If “what if” thoughts are making it hard for you to focus, here are steps to stop intrusive thoughts that may come along with OCD.

Have you ever had an unwanted thought get stuck in your head that keeps playing repeatedly? This is called an intrusive thought. Intrusive thoughts can come out of nowhere and cause a great deal of anxiety.

When thoughts go beyond intrusive, this can be a sign of obsessive-compulsive disorder (OCD). OCD is a common chronic anxiety disorder involving recurring unwanted thoughts or obsessions that often make you feel driven to do something repeatedly.

About 1 in 100 adults and as many as 1 in 200 children and teens in the United States have OCD.

If you find yourself worrying about things that might happen — such as, “What if I fail my driver’s test?” or “What if my headache is a sign of something serious?” — know that these thoughts can be managed.

You can learn some practical ways to shift your mindset and put your mind at ease with practice.

Many of us experience “what if” thoughts daily, but we understand that these thoughts don’t always align with what we know about ourselves. So we often forget about them and go on with our day.

But for those living with OCD, these thoughts can become stuck and become a compulsion, says John Carnesecchi, a licensed social worker based in New York City.

“The compulsive, repetitive behavior that characterizes many cases of OCD is commonly driven by fearful ‘what if’ thoughts,” explains John F. Tholen, PhD, author of “Focused Positivity: The Path to Success and Peace of Mind.”

If you’re having unwanted thoughts, like, “what if I have cancer?” this can create the compulsion to seek unnecessary medical scans, says Tholen.

Our minds create hypothetical catastrophes, and those thoughts often prompt people with OCD to solve problems that don’t yet exist, says Tholen. “Repetitive, compulsive actions are impelled because it seems too reckless to ignore warnings of impending disaster.”

Other examples of “what if” thoughts can include:

  • What if I lose my job?
  • What if my partner leaves me?
  • What if I have a heart attack?
  • What if I have a panic attack?
  • What if I fail my exam?

One way to manage “what if” thoughts is to find and adopt a good strategy for addressing them, says Tholen. Here are some tips to help you manage and regulate your thinking process.

Consider reflecting on what you think may be triggering these thoughts. Did something happen? Is there something making me question this? These anxious thoughts are usually driven because of a specific situation, says Carnesecchi.

Take some time to see whether you can pinpoint what the trigger is. If you know your trigger ahead of time, you can go into the situation more prepared.

Try to be aware of whatever is happening in your mind and body, says Tholen. He suggests noting the thoughts that are disturbing you (only as much as is necessary) and recording them to help you identify a more reasonable alternative.

Journaling your “what if” thoughts can help release them from your mind and allows you to become more aware of how often you’re having intrusive thoughts, explains Carnesecchi.

He suggests trying to transform “what if” thoughts to “even if” thoughts because changing the terminology may feel more reassuring.

To help inspire and motivate you, consider recording your reasonable thoughts and reviewing them daily. “By making it a habit to review functional thoughts, we can gradually make them the focus of our attention, thus enhancing our mood and motivation,” says Tholen.

To help manage obsessive thoughts, consider trying CBT. This is where you and a therapist work together to deal with obsessive thoughts.

“Cognitive behavioral therapy (CBT) helps work through the thinking patterns associated with compulsions and obsessions,” says Carnesecchi.

It’s also considered the “gold standard of psychotherapy.”

According to a 2018 review, CBT is an effective psychological treatment approach that can help treat depression, anxiety, and other related conditions.

According to Tholen, the most effective CBT method for treating OCD is exposure and response prevention. It involves experiencing the situation that triggers your symptoms, such as not being able to wash your hands after touching dirty dishes.

Tholen says, “Having been forced to remain in a dreaded situation (contact with dirty items), the OCD patient is forced to consider the possibility that they can tolerate such circumstances and their ability to resist the ‘what if’ urge to perform the ‘corrective’ compulsive action is strengthened.”

Everyone experiences an occasional intrusive thought where you wonder, “what if” something bad happens? While these thoughts may be disturbing, many people don’t dwell on them.

When these thoughts become more than intrusive, you may have OCD.

It’s important to develop a strategy for managing irrational thoughts.

And know that you’re not alone. If your intrusive thoughts interfere with your day-to-day life, it may be time to consider speaking with a mental health professional.

You may also find it helpful to join a support group and learn from others about how to manage your OCD-related anxiety.