How to manage intrusive thoughts - a common phenomena of upsetting, unwanted thoughts that won't go away
Intrusive thoughtsare unwanted and upsetting thoughts that frequently disrupt your day.
- They can be a symptom of
mental healthconditions like OCD, eating disorders, PTSD, and anxiety.
- Behavioral therapy, exposure therapy, and mindfulness can help manage these thoughts.
If you're distracted by unwanted and upsetting notions, ideas, or images that arise spontaneously and are difficult to get rid of, you may be having intrusive thoughts.
Intrusive thoughts are time-consuming and cause significant distress that can impair your ability to function normally. It's common to have unwelcome thoughts, but intrusive thoughts may be caused by a mental
"Intrusive thoughts can be a symptom of a few mental health conditions. Namely, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), eating disorders, generalized anxiety disorder, panic, and even depression," says Natalie Dattilo, PhD, director of psychology at Brigham & Women's Hospital Department of Psychiatry.
What sets apart normal unwelcome thoughts from intrusive ones is that they are manageable, infrequent, and hardly distressing. For example, you may think about harming a family member in a moment of rage.
However, if you didn't get fixated on the thought long after the moment has passed and it hasn't affected your ability to do normal activities, it might not be an intrusive thought.
Here are the causes and treatments of intrusive thoughts.
What are examples of intrusive thoughts?
Intrusive thoughts can be violent, sexual, or even religious in nature. Here are some examples, according to Lawrence Needleman, PhD, a clinical psychologist at The Ohio State University Wexner Medical Center:
- What if the plane with my loved one suddenly crashes?
- What if the bump I felt while driving was a person that I hit with the car?
- What if my god is unhappy with me and I go to hell?
Other examples can be extremely violent in nature and involve murder and pedophilia.
Typically, the content of intrusive thoughts is the worst thing they can imagine about something they deeply value, which reflects how important it is to them, says Needleman.
A person with intrusive thoughts about harming their child likely values their child more than anything in the world, and those with religious intrusive thoughts might deeply value their faith, he says.
How do you know if you have intrusive thoughts?
Here are some questions that can help you identify if you're having an intrusive thought, according to Dattilo:
- Are you unable to distract yourself from this thought?
- Are you unable to focus your attention on something else and make it go away, even temporarily?
- Does it just keep showing up despite your best efforts to think about something else?
- Does it disrupt your ability to focus and concentrate on what you would rather be thinking about?
- Does it bother you to have it?
If you answer 'yes' to all these questions, most likely, you are having an intrusive thought. It might not be an intrusive thought if it was irrelevant, insignificant, and you didn't get fixated on it, says Needleman.
Unwelcome and upsetting thoughts are normal to have from time to time and they're not necessarily an indication of a clinical problem. According to Dattilo, what distinguishes them from a disorder are a few qualities, such as:
- Duration: They keep you preoccupied every day for most of the day.
- Intensity: They are vivid, making you anxious or distressed.
- Degree: They are unmanageable that you feel the need to neutralize them with a ritual or particular behavior.
- Impact: They affect your relationships and/or your ability to function and do the things you enjoy, like exercising or socializing.
Causes of intrusive thoughts
Any person may have unwelcome thoughts because the human brain is capable of imagining an infinite variety of events and problems, says Needleman. This ability enables us to visualize incredible accomplishments, like going to the moon or creating the internet, in the same way that it allows us to think of unwanted circumstances.
Some mental health conditions may cause individuals to have intrusive thoughts, such as OCD, PTSD, or depression. According to Dattilo, anxiety tends to be the root cause of intrusive thoughts, but traumatic brain injuries may also trigger symptoms of OCD.
Note: Intrusive thoughts of a sexual nature are often inappropriate and taboo, involving children or animals, or having incestuous or violent themes. It affects about 13% to 21% of people with OCD. Aside from anxiety and psychological distress, frequent sexual daydreaming and greater openness to sex and sexuality may also increase its likelihood.
According to Needleman, this can make intrusive thoughts more frequent and intense, and even prevent individuals from seeing that their catastrophic fears don't really come true. It's highly important to seek treatment for intrusive thoughts.
How to treat intrusive thoughts
According to Dattilo, "highly effective, evidence-based, psychological treatments for intrusive thoughts exist," which include:
- Cognitive-behavioral therapy (CBT): CBT is a type of psychotherapy where people address emotional challenges and painful experiences with a mental health counselor to treat anxiety disorders. "We often teach behavioral relaxation skills, like breathing [techniques], to prevent anxiety-related intrusive thoughts or reduce the anxiety that the thoughts produce," says Dattilo.
- Exposure and response prevention (ERP): ERP is an effective treatment that helps individuals gradually and intentionally expose themselves to situations that trigger their intrusive thoughts so they can "learn that these aren't dangerous and that they don't need to do compulsions in response to those thoughts and feelings," says Needleman. With this treatment, individuals can tolerate triggering situations and reduce anxiety.
- Mindfulness: Mindfulness is a type of meditation where individuals focus on being fully aware and present of their thoughts, feelings, and environment. It helps people manage "thought-action fusion" - the belief that thinking about an action has the same weight as actually carrying it out - and reduces the anxiety from intrusive thoughts.
"Getting rid of intrusive thoughts is not a goal," says Needleman. "With successful treatment, OCD clients - like everyone else - will continue to have intrusive thoughts, but the thoughts won't be as distressing, frequent, or intense."
Medications may be used to treat underlying mental health conditions that cause intrusive thoughts. The time it takes to get over them varies from one individual to another and may depend on the degree to which the thoughts interfere with their quality of life, says Dattilo.
Mental health conditions like OCD, PTSD, depression, or anxiety may cause intrusive thoughts, which are time-consuming, unwanted, and distressing ideas or images that are difficult to shake off. They often have violent, sexual, or religious themes involving the self, family, friends, or strangers.
Intrusive thoughts never fully go away, but cognitive-behavioral therapy, exposure and response prevention, and mindfulness can reduce its frequency and intensity. These treatments help people tolerate triggering situations and reduce the anxiety, fear, and distress caused by their thoughts.The 5 types of anxiety disorders and how to know if you have one How to determine if you have OCD: symptoms, risk factors, and a quiz The 5 major types of OCD and how to recognize key symptoms How to meditate with a complete beginner's guide to meditation and mindfulness
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