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Intrusive vs. Impulsive Thoughts: What Are the Differences?

Written by:
Dorianne Green
MD
Reviewer:
Laura Maleknia
CRNP, FNP-C

Content

Highlights

  • When comparing impulsive vs intrusive thoughts, note that while both arise spontaneously in the moment, they differ in purpose, duration, and accompanying feelings. Immediately seeking professional mental health support is advised if the themes of intrusive or impulsive thoughts include violence, self-harm, or suicide.
  • Intrusive and impulsive thoughts might have unwanted consequences, usually in the form of unsettling emotions resulting from intrusive thoughts and reckless behaviors resulting from impulsive thoughts.
  • Both kinds of thoughts might be symptoms of underlying mental health conditions such as OCD, ADHD, PTSD, or anxiety disorders.
  • Immediately seeking professional mental health support is advised if the themes of intrusive or impulsive thoughts include violence, self-harm, or suicide.

Some concerning thoughts have recently plagued you, and you’re worried they will get you into trouble. You may be convinced there is something seriously wrong with you and are weary of talking it through because, let’s face it, you’re judging yourself, so what would other people think? These could be impulsive or intrusive thoughts, and they are sometimes normal, but let’s explore the differences and what to pay attention to.

Go through a detailed mental health assessment and get personalized recommendations and treatment.

What Are Intrusive Thoughts?

Intrusive thoughts are unwanted; they are invasive thought patterns that occupy your brain and may cause distress. These unwanted ideas are opposite to what you truly want or feel.

Believe it or not, intrusive thoughts are a normal part of human cognition and thinking, affecting approximately six million Americans [1*] , according to the Anxiety and Depression Association of America.

However, despite being common, disturbing intrusive thoughts can lead to negative consequences if they are not recognized as such and dealt with. The unwanted thoughts alone can result in significant anxiety, worry, shame, paranoia, self-loathing, or anger. If repetitive, they might lead to obsessive ideas or compulsive behaviors.

Examples of Unwelcome and Troubling Intrusive Thoughts

Here are some examples of intrusive thoughts:

  • Unexplained and irrational concerns about personal appearance
  • Unwanted sexual thoughts surrounding orientation, identity, or improper encounters
  • Recurring fears about safety or death
  • Socially or religiously unacceptable thoughts
  • Unjustified doubts about relationships
  • Unwanted thoughts about violence towards others
  • Recurrent thoughts about self-harm or suicide
  • Overwhelming self-doubt without reason
Have you been experiencing any of these? Discuss your concerns with a healthcare provider online.

What Are Impulsive Thoughts?

On the other hand, impulsive thoughts lead to sudden urges or actions that seem necessary to complete for immediate gratification. They are in-the-moment spontaneous desires that may result in poorly thought-through impulsive behaviors.

"As a NP, I recognize that both intrusive and impulsive thoughts can significantly impact mental health. Understanding the distinctions between these thought patterns is crucial for effective treatment and management. Remember, seeking professional support is a vital step towards wellness."
Healthcare provider at MEDvidi

Intrusive vs. Impulsive Thoughts

Let’s make it easier to understand which thoughts are bothering you by comparing their key characteristics.

Similarities

Intrusive and impulsive thoughts are normal to experience occasionally; they are both involuntary, unplanned, and unexpected.

Differences

So, what’s the difference between these thoughts? Intrusive thoughts differ from impulsive in that they cause significant distress immediately, whereas impulsive thoughts are often viewed as offering some reward if acted on. Unlike intrusive thoughts, which have overwhelmingly negative consequences, impulsive thoughts occasionally have positive outcomes.

INTRUSIVE

IMPULSIVE

Unusual or unacceptable thought that contradicts individual, societal, or moral norms

Exaggerated or inappropriately-placed thought about a normal action

There is a lack of a clear purpose

The purpose of these thoughts is the feeling of immediate gratification

A person avoids acting on thoughts

Sometimes, this results in immediate actions

Usually, negative outcomes are due to the internalization of self-judgment

Negative consequences are due to spontaneous actions and risky behaviors, but may have positive outcomes

May last years

Usually sudden and short-lived

Often repetitive

Usually, once off, but may be repetitive

Not provoked; come out of the blue

Usually circumstantial or triggered by something

A person considers the consequences of following through on the disturbing thought

Lack of consideration of the consequences focusing on immediate perceived gain

Cause unwanted feelings such as distress, shame, or anxiety

Might cause a feeling of excitement.

How to Identify Impulsive vs Intrusive Thoughts

Are you still unsure which of these you’re experiencing? Below are examples using random topics to help identify them.

 

WEDDING CAKE

YOUR LOVED-ONE

INTRUSIVE

You are in the office and have a thought, out of the blue, that you want to smash, gouge on, and cover yourself with your friend’s wedding cake. This confuses you because you are not hungry, love your friend, and want her wedding day to be perfect on Saturday. You feel embarrassed and confused by this disturbing thought.

While walking in a park, you suddenly imagine standing in a subway station and pushing your partner off the platform in front of the train. This thought horrifies you; it came from nowhere. You are not even angry with your loved one; your relationship is perfect. Or, not as extreme, you have troubling, relentless thoughts that your partner is unfaithful even though there is no behavior to suggest this.

You feel overwhelming shame and anxiety about these thoughts.

IMPULSIVE

You are at your friend’s wedding and have already had a large piece of cake. Not much is left, and not everyone has had a slice. But it is delicious, and you suddenly feel an overwhelming urge to grab another piece while no one is around. You need to satisfy that craving.

You feel happy and content at home watching a series with your partner. Then, suddenly, you are overtaken by the thought of doing something dramatically spontaneous; you feel excited as you pick up your mobile and browse flights to Paris even though there is no budget for a holiday.

"Recognizing the difference between intrusive and impulsive thoughts is essential for addressing underlying mental health issues. Empowering individuals with knowledge can lead to more effective strategies for coping and recovery. Always prioritize seeking help when needed."
Healthcare provider at MEDvidi

Mental Health Conditions as the Causes

Sometimes, mental health disorders may trigger intrusive thoughts and impulsivity, or the reverse can also happen; repetitive, unwanted, or harmful thoughts may lead to mental health conditions such as anxiety disorders or depression.

Obsessive-Compulsive Disorder (OCD)

OCD-related intrusive thoughts are known as obsessions and often result in repetitive actions, called compulsions. On average, OCD affects 2% of people globally [2*] .

The themes of OCD often involve fear of harm, contamination, or intrusive aggressive or sexual images that might lead to impulsive checking, ordering, or counting behaviors.

Post-Traumatic Stress Disorder (PTSD)

PTSD has a mix of intrusive and impulsive thoughts. Firstly, intrusive thoughts may come in the form of unwanted memories [3*] or feelings of a traumatic event, also called flashbacks. Secondly, impulsive thoughts and behaviors [4*] develop because the patient with PTSD cannot regulate their emotions; the results are aggression, overeating and purging, self-harm, risky sexual behavior, and substance abuse.

Borderline Personality Disorder (BPD)

BPD is associated with one negative thought that is both intrusive and impulsive and can lead to self-harm behavior. In fact, patients with BPD are 53 times more likely to commit suicide [5*] than the general population, a worrying statistic.

If you’re experiencing suicidal or self-harming thoughts and require immediate assistance, contact a crisis hotline, such as 911, 988 suicide & crisis lifeline [6*] (toll-free), or Samaritans (116-123 or via chat).

Impulse Control Disorders (ICD)

ICDs result from abysmal impulsive thought control [7*] ; the diagnosis is made when a person is failing to resist an impulse, temptation, or drive results in action causing harm to themselves or others. Subcategories of ICDs are oppositional defiant disorder (ODD), intermittent explosive disorder (IED), conduct disorder (CD), kleptomania, and pyromania.

Attention Deficit Hyperactivity Disorder (ADHD)

Impulsivity, in various forms, is a common symptom of ADHD, especially in the predominantly hyperactive type of this condition.

Mood Disorders

Patients with generalized anxiety disorder, bipolar disorder, or depression may also experience intrusive and impulsive thoughts, causing increased anxiety, risk-taking, and mood swings, particularly aggression. There is some symptom overlap between anxiety disorders and OCD as well, relating to these thoughts.

If your unwanted thoughts are prolonged and causing distress, consult with a healthcare professional online.

Can Someone Experience Both Intrusive and Impulsive Thoughts?

Yes, it is possible; as you have learned above, people with different mental health disorders experience a mixture of both impulsive and intrusive thoughts or actions. But so can the general population. You have likely experienced an impulsive thought like “I’m going to buy that expensive dress!” or, “I’m just going to book that cruise!”, and remember the six million Americans bothered by intrusive thoughts? They are likely to have them, too.

Effective Treatment Approaches

Managing Impulsive Thoughts

Techniques [8*] for curbing impulsivity aim at action or response prevention; this means avoiding impulsive actions by delaying decision-making or distracting attention from the thought. 

  1. Delay: Setting a time frame before acting on the impulsive thought.
  2. Distraction: Diverting the mind’s attention to a new task and away from the thought.

The first step, however, is recognizing the thought as impulsive.

Managing Intrusive Thoughts

Sleep More

Poor sleep can lead to impaired thought control [9*] and make it harder for your conscious brain to suppress disturbing repetitive thoughts. This then starts a vicious cycle of more intrusive thoughts that cause anxiety, which leads to more sleeplessness.

A Three-Step Approach

Utilizing deliberate and conscious strategies is a great way to manage intrusive thoughts. Harvard Med [10*] suggests three simple baseline steps:

  1. Identify the thoughts as intrusive: If disturbing or negative thoughts do make their way from the subconscious mind into your awareness, recognize and label them as intrusive.
  2. Don’t fight it: Trying to ignore or suppress the unwanted thought doesn’t help to eliminate it. On the contrary, it often becomes more invasive, pronounced, and fixed.
  3. Don’t judge yourself: An intrusive thought does not define one’s character.

Seek a Diagnosis That Will Guide a Specific Mental Health Treatment

An example of this would be if your intrusive thoughts were a symptom of OCD, you might require Exposure and Response Prevention (ERP). For instance, if you have a fear of germs and you touch a door handle, you feel compelled to wash your hands 15 times. An ERP therapist will get you to touch a door knob, feel the anxiety, but prevent the washing while calming the fear. Another specialized mental health treatment may be cognitive-behavioral therapy.

MEDvidi offers a convenient way to assess your mental health by connecting with a licensed healthcare provider, such as an OCD specialist online. You receive a personalized treatment plan and can learn how to manage OCD symptoms effectively from the comfort of your home.

When to Seek Professional Support

If your intrusive or impulsive thoughts have unwanted consequences, such as feelings of anxiety, unwanted behaviors causing significant distress, or if they affect your daily life and relationships, you should be seeking professional help. More importantly, if you are having unwanted thoughts about violence, self-harm, or suicide, you should be looking for mental health support immediately.

To identify and deal with disturbing symptoms early on, go through a mental health assessment online at MEDvidi, book an appointment just in a minute.

Sources

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10 sources
  1. Bilodeau K. Managing intrusive thoughts. Harvard Health. Published October 1, 2021.
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  2. Brock H, Rizvi A, Hany M. Obsessive-Compulsive Disorder. [Updated 2024 Feb 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.
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  3. Bomyea J, Lang AJ. Accounting for intrusive thoughts in PTSD: Contributions of cognitive control and deliberate regulation strategies. Journal of Affective Disorders. 2016;192:184-190.
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  4. Weiss NH, Tull MT, Viana AG, Anestis MD, Gratz KL. Impulsive behaviors as an emotion regulation strategy: Examining associations between PTSD, emotion dysregulation, and impulsive behaviors among substance dependent inpatients. Journal of Anxiety Disorders. 2012;26(3):453-458.
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  5. Mason CK, Kelley K, DeShong HL. Repetitive negative thoughts and thought control strategies within borderline personality disorder: A systematic review. Journal of Affective Disorders Reports. 2024;15:100693-100693.
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  6. https://988lifeline.org/
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  7. Fariba KA, Gokarakonda SB. Impulse Control Disorders. [Updated 2023 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.
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  8. Smith T, Panfil K, Bailey C, Kirkpatrick K. Cognitive and behavioral training interventions to promote self-control. Journal of Experimental Psychology: Animal Learning and Cognition. 2019;45(3):259-279.
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  9. Harrington MO, Cairney SA. Sleep Loss Gives Rise to Intrusive Thoughts. Trends in Cognitive Sciences. 2021;25(6):434-436.
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  10. Bilodeau K. Managing intrusive thoughts. Harvard Health. Published October 1, 2021.
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Written by:
Dorianne Green
MD
Reviewer:
Laura Maleknia
CRNP, FNP-C
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