Woman with intrusive thoughts

“Yes, I am a prisoner of sorts, but my prison isn’t the house. It’s my own thoughts that lock me up!” – V.C. Andrews

Intrusive thoughts are unwanted thoughts that can pop up in our minds unannounced, at any time. Their repeated occurrence can make it hard to focus on daily tasks and sustain healthy relationships. They can be a symptom of common mental health conditions such as anxiety, depression or obsessive-compulsive disorder (OCD).

To address these often-debilitating thoughts and advance the conversation on mental illness, we need to understand how they manifest themselves in each mental health condition.

How Intrusive Thoughts Manifest

Generalized Anxiety Disorder

People with generalized anxiety disorder can battle impaired concentration, difficulty sleeping and excessive worry when intrusive thoughts pop into their minds. For instance, they may have repeated worrisome thoughts about someone getting hurt or developing an illness. They may worry that they will lose their job.

These thoughts are not based on facts or past results — rather they are irrational and unlikely. However, they can seem very real and probable to someone who ruminates on them. These thoughts can be concerning to loved ones, especially when they start controlling the person’s behavior.


Rumination can also accompany depression. In this case, when a person has a problem, they may find themselves thinking about it repeatedly and analyzing it for hours. The person may focus more on problems instead of solutions, and this may stop them from undertaking important tasks.

Examples of intrusive thoughts that accompany depression include seeing situations as “black- and-white,” assuming it will end disastrously because of past bad outcomes or viewing small mishaps in a magnified way. Another way in which intrusive thoughts affect people who have depression is that they can sometimes try to predict what someone is thinking, even if there’s no rationale for it. This can be distressing and take a toll on anxiety levels.

Obsessive-Compulsive Disorder

A 2020 study published in the journal PLOS showed that people with OCD may place less trust in their past experiences, leading to greater uncertainty, indecisiveness and explorative behaviors. In this study, the researchers asked 58 participants with various levels of OCD symptoms to complete a decision-making task by thinking about their reaction to past experiences and comparing them to more recent ones. The findings showed that participants with higher levels of OCD symptoms were less trusting of past experiences. As such, their environment seemed consistently unpredictable.

This mistrust may cause intrusive urges, images or thoughts to arise, resulting in behavioral rituals, also known as compulsions. These can vary from compulsive handwashing, checking locks or switches or the repetitive pulling of hair (trichotillomania) or compulsive skin picking.

Strategies To Reduce Intrusive Thoughts

Managing Stress Levels

Experiencing a high level of stress can cause intrusive thoughts. According to the American Academy of Sleep Medicine, the genetic factors that cause sleep problems when some people are stressed are the same that can make people with intrusive, ruminative thoughts have a higher rate of insomnia.

This is one of the reasons why some of the most successful methods for battling anxiety and intrusive thinking involve curbing stress before it becomes a problem. In order to reduce stress and anxiety, developing emotional awareness is key. Signs that one is stressed include racing heart, experiencing changes in the stomach or bowel and having difficulty concentrating.

Scientifically-proven means of reducing stress include controlled breathing, mindfulness meditation and reframing negative thoughts into more positive ones. Journaling, soothing fragrances (such as therapeutic-grade essential oils like lavender or orange), spending time in nature, yoga, meditation and exercise have all been found to lower stress hormone (cortisol) levels.

Prioritizing Sleep

One of the most important strategies for keeping intrusive thoughts or rumination at bay is to get quality sleep. Research produced by scientists at Binghamton University found that sleeping less than eight hours a night is linked to intrusive, repetitive thoughts. The researchers showed participants a series of images that were intended to produce emotional responses. They found that those who had experienced regular sleep disruptions had greater difficulty in shifting their attention away from negative information.

Identify the Root of the Fear

In addition to battling stress and embracing good sleep hygiene, people who have intrusive thoughts can also take a behavioral approach to this issue. One useful strategy is to identify the root causes of the disturbance. By knowing your core values and identifying your boundaries, it becomes easier to identify why specific situations or experiences provoke disgust, fear or other distressing emotions.

For example, you may have experienced loss — perhaps the untimely death of someone you loved. This may begin to affect you negatively in other areas of your life. You may worry or experience intrusive thoughts that someone else close to you may pass suddenly, or in the same way. To help deal with this, you may develop repetitive behaviors that you think are going to solve the problem or stop it from happening.

Rather than suppressing intrusive thoughts, you can take a mindful approach, accepting them without judgement but knowing that they do not define you and despite their strength, you can maintain healthy thinking processes.

Facing Intrusive Thoughts Head-On

You should avoid “running away” from situations that can cause you stress, as this can push you into rumination. If you find that intrusive thoughts severely or persistently interfere with your health and well-being, consider seeing a therapist. Approaches like cognitive-behavioral therapy (CBT) can help you understand the vital link between your thoughts, emotions and behaviors. Your therapist can suggest behavioral changes and ask you to recognize how these changes affect the way you think or feel about a situation. They can also help you reframe negative thoughts into positive ones.

People who find that intrusive thoughts are exacerbating mental conditions like depression, anxiety and OCD should seek professional help — as should those who are unable to undertake daily tasks or sustain relationships because of intrusive thoughts. Therapy combined with medication and a holistic approach to health and self-care are important ways forward in the healing and wellness process. What works well for one person may not for another, so finding a personalized way to deal with these issues is the best way forward.

Jackie Edwards is a freelance writer who has had lifelong experience of anxiety and depression. She left her previous career due to ill health, but now has a much better work-life balance and finds that working from home suits her temperament. In her free time, she takes walks, meditates and volunteers for a few local animal welfare charities.