Attention-deficit/hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD) are complex mental health conditions with a wide range of symptoms, including intrusive thoughts. These intrusive thoughts can make it difficult to maintain stable relationships, perform well at work or school, and lead to other issues.

In this post, we explore ADHD intrusive thoughts and how they differ from OCD intrusive thoughts.

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What are ADHD intrusive thoughts and how do they differ from OCD?

Intrusive thoughts are unwanted, involuntary thoughts, images, or urges that cause distress or anxiety. They can happen with both ADHD and OCD, although the nature and response to these thoughts may differ between the 2 conditions.

Individuals with ADHD can have trouble focusing on a single task or thought due to their minds constantly jumping from one idea to another. And ADHD intrusive thoughts manifest as racing thoughts or difficulty filtering out irrelevant information.

Intrusive thoughts can also happen with OCD, but are more persistent and distressing than with aDHD. They’re often accompanied by rituals or compulsions to neutralize the anxiety caused by these obsessions. For example, someone with obsessive-compulsive disorder might have an intrusive thought about germs and then engage in excessive hand washing to mitigate their fear of contamination.

While ADHD intrusive thoughts can be distressing, people with ADHD usually don’t engage in compulsive behaviors to alleviate their anxiety.

The difference between ADHD intrusive thoughts and OCD intrusive thoughts

There are some key differences between intrusive thoughts in ADHD and OCD.

	OCD intrusive thoughts	ADHD intrusive thoughts
Nature	Typically obsessive, repetitive, and distressing; often irrational, cause anxiety or discomfort, and may be related to fears, inappropriate images, or taboo subjects	Characterized by daydreaming, forgetfulness, and a general inability to sustain attention; may not necessarily be distressing or cause anxiety
Response	Sufferers may try to suppress or neutralize their intrusive thoughts by engaging in compulsions or rituals to reduce their anxiety or distress	Sufferers are more likely to act impulsively on their intrusive thoughts without thinking about the consequences
Context	Often revolve around specific themes, such as contamination OCD, harm to oneself or others, religious or sexual themes, or the need for symmetry or order	More likely to arise due to difficulties with focus and attention, leading to a broad range of thoughts that may not be related to any specific theme or pattern

Mental health disorders can present differently in each individual, and sometimes, ADHD and OCD can co-occur.

Types of intrusive thoughts

Intrusive thoughts are unpredictable both in what they’re about and when they’re triggered. While intrusive thoughts can be about anything, there are a few key subjects they tend to center around. Identifying these subjects is central to understanding why these thoughts occur, and it’s the first step toward finding relief from harmful lines of thought.

Intrusive sexual thoughts

Individuals with ADHD often struggle with having a sex drive that’s higher or lower than others. This makes maintaining a healthy sexual relationship with a partner difficult and can contribute to intrusive sexual thoughts.

These thoughts can be distracting, especially if they occur at an inappropriate time or place, making it difficult to complete work or feel comfortable in social situations.

Intrusive violent thoughts

ADHD intrusive thoughts can also be violent in nature and are often spurred by negative feelings of anger. Just as ADHD makes it difficult to control sexual desires and compulsions, it also makes it challenging to regulate your anger and other related emotions.

These intrusive thoughts can be particularly harmful, because acting on them can have serious consequences. It’s essential to not let violent intrusive thoughts go unchecked, so they don’t continue or get worse.

Catastrophizing intrusive thoughts

With ADHD comes heightened feelings of anxiety, and this anxiety often manifests as catastrophizing intrusive thoughts.

For example, you may have catastrophic thoughts before a large public event that shifts from one unlikely situation to another. You may think you’re going to embarrass yourself in some way, then you may think someone is going to physically harm you, and then your thoughts could continue to snowball from there.

For many people with mental health disorders or other mental health conditions, intrusive thoughts about the worst-case scenario are commonplace. And getting ahead of these catastrophizing thoughts is often easier said than done.

Why do intrusive thoughts happen?

Intrusive thoughts are common in people with mental health disorders because these thoughts often stem from or are exacerbated by underlying cognitive, emotional, or neurobiological factors associated with various mental health conditions.

Here are a few reasons why intrusive thoughts are more prevalent in people with mental health disorders:

Cognitive distortions: Many mental health disorders involve cognitive distortions or dysfunctional thought patterns, which can contribute to the development of intrusive thoughts. For instance, individuals with depression or anxiety may have a negative cognitive bias, making them more prone to experiencing distressing thoughts.
Dysregulated emotions: Some mental health disorders, like borderline personality disorder or bipolar disorder, involve intense and fluctuating emotions. These emotional dysregulations can make it more challenging for individuals to manage intrusive thoughts effectively, leading to increased distress and rumination.
Neurobiological factors: Research suggests that differences in brain function and neurotransmitter levels in people with mental health disorders may play a role in the development of intrusive thoughts. For example, imbalances in serotonin, dopamine, or norepinephrine levels may contribute to intrusive thoughts in individuals with anxiety, depression, or ADHD.
Stress and coping: Mental health disorders often involve heightened stress levels and impaired coping mechanisms. This can make it more difficult for individuals to effectively manage intrusive thoughts or prevent them from becoming overwhelming.
Sensitivity to uncertainty or threat: Some mental health disorders, such as anxiety disorders, are characterized by heightened sensitivity to potential threats or uncertainty. This increased vigilance may make individuals more prone to experiencing intrusive thoughts related to their fears or concerns.
Maladaptive coping strategies: In some cases, intrusive thoughts may be inadvertently reinforced by maladaptive coping strategies, such as avoidance or reassurance-seeking. For example, individuals with OCD may engage in compulsive behaviors to neutralize their intrusive thoughts, inadvertently strengthening the connection between the thoughts and anxiety.

Experiencing intrusive thoughts isn’t exclusive to people with mental health disorders. But frequency, intensity, and impact of intrusive thoughts are typically more pronounced in individuals with mental health conditions.

Common triggers of intrusive thoughts

The root cause of intrusive thoughts can be challenging to identify. They typically connect to how someone feels, so if you’re particularly sad or angry, you’re more likely to have intrusive thoughts in line with those emotions. Some of the most common causes of intrusive thoughts are listed below.

Periods of high stress and vulnerability

Periods of high pressure can lead to intrusive thoughts that can worsen your stress. If you’re working on an important project at your job, for example, you may have intrusive thoughts about what would happen if the project isn’t well received. And those thoughts can lead you to imagine this project determines the fate of your career when, in reality, the stakes are much lower.

Intrusive thoughts can also occur in situations where you feel vulnerable. Returning to the previous example from work, if you’re receiving constructive criticism, you may feel vulnerable and take the critique personally. You may overthink it to the point where you apply the criticism to your own self-worth and discourage yourself from pursuing similar projects in the future.

Periods of isolation

When intrusive thoughts are an issue in your daily life, periods of isolation can cause you to hyper-fixate on those thoughts. Without anything to distract you or someone to tell you that your thoughts are irrational, it can be challenging to get yourself away from cyclical ideas and false perceptions.

After traumatic or stressful events

Even if you aren’t in an actively stressful situation, you may still experience intrusive thoughts due to past stressful events. This is where many catastrophizing intrusive thoughts come into play, as ruminating on a traumatic or stressful event may lead you to believe you’ll relive it for the rest of your life.

There is a tendency for people with post-traumatic stress disorder (PTSD) to experience intrusive thoughts regarding a past traumatic incident. Therefore intrusive thoughts can be a symptom of PTSD.

How to prevent intrusive thoughts

While it may seem impossible to prevent ADHD intrusive thoughts with how sudden and unexpected they are, there are ways to regain control of your mind. Like anything, it takes practice and dedication to find relief from this symptom of ADHD. Some ways to prevent intrusive thoughts are listed below.

Identify your triggers

Although some intrusive thoughts may feel random, they are often triggered by some kind of stimulus. Identifying your triggers can play a significant role in overcoming intrusive thoughts, as you’ll learn how to avoid them and prevent them from happening in the first place.

Remain calm

Whenever you do have intrusive thoughts, it’s essential to remain calm. These thoughts are just information about how you’re doing at that moment. If you allow yourself to panic, your thoughts will likely become more severe to the point where they spiral out of control. The more you can remain calm, the more likely your intrusive thoughts will pass without disrupting your day.

Find a distraction

An effective way to avoid intrusive thoughts is by redirecting your attention elsewhere. If you find that you’re focusing too much on 1 negative thought, try doing something like playing a game or writing in a journal. By switching to an activity that requires focus, you’ll have fewer opportunities to focus on your intrusive thoughts.

Let ADHD intrusive thoughts pass and fade away

If you have an intrusive thought that is violent or sexual, one way to prevent them from taking hold of your mind is by simply letting them pass. For many people, so long as they don’t act on their thoughts, they’ll fade away with time as other distractions arise.

It may take longer for some than others, and letting an intrusive thought pass can eventually show that it’s not worth thinking about.

Get treatment for intrusive thoughts

Treatments for ADHD intrusive thoughts

Medication: stimulant medications, such as methylphenidate (Ritalin) or amphetamine (Adderall), are often prescribed for ADHD. These medications can help improve focus, reduce impulsivity, and manage other ADHD symptoms, including ADHD intrusive thoughts. (Dependency warning: It is important to be aware that stimulant medications have the potential for dependence and misuse. These medications should only be used under the supervision of a qualified healthcare professional. Follow the prescribed dosage and regularly communicate with your healthcare provider to monitor effectiveness and any potential side effects. Abruptly stopping these medications can lead to withdrawal symptoms.)

Behavioral therapy: Behavioral interventions for ADHD often involve teaching individuals specific skills, such as organization, time management, and goal-setting, to help them manage their symptoms more effectively.
Cognitive behavioral therapy (CBT): CBT can also be adapted for individuals with ADHD, focusing on strategies to improve attention, reduce impulsivity, and manage intrusive thoughts.
Mindfulness and relaxation techniques: Mindfulness meditation, deep breathing exercises, and other relaxation techniques can help individuals with ADHD improve their focus and manage intrusive thoughts.

Treatments for OCD-related intrusive thoughts

Medications: Selective serotonin reuptake inhibitors (SSRIs) are a class of antidepressant medications commonly prescribed for OCD and other mental health symptoms. SSRIs may help reduce the intensity of intrusive thoughts and compulsions by increasing serotonin levels in the brain.
Cognitive behavioral therapy (CBT): CBT is a widely used and evidence-based therapy for OCD. It involves identifying and challenging irrational thoughts and beliefs while also teaching new behavioral strategies to manage anxiety and resist compulsions.
Exposure and response prevention (ERP): ERP is a specific type of CBT that focuses on gradually and systematically exposing individuals to their fear triggers while preventing them from engaging in compulsive rituals. This helps individuals learn to tolerate distress and reduces their reliance on compulsions.
Mindfulness and acceptance-based therapies: Approaches like acceptance and commitment therapy (ACT) or mindfulness-based cognitive therapy can help you become more aware of your thoughts and feelings and let you accept and respond to them in healthier ways.

Find a provider and get help resolving intrusive thoughts

A provider on Klarity Health can help you get to the root cause of your intrusive thoughts, whether it’s from ADHD, OCD, an anxiety disorder, or another related mental health issue.

Find a provider and start putting intrusive thoughts behind you with an appointment in as little as 24 hours.*

Sources: CHADD, I Can’t Stop Thinking About It, Caroline Maguire, MEd, ACCG, PCC, https://chadd.org/adhd-news/adhd-news-adults/i-cant-stop-thinking-about-it/

Mayo Clinic, Adult attention-deficit/hyperactivity disorder (ADHD), Mayo Clinic Staff, https://www.mayoclinic.org/diseases-conditions/adult-adhd/symptoms-causes/syc-20350878

Psychiatry Res, Unwanted intrusive and worrisome thoughts in adults with Attention Deficit\Hyperactivity Disorder, Abramovitch A, Schweiger A, https://pubmed.ncbi.nlm.nih.gov/19570581/
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If you’re having a mental health crisis or experiencing a psychiatric emergency, it’s crucial to seek immediate help from a mental healthcare professional, such as a psychiatrist, psychologist, or therapist. You can also call your local emergency services, visit your nearest emergency room, or contact a crisis hotline, such as the National Suicide Prevention Lifeline, by calling or texting 988 or dialing the Lifeline’s previous phone number, 1-800-273-TALK (1-800-273-8255) in the U.S.