Types of intrusive thoughts

Jessica Kennedy, Mental Health America

There you are, minding your own business, and suddenly your brain starts getting hammered with worries, concerns, or desires to hurt yourself. You tell your brain to shut up, but it keeps going. You change tasks to stay distracted, but the nagging thoughts keep coming back. You feel like your brain is attacking you. Intrusive thoughts are unwelcome and distressing.

Intrusive thoughts come in all kinds of varieties. They can be signs of anxiety disorders or obsessive-compulsive disorder. They can be symptoms of psychosis. They can be what we call cognitive distortions, which most people have in some form or another.

Some categories of intrusive thoughts include:

Wanting to hurt yourself or someone else. These are very alarming thoughts. You may experience this as a desire to punch someone you’re talking to, an urge to crash your car into a tree, or an urge to jump off the balcony of your apartment building. Every once in a while, having an aggressive thought like this (like when someone cuts you off in traffic and you maybe wish their car would catch on fire) is probably just you being petty. But if you’re experiencing angry and aggressive thoughts like this all the time, that’s not good for your health or your mind. It’s a good idea to consult a therapist about this. Exposure therapy and Cognitive Behavioral Therapy (CBT) are two techniques that are used to address intrusive thoughts.

Intrusive sexual thoughts. If you’re thinking about sex all the time, you may have a problem. Look, it’s normal to think about sex, because sex feels good. But there’s a difference between fantasizing about a partner throughout the day and having so many thoughts about sex you can’t get your work done. Another kind of intrusive thought here is the constant thought or fear of being gay, bisexual, or transgender. It may be possible that you are (by the way, there’s nothing wrong with that). Or the fixation could be something else. Either way, if this is happening, you want to find a counselor or therapist. Look for someone who specializes in sex issues.

Delusional thoughts. If you have intrusive thoughts that are more bizarre in nature—like constant obsessions with Armageddon or the second coming—you may be experiencing signs of psychosis. Psychosis can be a sign of a mental illness like schizophrenia, a feature of depression, or even the aftermath of a bad encounter with drugs. Either way, if you find these thoughts disturbing or distressing and can’t get rid of them, it’s a good idea to talk to a doctor. You’ll probably end up with a referral to a psychiatrist or a neurologist.

Postpartum issues. If you have given birth lately, you may have a lot of distressing thoughts about your baby. Your baby starts crying at 3 am and you lie in bed shouting, “SHUT UP SHUT UP SHUT UP.” If you think about hurting your baby or if you feel sad or angry all the time, you may have a postpartum condition. Most people are familiar with postpartum depression, but there are other variations on the condition like postpartum anxiety and psychosis.

Other intrusive thoughts. You might be obsessed about whether you remembered to do something or maybe something bad is going to happen to someone you care about. These worries or concerns may be normal. Or they may be symptoms of obsessive compulsive disorder (OCD), anxiety, or something else. Anytime you feel like these thoughts or behaviors are interfering with your life, you can get help by talking to a doctor or a therapist. Some people don’t realize what it’s like to think and live without these thoughts, but treatment is possible.

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