OCD Intrusive Thoughts: Effects on Mental Health

Category: Mental Health
9 minute read.

Can you remember the last time you had an unwanted thought or unpleasant image stuck in your head? You can often ignore it, and soon after, it goes away. But other times,  despite your best efforts,  it keeps popping up. You don’t want to have these persistent, uncomfortable thoughts. So why do they happen to you? These thoughts are called “intrusive thoughts,” and virtually everyone experiences them at some point. Intrusive thoughts can consist of random or illogical images or disturbing or violent ideas like hurting yourself or someone else. If you find you obsess about intrusive thoughts or must “do things” (such as tasks or rituals) to make them go away, it may suggest a more profound, underlying mental health challenge such as obsessive-compulsive disorder.

Understanding OCD

Obsessive-compulsive disorder is a mental illness characterized by two distinct sets of symptoms; obsessions and compulsions. Someone with OCD experiences obsessions, which are repetitive, unwanted thoughts and irrational urges to do specific things or repeat particular actions. Although they may understand that their obsessions are irrational and illogical, they cannot stop them from occurring. In general, obsessions are often upsetting and can lead to significant anxiety, primarily when they are not addressed. Unfortunately, even if one tries to suppress obsessive thoughts, it will inevitably lead to considerable fear and panic associated with the idea that the harmful thought could “come true” if they do not act on it. Eventually, obsessive thoughts become so strong that the individual will act upon their thoughts by performing compulsions “behaviors or activities” to reduce the intensity and severity of their obsessions.

Compulsions are the behaviors or activities brought about by obsessions. Compulsions are repetitive acts such as hand washing, turning light switches on and off, organizing things, and checking things, that someone with OCD must perform to help manage obsessive thoughts. Someone suffering from the long-term obsessive-compulsive disorder will adopt these behaviors and activities to cope with the intensity and severity of their symptoms. Because of how symptoms of OCD affect the mind, individuals with OCD symptoms will believe that if they do not perform these rituals in a specific way each day, terrible things may happen to themselves or a loved one.

Types (or Dimensions) of OCD

It is also important to note that there is more than one type or category of OCD. The Diagnostic and Statistical Manual of Mental Disorders (DSM) lists specific criteria for four main categories of OCD. These include Symmetry and Ordering, Forbidden Thoughts, Cleaning and Contamination, and Hoarding. Like many other mental illnesses, each person with OCD will experience symptoms and challenges related to the condition in unique ways. Also, it is possible to experience symptoms from more than one type or dimension of obsessive-compulsive disorder. Someone living with an obsessive-compulsive disorder will likely encounter various symptoms, often from multiple OCD dimensions..

Cleaning and Contamination

This type or dimension of OCD is characterized by symptoms such as persistent worry about sickness, germs, and exposure to viruses or other contaminants. To reduce the risk of illness, someone with cleaning and contamination dimension symptoms will experience compulsions to wash, clean, or perform specific rituals around cleaning and sanitizing.

Symmetry and Ordering

The symptoms from this dimension fixate on the overwhelming need for everything to be organized, symmetrical, and aligned in a certain way. If things are disorganized, you will feel incomplete and anxious. Engaging in counting, cleaning, and organizing rituals is the only way to, at least temporarily, relieve anxiety. 

Forbidden Thoughts

The forbidden thoughts dimension encompasses intrusive thoughts that can be overwhelming and painful period examples of these intrusive thoughts are explained in greater detail below but include violent, sexual, and negative thoughts. Worrying that you will harm yourself or someone else, causing bad things to happen, and reliving your day to ensure that you didn’t do anything “bad” to someone else are all examples of intrusive thoughts. This particular dimension of obsessive-compulsive disorder involves a more significant internal challenge as the intrusion, and emotional challenges that evolve from intrusive thoughts are not outwardly visible to others. Additionally, few compulsions help to reduce the intensity of intrusive thoughts.


The fourth dimension of obsessive-compulsive disorder is hoarding. However, it is crucial to remember that in the context of OCD, hoarding differs from a hoarding disorder which is a separate or distinct mental health condition. The key difference between the two is that with hoarding disorder, someone “wants” the things they collect. With hoarding in OCD, you may not want the stuff you collect; however, you feel compelled to save them because of the nature of obsessive thoughts and compulsions. You may worry that if you throw something away, it could bring harm to you or a loved one. You may fear contamination by touching a particular object. You may feel compelled to check or review your possessions consistently to ensure nothing has been inadvertently lost or thrown away. As a result, someone with hoarding dimension OCD will “collect” and keep items because they cannot throw them away.

More About Intrusive Thoughts

The intrusive thoughts that accompany obsessive-compulsive disorder can interfere with your daily life. There are several types of intrusive thoughts that can occur.

Sexual thoughts

Almost everyone, regardless of gender, has sexual thoughts. They are a natural and normal part of life. Sometimes sexual thoughts can be shocking or make you feel uncomfortable, so you try to bury them in the back of your mind to avoid thinking about them any further. Rather than fixating on them, it is best to remember they are merely a passing thought or idea and, if left alone, will resolve.

Violent thoughts

Intrusive thoughts can also take on violent or dark themes, such as hurting someone else or engaging in self-harm. Like sexual thoughts, violent intrusive thoughts are also harmless ideas you do not intend to act on and will pass in time. However, if you find yourself planning to follow through with your thoughts or need to perform rituals or other activities to “take your mind off the thought and reduce anxiety around it, it may suggest you should seek help from someone to assess the root causes of your thoughts.

Negative thoughts

Negative thoughts can arise when something doesn’t work out as planned or intended making you feel “not good enough” or inadequate. Typically, these thoughts fade as the situation itself changes or fades into memory. But, if negative thoughts persist and cannot be resolved, it could suggest a mental health condition that could benefit from treatment at The Los Angeles Outpatient Center.

If intrusive thoughts consume your energy, cause you distress, or make it hard to go about your day, it may be time to seek help. If you feel like acting on your intrusive thoughts in a way that could cause harm to yourself or someone else, it is crucial to seek medical and mental health help immediately.

Help for Obsessive-Compulsive Disorder at The Los Angeles Outpatient Program

Mental health professionals generally consider combination therapy (psychotherapy and medication) the most beneficial and effective treatment for OCD. A specific type of therapy, exposure, and response prevention therapy or ERP is typically the most recommended therapeutic approach. This treatment gradually exposes you to the subject of your obsession or the root causes of your compulsions. Working in the safety of the therapeutic setting with a highly trained mental health provider, you can learn how to cope with the discomfort you experience when you do not complete compulsions. During therapy, you will practice these skills and learn healthier coping mechanisms that you can take with you into the post-treatment environment to manage potential triggers.

If your symptoms do not respond to therapy alone, your treatment team may recommend using medications in conjunction with ongoing therapy. It is crucial to remember that most mental health medications can cause unwanted side effects. For this reason, they are not suitable for use in all situations. Your provider will work with you to determine if the benefits of medications outweigh the potential risk of their use.

Generally, the most beneficial medications for obsessive-compulsive disorders include antipsychotic and antidepressant medications. Research suggests that some OCD symptom dimensions respond better to one class of drug over another, so the best choice for you will depend on your specific treatment needs. Similarly, specific treatment models are sometimes more effective for one treatment symptom class than another.

It is not uncommon for everyone, even those who do not meet the diagnostic criteria for obsessive-compulsive disorder, to experience minor obsessive or compulsive symptoms from time to time. Intrusive or fixative thoughts are also common. We all get an image stuck in our heads or have moments where we can’t shake a particular thought or vision. Intrusive thoughts can range from harmless and minor to violent and dangerous. Typically, intrusive thoughts are harmless and disappear after a short time. However, if your experiences with intrusive thoughts continue to return frequently and without warning, it may suggest obsessive-compulsive disorder.

When your obsessions and compulsions consume more than an hour of your day or if you notice your symptoms get in the way of accomplishing the things you need and want to do, it is time to consider seeking help and treatment at a program like The Los Angeles Outpatient Center. It is crucial to remember that, without treatment, symptoms connected to an obsessive-compulsive disorder may worsen over time, eventually damaging your relationships and quality of life.

With treatment, however, symptoms often improve. At The Los Angeles Outpatient Center, we understand deciding to seek treatment to learn how to manage OCD symptoms can be challenging. Therapy itself can bring about feelings of anxiety and distress. Research has shown the best outcome for adults with obsessive-compulsive disorder symptoms involves comprehensive, evidence-based treatments with specialists skilled in treating obsessive-compulsive disorder. If Your OCD symptoms hinder your ability to live your best life without interference from intrusive thoughts or compulsions, don’t wait another day to reach out to our caring and compassionate team here at our Los Angeles area treatment center. Let our admissions staff teach you more about how our treatment programs can help you learn to cope with the intrusive thoughts that lie at the root of obsessive-compulsive disorder symptoms.