario slide into your brain seemingly out of nowhere? You’re certainly not alone if you’ve experienced something similar. Disturbing, intrusive thoughts are more common than you realize.

When people experience intrusive thoughts, they often feel so ashamed that they don’t even tell therapists about them, let alone their partners or friends. Some might wonder if the disturbing thoughts mean there’s something wrong with them, or that the dark scenario they just imagined must be what they really want to do, deep down, because otherwise, why would they even think it?

The reality is that “intrusive thoughts” — unwanted thoughts that are often disturbing or embarrassing — happen to almost everyone, says Debra Kissen, Ph.D, a cognitive behavior therapist specializing in anxiety and author of Break Free From Intrusive Thoughts: An Evidence-Based Guide for Managing Fear and Finding Peace.

Intrusive thoughts exist on a continuum. They can be benign or helpful, prompting you to double-check that the stove is off. Imagining the alarming scenario of your child being hit by a car can trigger you to remind her to look both ways before crossing the street. At the other end of the spectrum are thoughts that are violent, inappropriately sexual, or otherwise disturbing.

Anyone can have such thoughts pop into their mind when they’re trying to focus on something else, says forensic psychiatrist Tracey Marks, MD, author of Why Am I So Anxious?: Powerful Tools for Recognizing Anxiety and Restoring Your Peace. Fleeting intrusive thoughts that come and go and don’t pop up again and again — no matter how messed up they are — don’t necessarily signal a psychological problem. It can be problematic, however, if someone is unable to filter out the thoughts and focus on what they want and need to do.

“The difference is that fleeting intrusive thoughts are not necessarily that ‘sticky,’ like a helmet of thoughts you can’t take off,” she says. “Those thoughts can come into your awareness in a way that’s disturbing and distressing for you, or you may have trouble not focusing on them.”

What it really boils down to, however, Marks says, is your reaction to intrusive thoughts and how you behave because of them.

Why Intrusive Thoughts Occur

In any given moment, our brains whizz around constantly trying to handle myriad tasks in addition to what we’re trying to intentionally think about, Kissen says. Some of the thoughts our brains spit out at us, much like dreams, can be random and weird but aren’t indicative of a true or deep-seated desire.

For example, it isn’t unusual for people to be standing on a subway platform and suddenly think, Gee, I could jump in front of the train right now, says Dr. Ziv Cohen, MD, a forensic and clinical psychiatrist and an assistant professor at Weill Cornell Medical School and adjunct faculty at Columbia University in New York City.

“They’re not necessarily suicidal or even depressed, but sometimes even a fleeting thought can cause a lot of distress, just because it seems so strange,” he says. “The person is disturbed that their brain even generated the thought.”

One of the first things therapists do with patients who are concerned, therefore, is to reassure them that intrusive thoughts are normal and unlikely to be revealing of a repressed desire.

“If intrusive thoughts are random, fleeting, and out of context, there’s a low risk that they’re an indication of a problem,” Cohen says. “But if they’re becoming so persistent that they’re troubling you most of the time, you should talk to a professional about it.”

Intrusive thoughts can occur with or without an accompanying mental health condition. People who struggle with self-esteem might find that intrusive thoughts reinforce their negative narratives about themselves. Having them doesn’t mean you likely have depression or an anxiety disorder such as generalized anxiety, obsessive-compulsive disorder (OCD), or post-traumatic stress disorder (PTSD). But people with anxiety disorders commonly experience intrusive thoughts. They’re particularly linked with OCD, as having relentless, obsessive thoughts you can’t control that burst into your consciousness and dominate you is pretty much the definition of OCD, Cohen notes.

Intrusive thoughts can also be triggered by anxiety and stress, Cohen continues. It’s also suspected that sleep deprivation might increase them, University of York researchers noted in a 2020 study. The authors wrote that lack of sleep could become a vicious cycle, as the inability to manage intrusive thoughts could make sleep problems worse.

Researchers studying the prevalence of intrusive thoughts postpartum mostly have focused on mothers, such as a review of research published in 2017 finding that “harming intrusions,” or obsessive thoughts about hurting one’s baby, are common in postpartum women whether they had a psychiatric disorder or not. Importantly, the authors wrote that moms who experienced isolated thoughts about harming their babies didn’t appear to be at any greater risk for carrying out violent behavior toward their children. Literature on dads lags behind, but the authors of a 2019 paper published in Behavioural and Cognitive Psychotherapy concluded that intrusive harm thoughts are common among fathers too.

The research link between sleep and intrusive thoughts makes sense, Kissen speculates, because when we’re getting less sleep, our brains’ filters aren’t working as well. “It’s like a spam mail filter is broken, so every email comes through and feels important, and we might feel like we have to attend to all of them rather than just the important ones,” she says.

The stress of a new baby could make some parents experience intrusive thoughts that could be more frequent or more disturbing than they’ve experienced before, Cohen says. Intrusive thoughts also can spring from financial or other types of stress.

“So if a father, for example, is having thoughts about running away from his family, we would want to assess how much stress he’s under,” Cohen says.

Signs Intrusive Thoughts Might Be Affecting Your Life

When should you worry about intrusive thoughts? More important than the particular weird scenario or thought that ran through your mind is the frequency of such thoughts and how much you get caught up in them, Kissen says.

Obsessing about intrusive thoughts can increase distress and the likelihood you’ll have more. Ruminating about them also can devolve into self-loathing and criticism, which can be draining.

“There’s an emotional toll for people who view these thoughts as a sign something’s wrong with them, where they think, ‘I’m a monster,’ or ‘I’m sick’ every time they have an intrusive thought,” Kissen says. “They might think, ‘I’m an awful person who doesn’t deserve happiness.’”

If intrusive thoughts are impairing your ability to function, such as you’re having trouble focusing at work, holding a conversation, or taking care of your kids, you might need help managing them, Kissen says.

Someone experiencing frequent intrusive thoughts might start avoiding things that are upsetting, and subsequently miss out on things, Kissen continues. If a person is having frequent intrusive thoughts about death, for example, they might travel miles out of their way to avoid a street with a funeral home, or not attend their grandparent’s funeral and miss out on an opportunity to heal with loved ones also coping with the death.

“Avoidance can make their world smaller and smaller, so they miss out on living a vital life,” she says.

How To Handle Intrusive Thoughts

So, how do you deal with intrusive thoughts? Cohen and Kissen both say mindfulness can help.

One tactic: Practice letting intrusive thoughts travel in and out of your head without judgment or analysis. Try to think of them like a friend who popped by unannounced. Let them stay a while without urging them to leave or demanding to know why they’re there. Remind yourself that thinking something isn’t doing it, so there’s no need to beat yourself up about a random thought you would never act upon.

This technique is kind of the opposite of frequent therapy advice to “unpack” something. Although we might want to understand, say, feelings of anger and try to figure out where they’re coming from, dissecting intrusive thoughts tends to backfire. That’s because, per Kissen, the very act of checking and questioning thoughts breeds doubt. If you imagine shaking your child, for example, but have never done so and never would, it’s very hard to “disprove” you don’t secretly want to shake your kid by asking yourself over and over why the thought popped into your head. Repeatedly evaluating the idea erodes your sense of confidence that the thought was random and meaningless.

“We can only control our reaction to intrusive thoughts,” Kissen says. “Just because we think things doesn’t mean we have to respond to them.”

If mindfulness on your own isn’t helping, consider seeing a therapist about intrusive thoughts. Although the problem is literally just in your head, intrusive thoughts can have a significant impact on quality of life.

“You don’t want to be white-knuckling through life because you’re so upset by intrusive thoughts that they’re affecting your ability to function,” says Kissen. “If they’re causing emotional distress, get help.”

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