Have you ever found yourself in a boring meeting and thought, “What if I just started shouting?” Or maybe while driving, you wondered, “What if I crash?” These unsettling scenarios are known as “intrusive thoughts,” which most of us experience occasionally and can usually dismiss.
However, for some, these thoughts can become overwhelming and develop into obsessions, leading to compulsive behaviors. Research shows that while most of us experience these unsettling thoughts from time to time, for a small percentage, they can spiral into serious distress.
What Are Intrusive Thoughts?
Dr. Nina Higson-Sweeney recalls a childhood experience where she felt certain that unless she only had “good” thoughts on her way home from school, her family would be harmed. “If I had an intrusive thought, I’d restart the walk from the bus stop,” she explains. “I was genuinely terrified that if I didn’t redo it, something would happen, and it would be my fault.”
Dr. Higson-Sweeney, now a psychology researcher at the University of Oxford, was diagnosed with obsessive-compulsive disorder (OCD) at age 10. She specializes in child and adolescent mental health. According to Dr. Higson-Sweeney, “Obsessions are intrusive, unwanted thoughts, feelings, and sensations. Compulsions are repeated, ritualized acts done to neutralize or alleviate the anxiety caused by the obsessions.”
The Growing Prevalence of OCD
Around 1-4% of the population is thought to live with OCD, with a marked increase in the number of 16-24-year-olds reporting symptoms. Research suggests that the condition has become the second-most widespread mental health disorder for young adults in England.
Intrusive thoughts are distressing and often focus on subjects completely at odds with a person’s values or identity. These thoughts can include fears about harming loved ones, questioning one’s sexuality, or worrying about contamination.
“People with OCD may experience extreme thoughts, like worrying about being a paedophile or fearing that they’ll spread illness,” explains Dr. Higson-Sweeney. These types of thoughts are often difficult to dismiss and can lead to compulsive actions that temporarily relieve anxiety but do not resolve the underlying issue.
Signs of OCD and Compulsions
Psychologist Kimberley Wilson explains that almost everyone experiences intrusive thoughts occasionally. “Around 80% of people have them,” she says. For most, these thoughts pass quickly, and they can dismiss them with little difficulty. However, for those with OCD, these thoughts don’t fade—they persist and intensify, taking up residence in the mind.
As OCD progresses, the intrusive thoughts can become all-consuming, and compulsions may develop. These compulsions can be mental, such as counting, or visible, like repeatedly checking something (e.g., car tires), even when you know it’s unnecessary.
Managing OCD
When intrusive thoughts become overwhelming, seeking professional help is often necessary. A therapist or specialist can develop a treatment plan tailored to the individual.
In addition to professional therapy, Dr. Higson-Sweeney offers practical tips for managing OCD daily. One key strategy is learning to label thoughts: recognizing that “I’m having an intrusive thought” can create distance and remind you that the thought is not a reflection of who you are.
Some people find it helpful to visualize OCD as a separate entity. “Drawing what OCD looks like can help,” says Dr. Higson-Sweeney. “There’s me, and then there’s OCD, and those are two different things.”
Self-care also plays a vital role in managing OCD. Dr. Higson-Sweeney explains that eating well, resting, and staying active can help reduce symptoms, especially since OCD often worsens when a person is stressed or neglecting their health.
Living with OCD
Although Dr. Higson-Sweeney still lives with OCD, she has learned how to manage it. “I’ve never gotten over OCD, but I can function with it,” she says. “I now have mild intrusive thoughts and a lot of insight into how I manage them. However, when I’m stressed, these thoughts become harder to dismiss, and they can still lead to compulsions.”
Managing OCD involves ongoing effort and the right strategies to cope with intrusive thoughts and compulsive behaviors. While it may never fully go away, with the right support and tools, people with OCD can lead functional, healthy lives.
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Intrusive thoughts can be difficult to manage, but with the right understanding and support, people can navigate OCD successfully. Learning to recognize and cope with these thoughts is a critical step in reclaiming control.
