Intrusive Thoughts in Teens: Recognizing, Understanding, and Supporting
Intrusive thoughts in teens are involuntary, unwanted thoughts, images, or urges that can pop into their heads. So, if your child has ever asked, “Why would I think something like that?” – their voice filled with shame or fear, they may be having intrusive thoughts.
Unwanted thoughts or images can, understandably, be confusing and disturbing. Plus, they’re sometimes linked to underlying mental health conditions and are often more common than people realize.
Raising mental health awareness in teens can help families recognize when a child is struggling with an underlying issue. Intrusive thoughts could be a sign that your child needs support, and early intervention can make all the world of difference.
This page can help you understand intrusive thoughts in teens by discussing:
- What intrusive thoughts in teens are
- Common causes of intrusive thoughts
- When intrusive thoughts may signal OCD or another condition
- How to support your teen at home
- Effective treatments for intrusive thoughts
- Where to seek professional help
What Are Intrusive Thoughts in Teens?
Some examples of teen intrusive thoughts include, What if I accidentally hurt someone? Did I shut the door when I left home? Or Everybody hates me.
Additionally, these thoughts may also take the form of…
Doing something embarrassing, like saying inappropriate things to a teacher- Unwanted images related to taboo sexual activities
- Wondering what it would be like to do something risky, like jump from a balcony they are standing on, or to punch a stranger
Teens may also find themselves grappling with intrusive thoughts related to adolescent changes, such as body image, relationships, or being accepted by people.
It’s useful to know that intrusive thoughts are usually harmless. Almost everyone has experienced an unwanted thought that gets stuck in their mind and won’t seem to leave.3 Thoughts are just thoughts; not predictions of the future or a reflection of urges.
However, although many people experience them occasionally, if they occur frequently or affect daily functioning, they may be a sign of a deeper issue, such as a mental health condition.
Why Do Teens Have Intrusive Thoughts?
Intrusive thoughts in teens may be triggered by factors such as stress, neurodevelopmental differences, and even the process of adolescence itself. Let’s examine each of these potential contributors in closer detail.
Adolescence and Biological Changes
Adolescence is a significant developmental stage in life that is often accompanied by considerable changes and challenges. For instance, hormonal shifts and fluctuations triggered by puberty can affect neurotransmitters in the brain – such as serotonin – that are associated with mood regulation, impulse control, and anxiety.4
Additionally, the teenage brain is still developing, meaning that the neural connections involved in anxiety, emotional processing, and self-control are not yet fully formed or matured.5 This can make teens more likely to experience random, intrusive thoughts, to feel more disturbed by them, and to potentially struggle with adolescent emotional regulation.
Stress and Underlying Mood Disorders
Persistent, intrusive thoughts are often linked to certain mental health conditions. Most commonly, they are a key feature of obsessive-compulsive disorder (OCD), but can also occur with depression and post-traumatic stress disorder (PTSD).6
Anxiety and intrusive thoughts are also closely linked, as anxiety puts the brain into a heightened state of threat awareness.7 This may make it easier for unwanted or distressing thoughts to come to the forefront of the mind.
Similarly, a connection exists between stress and intrusive thoughts.8 With teens experiencing stress from various sources, such as academic expectations, physical changes due to puberty, or peer pressure, the risk of having intrusive thoughts can increase.
Neurodevelopmental Disorders
Neurodiversity can also factor into intrusive thoughts. For instance, research shows people with attention-deficit hyperactivity disorder (ADHD) tend to have more intrusive thoughts than neurotypical people. This may be due to the brain wiring present in ADHD that causes people to struggle with focusing their attention or thoughts.9
The above elements can all contribute to teens experiencing intrusive thoughts. Further, when these thoughts become persistent and cause distress, they may be a sign of a mental health condition.
For example, one of the key features of OCD is obsessional, intrusive thoughts. But how can you tell if your child could have this condition?
When Intrusive Thoughts in Teens May Be a Sign of OCD
OCD affects up to three in every hundred children and adolescents.10 The American Academy of Child & Adolescent Psychiatry defines OCD as “recurrent intense obsessions and/or compulsions that cause severe distress and interfere with day-to-day functioning.”10
This definition means teens may have repetitive, intrusive thoughts that cause significant anxiety or distress, and, to alleviate this anxiety, they may perform compulsions, also known as rituals. For example, a teen plagued by obsessive thoughts of their home being broken into may check the door locks repeatedly. Yet, compulsions only ever bring a temporary relief from intrusive thoughts.
Some of the most common OCD symptoms in teens include:11-13
Experiencing obsessions, compulsions, or both, on most days- Obsessions or rituals that take up over an hour a day
- Obsessions or compulsions that cause problems in daily functioning
- Intrusive thoughts and compulsions that are repetitive, unpleasant, and cause distress
- Feeling as though they cannot control obsessions or rituals
- Avoiding situations that may trigger intrusive thoughts or compulsions
- Not doing the compulsions for pleasure, other than getting a temporary sense of relief
If your teen mentions intrusive thoughts and also shows signs of compulsions, they may benefit from an assessment for OCD. Fortunately, it is a highly treatable condition, and with early intervention for OCD, teens may find relief before symptoms progress further.
While intrusive thoughts are often hidden from others, certain behaviors may indicate an emotional or mental struggle. The next section focuses on some of the changes you may notice in your child if they have a mental health challenge.
Recognizing Mental Health Symptoms in Teens
It can be tricky to know what a teenager is thinking; therefore, it may be difficult to detect intrusive thoughts unless they explicitly tell you.
Yet, certain behaviors can accompany intrusive thoughts in teens and be symptoms of a mental health condition, such as OCD, depression, or anxiety.
Avoidance of things that may trigger anxiety- Repetitive behaviors (compulsions)
- Withdrawing from usual activities, including those involving friends and family
- Appearing anxious or nervous
- Becoming upset or frustrated when routines are disrupted
- Repeatedly asking for reassurance
- Constantly apologizing unnecessarily
- Saying they feel ashamed
- Low mood or energy
If any of these behaviors seem familiar to your teen, they may be struggling silently with a mental health condition. Recognizing the signs early allows you to find ways to support your teen and seek professional help.
There are several ways that parents can support their teens through emotional and mental health issues, which are explored next.
How Parents Can Support Their Teen
Parents watching their child struggle with a mental health condition can sometimes feel helpless, not knowing how to support their child without making things worse. This can be especially true when dealing with distressing, intrusive thoughts in teens.
Fortunately, there are several ways to provide support as your teen grows and recovers. Some suggestions for ways you can help include:
- Recognizing the signs: Knowing how to spot the signs of a mental health condition means you can help your teen get the timely support and treatment they need to recover and heal.
- Learning about their condition: Knowledge is power, and if your child has been diagnosed with a mental health condition, then learning about that condition can help you to support them with compassion and understanding.
- Creating a safe space: Try to make home a safe and stable environment for your teen. For example, minimize extra sources of stress if possible, and introduce routines that offer a sense of consistency and stability.
- Encouraging open communication: Let your teen know that they can talk to you about anything that’s on their mind, and that you won’t judge them for it. For instance, make mental health a part of normal conversation, reassure them that their feelings are valid, that you take them seriously, and that you are there to support them.
- Seek professional help: Mental health conditions and emotional struggles can be complex, and professional support is often required for teens to recover. Encourage your teen to seek help from a mental health professional, such as a doctor or therapist.
For more specific parental support for OCD, check out our guide: OCD in Teenagers. Our page Coping With OCD as a Teenager also contains suggestions for coping strategies for adolescents with OCD. It includes tips for managing intrusive thoughts and supporting teens with obsessive thinking.
Effective Treatments for Intrusive Thoughts in Teens
Sometimes, even with the best will in the world, self-help and parental support aren’t enough to tackle the intrusive thoughts teens may have. Fortunately, effective treatments are available that can bring relief for adolescents struggling with these thoughts. The following sections provide an overview of these options.
Therapy for Intrusive Thoughts
An effective therapy for treating intrusive thoughts is cognitive behavioral therapy for teens (CBT).16
CBT is a structured, focused, and evidence-based therapy that allows teens to recognize how their thoughts, feelings, and behaviors are connected. Once this link is understood, adolescents can gradually confront their intrusive thoughts and the anxiety that they bring up through a technique called exposure and response prevention (ERP). This process involves two key elements: slowly exposing a person to anxiety-triggering thoughts, then sitting with the resulting emotions without doing anything to try to reduce the anxiety.
Through ERP, teens can learn to tolerate the anxiety and distress caused by intrusive thoughts, taking away the power that these thoughts once had over them.
Medication for Intrusive Thoughts
Although not a first-line treatment for intrusive thoughts, medication may be an option for teens with moderate to severe symptoms or if therapy hasn’t been completely successful. In these circumstances, doctors may prescribe antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), to treat conditions such as depression, anxiety, or OCD.3,17
Receiving the right support can make a significant difference to a teen’s mental health and overall well-being. If you’re unsure how to help your teen, reach out for professional guidance at the earliest opportunity.
Healing Teen Intrusive Thoughts With Mission Prep
Having intrusive thoughts can be scary, and witnessing your child experience these can be highly distressing. However, with understanding, the right support, and evidence-based treatment, your teen can learn to manage these thoughts and regain control.
Mission Prep specializes in treating adolescent mental health challenges, including OCD and intrusive thoughts. Our team of mental health professionals offers evidence-based therapies, including CBT and ERP. We can also provide support through virtual sessions, face-to-face therapy, and residential programs. Whether your child needs just a little extra guidance or an intensive treatment package, we have options to suit their needs.
If you are concerned about your teen’s mental health, reach out to us today to discover how we can help them heal.
References
- APA Dictionary of Psychology. (2018, April 19). Intrusive Thoughts. https://dictionary.apa.org/intrusive-thoughts
- Cleveland Clinic. (2025, April 28). What are intrusive thoughts? https://health.clevelandclinic.org/intrusive-thoughts
- Wiginton, K. (2024, April 23). What are intrusive thoughts? WebMD. https://www.webmd.com/mental-health/intrusive-thoughts
- Karpinski, M., Mattina, G. F., & Steiner, M. (2016). Effect of gonadal hormones on neurotransmitters implicated in the Pathophysiology of Obsessive-Compulsive Disorder: A Critical review. Neuroendocrinology, 105(1), 1–16. https://doi.org/10.1159/000453664
- Xie, S., Zhang, X., Cheng, W., & Yang, Z. (2021). Adolescent anxiety disorders and the developing brain: comparing neuroimaging findings in adolescents and adults. General Psychiatry, 34(4), e100411. https://doi.org/10.1136/gpsych-2020-100411
- Kralj, A., Payne, A., Holzhauer‐Conti, O., Young, J., & Meiser‐Stedman, R. (2024). Intrusive thoughts and memories in adolescents with major depressive disorder or post‐traumatic stress disorder. British Journal of Clinical Psychology, 63(4), 543–557. https://doi.org/10.1111/bjc.12488
- Kandola, A. (2022, October 27). What are intrusive thoughts? Medical News Today. https://www.medicalnewstoday.com/articles/intrusive-thoughts
- Bilodeau, K. (2024, March 26). Managing intrusive thoughts. Harvard Health. https://www.health.harvard.edu/mind-and-mood/managing-intrusive-thoughts
- Abramovitch, A., & Schweiger, A. (2009). Unwanted intrusive and worrisome thoughts in adults with Attention Deficit\Hyperactivity Disorder. Psychiatry Research, 168(3), 230–233. https://doi.org/10.1016/j.psychres.2008.06.004
- AACAP. (n.d.). Obsessive Compulsive Disorder Resource Center. Retrieved October 9, 2025, from https://www.aacap.org/aacap/Families_and_Youth/Resource_Centers/Obsessive_Compulsive_Disorder_Resource_Center/Home.aspx
- National Institute of Mental Health (NIMH). (2023). Obsessive-Compulsive disorder: when unwanted thoughts or repetitive behaviors take over. https://www.nimh.nih.gov/health/publications/obsessive-compulsive-disorder-when-unwanted-thoughts-or-repetitive-behaviors-take-over
- Mayo Clinic. (2023, December 21). Obsessive-compulsive disorder (OCD) – Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/symptoms-causes/syc-20354432
- Krebs, G., & Heyman, I. (2014). Obsessive-compulsive disorder in children and adolescents. Archives of Disease in Childhood, 100(5), 495–499. https://doi.org/10.1136/archdischild-2014-306934
- Anxiety and Depression Association of America, ADAA. (n.d.). OCD at school. Retrieved October 9, 2025. https://adaa.org/understanding-anxiety/obsessive-compulsive-disorder/ocd-at-school
- American Psychiatric Association. (2024). What is depression? https://www.psychiatry.org/patients-families/depression/what-is-depression
- IOCDF. (2024, May 20). OCD in Kids. https://kids.iocdf.org/professionals/mh/about-erp-for-pediatric-ocd/
- International OCD Foundation. (n.d.). Medication for pediatric OCD. In OCD in Kids. Retrieved October 9, 2025, from https://kids.iocdf.org/professionals/mh/meds-for-pediatric-ocd/
