Conditions > Obsessive-Compulsive Disorder > Intrusive Thoughts

Intrusive Thoughts

What are they, who gets them and how can they be treated?

Intrusive Thoughts

We've all had a strange idea or image pop into our head. Like picturing your boss naked in the middle of a meeting, or imaging driving your car off the road on your way to the store. They appear out of nowhere and for no good reason.

These are called intrusive thoughts — unwanted and distressing ideas that feel contrary to a person's nature. They often cause intense anxiety and stress.

Everyone experiences intrusive thoughts. They are a normal part of life. When they arise, most people can dismiss them as strange or no big deal. However some people — people with obsessive-compulsive disorder (OCD) — can’t shake them and assume they mean something more. They obsess over the nature of these thoughts, and what they could mean about who they are as a person.

Rose Cartwright on Pure O

Advocate and Made of Millions cofounder, Rose Cartwright, discusses sexual intrusive thoughts.

Intrusive thoughts come in countless forms. They can center around religious beliefs, sexuality, relationships, bodily functions, violence, physical health, and many other themes. Most intrusive thoughts are disturbing and distressing, but some can be so strange and bizarre, that they border on humorous.

For many people, intrusive thoughts center on the things they care about most in life: children, pets, family, faith, career trajectory. For example, if a person wants nothing more than to be a parent someday, their intrusive thoughts may center around child molestation or other child abuse, or if a person is a devout Christian, they may struggle with the doubt that Jesus is really God. 

Anxiety and OCD take the things we cherish most, and twist them into upsetting intrusive thoughts.

These different "themes" are used to group OCD into more specific subtypes. For instance, a person suffering from violent intrusive thoughts may be told they're experiencing something called Harm OCD. A person with blasphemous religious thoughts, may be told they're experiencing something called Scrupulosity or Religious OCD.

It is common for people to experience multiple subtypes at the same time, or cycle through different types over many years. These subtypes are not diagnoses. They are labels or categories used to better understand the form a person's OCD is taking.

Explore common subtypes below:

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How can you treat them?

All intrusive thoughts are normal, and no matter their theme, they can be treated with different forms of cognitive-behavioral therapy (CBT). Exposure and response prevention therapy (ERP) is the most highly recommended option for people with OCD.

Medication can also be used alongside therapy to help minimize anxiety. The main family of medicines used to treat OCD are known as Selective Serotonin Reuptake Inhibitors, or SSRIs. SSRIs enhance your natural serotonin activity and are used to treat major depressive disorders and anxiety conditions. Well known examples include Lexapro, Prozac, Paxil, Zoloft and Luvox.

It’s normal to hope treatment means intrusive thoughts will disappear, but treatment should equip OCD sufferers with techniques to address any intrusive thought that may arise. Your anxiety won't fully go away, but you'll be better prepared to cope with it and live a happy, healthy life. Learn more about OCD treatment here.

What resources can help?

The first-step towards overcoming intrusive thoughts, is educating yourself. Read articles from fellow sufferers, watch interviews with leading doctors and advocates, join community support groups. The more you understand your intrusive thoughts, the better you can manage them.


An upcoming live series all about exposure and response prevention therapy.

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