Mental-Cognitive Symptoms

Anxiety and Intrusive Thoughts: An Introduction

Micah Abraham, BSc

Written by

Micah Abraham, BSc

Last updated October 10, 2020

Anxiety and Intrusive Thoughts: An Introduction

Physical anxiety symptoms are what often drive people to seek help, because the physical symptoms of anxiety are often the most debilitating. But it's the intrusive thoughts of anxiety that are the cornerstone of an anxiety disorder.

Each disorder has its own type of intrusive thoughts, and these thoughts can so deeply occupy your mind that you may not be able to focus on your life or experience joy from your activities.

What Are Intrusive Thoughts?

Intrusive thoughts are thoughts that consistently enter your mind against your will. They're considered intrusive because you simply cannot get them out of your mind, and they often pop up at unusual moments. Intrusive thoughts may also occur in flashes, and often cause significant anxiety when they enter your mind. Another word for these thoughts is “rumination.”

There are many different types of intrusive thoughts, but they generally fall into these categories:

  • Unwanted Memories Though not often considered an "intrusive thought" in the medical sense, many people experience persistent, unwanted memories. Those with PTSD are especially prone to these types of memories, but anyone may have a memory that causes them significant distress, and those with anxiety are more likely to have that memory pop up at unwanted times.
  • Violent Thoughts Thoughts of violence and aggression may also be common in those with some types of anxiety, especially obsessive compulsive disorder. Generally, these are thoughts where the person imagines themselves doing violent/aggressive things. However, one could consider worries about danger happening to other people to be violent thoughts as well.
  • Sexual Thoughts Like violent thoughts, a person can have unwanted sexual thoughts. Sometimes these sexual thoughts are paired with religious-induced shame, while other times the sexual thoughts may also be somewhat violent in nature. These are also more common with those with specific types of anxiety disorders.

Still, any thought that comes at an inappropriate time may be considered an intrusive thought. Those with phobias may randomly experience a flash of the object that causes them fear, and in some cases that thought may be considered intrusive.

How Different Anxiety Disorders May Experience Intrusive Thoughts

Obsessive Compulsive Disorder (OCD)

Obsessive compulsive disorder is the disorder most well-known for these types of problematic thought processes. They're considered "obsessions" because the person cannot stop the negative thought. These individuals often turn to their compulsions (like closing a door 3 times) in an effort to rid themselves of the image.

Fears are also intrusive thoughts. Those that have a fear of germs may see these germs on everything, and ultimately believe that the germs are going to cause illness and penetrate the skin. The thought then causes them to wash their hands regularly or avoid dirty substances altogether.

Generalized Anxiety Disorder (GAD)

For GAD, the intrusive thoughts are rarely as graphic as those with OCD. Many with generalized anxiety disorder have worries that they cannot seem to get rid of, and often show themselves at unusual times. Someone with GAD may suddenly worry about a family member and will not be able to stop worrying until they speak to that person on the phone.

Social Phobia

Those with social phobia (and those with GAD, in some cases) may have problems getting over the "mistakes" they felt they made in the past. Someone with social phobia may constantly flash back to a time that they felt they embarrassed themselves, and this thought may jump into their minds at the most inopportune or inappropriate moments, causing significant distress.

Post-Traumatic Stress Disorder (PTSD)

Like those with social phobia, those with PTSD are also prone to flashbacks - in this case, their traumatic event. Often those with PTSD relive the event any time they come across a trigger. They may also relive the events in dreams/nightmares or at random times throughout the day. Once the traumatic event enters their mind, they may find it hard to forget it.

Panic Disorder

Those with panic attacks have very different types of intrusive thoughts. Many with panic disorder become preoccupied with the fear of having another panic attack. Some may think about their panic attacks all the time, worried that they'll have one. Others worry about a specific symptom, like whether or not they can get a full breath. For those with panic disorder, these thoughts can be so problematic that they increase the risk of having another panic attack.

Living With Intrusive Thoughts

Intrusive thoughts can become a serious issue, and are not limited to the examples above. The biggest question you need to ask yourself is whether or not these thoughts happen significantly enough and cause enough distress to be considered a problem. If they are, then you need treatment.

Many cognitive behavioral therapists are trained to teach people how to control their intrusive thoughts. There are also methods you can employ at home that will improve your ability to stay calm when these thoughts occur. In the long term, you'll need to discover ways to control your anxiety directly, because your anxiety is what causes these intrusive thoughts in the first place.

For example:

  • Cognitive Behavioral Therapy
  • Medication
  • Self-Help Techniques

Your first choice should be therapy or medication, as these empirically validated approaches are effective at reducing or helping you manage your anxiety. If you can learn to manage your anxiety, you should also be able to decrease the frequency and/or reaction to intrusive thoughts.

Questions? Comments?

Do you have a specific question that this article didn’t answered? Send us a message and we’ll answer it for you!

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Where can I go to learn more about Jacobson’s relaxation technique and other similar methods?

– Anonymous patient


You can ask your doctor for a referral to a psychologist or other mental health professional who uses relaxation techniques to help patients. Not all psychologists or other mental health professionals are knowledgeable about these techniques, though. Therapists often add their own “twist” to the technqiues. Training varies by the type of technique that they use. Some people also buy CDs and DVDs on progressive muscle relaxation and allow the audio to guide them through the process.

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