While most of us have intrusive thoughts from time to time, obsessive thoughts are more intense. They may cause a great deal of distress and can affect many aspects of your life.
There’s that thought again. You can’t stop thinking about whether or not you locked the front door, and you want to turn your car around right now and check — again.
Almost everyone has experienced these intense and recurring thoughts. But, for some people, they’re not temporary occurrences. Instead, obsessing thoughts are persistent and pervasive.
If this resonates with you, perhaps you’re living with obsessive-compulsive disorder (OCD) or another mental health condition that may have obsessions as a symptom.
In any case, these conditions can be managed and treated, and you can find relief.
Most people have intrusive or unwanted thoughts from time to time. Not all are obsessive, though.
Obsessive thinking or obsessions are a symptom of OCD. They’re thoughts, fantasies, or urges that are typically unwanted and highly distressing. These are commonly accompanied by compulsive rituals that aim to decrease the distress obsessions may cause.
Intrusive thoughts are common and, in many circumstances, natural and expected. They could include a memory that flashes in your mind, or a song that sticks around in your head for a while.
For example, it may be natural to have persistent intrusive thoughts about your ex-partner after breaking up. These intrusive thoughts may affect your mood and some of your behaviors. But eventually, they decrease in intensity and frequency.
You may even be able to avoid these thoughts if you focus on a task or distract yourself with friends and family.
“We all have upsetting thoughts that pop into our minds from time to time,” says Dr. Melissa Shepard, a psychiatrist in Baltimore, Maryland.
For some other people, however, intrusive thoughts become persistent, significantly distressing, and aren’t easily dismissed.
For example, you may constantly think about hurting your ex or their new partner, fear embarrassing yourself in front of them, or dread running into them. It may be difficult to put these thoughts away. You may start having difficulty sleeping or completing daily tasks.
Obsessive thoughts may start as intrusive thoughts, says Shepard, but they’re different in that they’re more intense, frequent, and upsetting.
Sometimes, obsessive thinking is similar to rumination, a common feature of those who live with an anxiety disorder.
The main difference is that rumination creates a distressing loop about the past, while obsessive thinking may also generate fear about the possibilities of the future.
Obsessions may often focus on themes, such as fear of:
- being contaminated with germs
- causing an accident
- doing something embarrassing
- forgetting something important
- losing an object
- something bad happening to those you love
- objects being out of order or asymmetrical
For some people, obsessions may be equated with action, a cognitive distortion known as
Obsessive thoughts exist on a continuum. Everyone’s experience will be different.
“These thoughts can range from mild annoyance to all-consuming,” says Dr. Jaclyn Bauer, a clinical psychologist in Ranchos Palos Verdes, California. “People may try to talk themselves out of these thoughts or distract themselves, but obsessive thoughts are not easily short-lived.”
In fact, obsessions have the potential to impact your overall sense of well-being and prevent you from enjoying activities, work, or relationships. These could lead you to experience other challenges such as:
- being unable to take action
- feeling unable to leave the house
- inability to go to work or school
- isolating from friends and family
- trouble concentrating on tasks
- running behind schedule
“The mind and body are intricately linked, so mental health conditions can also lead to physical health problems like high blood pressure, headaches, digestive issues, muscle aches, chronic pain, and an increased risk of infections,” Shepard adds.
While obsessive thoughts are most commonly associated with OCD, they can also occur in other mental health conditions. These include:
The best way to find out what’s at the root of your obsessive thoughts may be to work with a mental health professional. They’ll be able to evaluate your symptoms and provide a diagnosis and recommendations for treatment.
Obsessive thoughts are manageable, particularly if you treat the underlying condition that’s causing them.
While it may be difficult to stop them altogether, an effective treatment plan and coping strategies can help reduce the impact these thoughts have on your life.
If you live with a condition that includes obsessions as a symptom, treatment usually includes a combination of therapy and medication.
A successful form of treatment for obsessive thoughts and other OCD symptoms is exposure therapy, which involves:
- learning coping skills
- increasing distress tolerance
- incremental exposure to your trigger
“As challenging as it is, exposing yourself to your fears will train your brain to stop obsessing over them,” says Ray Sadoun, a mental health and addiction recovery specialist in London, England.
“For example, for my patient who had a fear of dying in a car crash, exposure would look like gradually increasing the amount of time they spend in the car, driving in unknown places, or driving with a stranger,” he says.
Mindfulness-based cognitive therapy
For those living with OCD, mindfulness-based cognitive therapy (MCBT) may be an effective complementary treatment to exposure therapy and medication, according to a 2018 study involving 125 people with OCD.
Peer support and support groups
Medications in the selective serotonin reuptake inhibitors (SSRIs) class are commonly used to treat the symptoms of OCD, according to the American Psychiatric Association.
Which drug to take may depend entirely on what your healthcare professional thinks will work better for your specific symptoms and needs.
Since not everyone is the same, and your symptoms could result from an underlying condition, you may want to try some of these self-care strategies and find out which works better for you.
Remember, discussing how you feel and your obsessive thoughts with a mental health professional is highly advisable for long-term improvement.
Identify the thoughts
You may find it useful to learn the difference between your usual thoughts and your obsessive thoughts through a meditation practice or a thought log. Both techniques can help you discover your triggers.
As you write your thoughts, you may identify patterns and themes that repeat or that are particularly distressing.
Counter the thoughts
“Once you identify the obsessive thought, talk back to it,” Bauer says. “Use your rational voice and tell the obsessive voice to stop. Explain to your obsessive thought that your friend is busy and will text when they are free, you already washed your hands, or the door is locked.”
You may find it helpful to remind yourself that these obsessive thoughts aren’t helpful or accurate. You are in control of your own choices and behaviors.
But if you find doing this difficult, also remind yourself this is a symptom and it’s not your fault. You’re doing the best you can to counter these thoughts.
Sit with the thoughts
If you’re living with obsessive thoughts, it may be tempting to constantly push the thoughts away, especially if they’re distressing. But, sometimes, this reaction can have the opposite effect, says Shepard.
“I think of it like the Chinese finger trap puzzle, that little woven tube that you can stick your fingers in,” she says. “Your instinct […] is to try and pull your fingers out when they start to feel stuck. But this only tightens the puzzle’s grip. Instead, you have to relax into the puzzle to free yourself.”
The same is true with obsessions, she says. Try to allow them to be there, in a nonjudgmental way, to help them dissipate.
It may also help to take out a notebook and write about what you’re feeling.
Journaling may provide emotional relief and help you accept the thoughts you’re having.
Engage in calming activities
“The more anxious we feel, the easier these thoughts invade us,” Bauer says. “It is important to understand our anxiety triggers and how to decrease and manage our anxiety.”
Several activities can promote relaxation. Some of these may work for you:
- deep breathing at least once a day, or when anticipating anxiety
- daily meditation
- progressive muscle relaxation
If you experience obsessive thoughts, it’s natural for them to affect your mood and behavior. If you live with OCD, obsessions may be a daily occurrence to you.
However, you can manage obsessive thoughts, and help is available. It may be a good idea to reach out to a healthcare professional to explore diagnosis and treatment options.
“It’s important to know that you are not alone,” Sadoun says. “Neither obsessive thoughts nor intrusive thoughts are your fault.”
Hearing about other people’s experiences may help you to feel less isolated, too, says Sadoun. He recommends a video on what it’s like to live with OCD by YouTuber Rose Dix. You can watch it here.
Reading more about OCD and obsessive thoughts may also help. Consider these books:
- “Getting Over OCD: A 10-Step Workbook for Taking Back Your Life” by Jonathan S. Abramowitz, PhD
- “Overcoming Unwanted Intrusive Thoughts” by Sally M. Winston, PhD, and Martin N. Seif, PhD
- “Unwinding Anxiety” by Judson Brewer, MD, PhD
- “The Anti-Anxiety Workbook: Proven Strategies to Overcome Worry Phobias Panic and Obsessions” by Martin M. Antony, PhD, and Peter J. Norton, PhD
- “The Mindfulness Workbook for OCD” by Jon Hershfield, MFT, and Tom Corboy, MFT
If you’d like to seek the support of a mental health professional, these resources are available:
- American Psychiatric Association’s Find a Psychiatrist tool
- American Psychological Association’s Psychologist Locator tool
- Asian Mental Health Collective’s therapist directory
- Association of Black Psychologists’ Find a Therapist tool
- Latinx Therapy’s therapist finder
- National Alliance on Mental Illness HelpLine and support tools
- National Institute of Mental Health’s helpline directory
- National Queer and Trans Therapists of Color Network
- Inclusive Therapists