PTSD Intrusive Thoughts: Causes, Triggers, & How to Cope

Can PTSD Cause Intrusive Thoughts?

Intrusive thoughts are a common symptom for individuals diagnosed with post-traumatic stress disorder (PTSD), occurring in up to 71% of individuals with PTSD.¹ These thoughts can occur as PTSD flashbacks, distressing ideas, or PTSD night terrors. These unwanted thoughts can arise in what seems to be out of nowhere. PTSD intrusive thoughts can be triggered by stress, anxiety, or one’s environment.

Types of PTSD Intrusive Thoughts

There are a few different types of PTSD intrusive thoughts, including flashbacks, mental images, and nightmares. Each of the different types is recurring, sudden, and distressing. Additionally, they each revolve around the person’s unique trauma.

Common types of PTSD intrusive thoughts include:

• Vivid flashbacks: Vivid flashbacks involve someone living the traumatic experience as if it is happening all over again. The person may see full or partial images of the event, hear sounds associated with the trauma, and even have the same emotions or body reactions you had during the traumatic event.
• Visceral flashbacks: Visceral flashbacks involve intense physical reactions alongside the presented images. For example, survivors of sexual assault during a visceral flashback might feel as if the abuser is right there touching them.
• Nightmares: Considered the hallmark symptom of PTSD, nightmares are when the individual will re-experience the event while asleep.² It is an intrusive sleep disturbance that can often feel life-threatening. It involves a replay of vivid images and bodily responses while asleep. Many veterans express images of war and waking up sweating and out of breath.
• Distressing mental images: Distressing mental images may be like the traumatic event experienced, but they are not memories. For example, someone involved in a fatal car accident might see images of other car accidents or similar scenarios.

Triggers for PTSD Intrusive Thoughts

There are many different triggers for PTSD intrusive thoughts that are dependent on the individual’s trauma. The trigger can be internal, such as a thought, feeling, or sensation, or external, including a particular smell, sound, person, trauma anniversary, or place. For example, a victim of domestic violence might experience PTSD intrusive thoughts when they smell a specific perfume that the abuser would use.

Impact of PTSD Intrusive Thoughts

PTSD intrusive thoughts can create executive dysfunction, which impacts concentration, emotional control, memory, organization, time management, and planning.³ Another area impacted by PTSD intrusive thoughts is sleep patterns, which can lead to irritability, mood swings, fatigue, and loss of concentration. These symptoms and side effects can impact how an individual interacts and communicates with others, as well as their ability to perform at work or school.

Treatment for PTSD Intrusive Thoughts

PTSD intrusive thoughts can be overwhelming, difficult to manage, and tough to process. Treatment for PTSD, including PTSD intrusive thoughts, can vary. Treatment usually involves a combination of medication and psychotherapy. A well-rounded treatment can also include support groups, self-help, and lifestyle changes. The main objective of treatment for PTSD intrusive thoughts can help the individual to gain a sense of control and begin to heal.

Here are some effective treatment options for PTSD intrusive thought:

• Trauma-focused cognitive behavioral therapy (CBT): TF-CBT is a short-term treatment model that effectively improves symptoms of PTSD. It has three main phases: safety and stabilization, gradual exposure, and integration. It works on helping individuals recognize PTSD intrusive thoughts and enhance coping skills.
• Medications: Medications for PTSD intrusive thoughts are normally selective serotonin reuptake inhibitors (SSRIs). These are prescribed when therapy alone is not enough to manage the symptoms or if they are too severe at the moment.
• Acceptance and commitment therapy: ACT is a mindful therapy that strives to help an individual stay focused on the present moment with acceptance and no judgments. It focuses on accepting and building mindfulness skills to live with the past rather than avoid it.
• Eye movement and desensitization and reprocessing (EMDR): EMDR is one of the most sought-after therapies for PTSD. It uses bilateral eye movements to stimulate the brain and reprogram intrusive thoughts and memories. It also combines the use of coping skills and mindfulness to control symptoms of PTSD better.
• Dialectical behavioral therapy (DBT): DBT for PTSD utilizes a combination of mindfulness, acceptance, and skills to manage intrusive thoughts. These skills include distress tolerance and emotion regulation, which are effective for intrusive thoughts.
• Emotional freedom therapy (EFT): EFT involves tapping specific pressure points in the body to release emotional thoughts. The tapping movement can also be done with specific phrases to counteract intrusive thoughts.
• Accelerated resolution therapy (ART): ART utilizes rapid eye movements to reprogram distressing images into positive ones. Once the negative images are replaced, nightmares and PTSD intrusive thoughts subdue.

How to Cope with PTSD Intrusive Thoughts

It can be difficult to avoid PTSD intrusive thoughts, but there are many ways to help manage the emotional response and stop intrusive thoughts from controlling your daily routine. Creating a strong support network is essential. Additionally, pairing different coping strategies such as grounding, distraction, and emotional release is very helpful for managing PTSD intrusive thoughts.

Here are six ways to cope with PTSD intrusive thoughts:

1. Practice Cognitive Defusion

Practicing cognitive defusion can be a game changer for intrusive thoughts. Cognitive defusion or thought defusion is a technique utilized in acceptance and commitment therapy (ACT) and dialectical behavioral therapy (DBT). Its main objective is to see thoughts, even intrusive ones, as just thoughts. Making the distinction between thoughts and facts helps individuals separate themselves from intrusive and unwanted thoughts.

Here are some cognitive defusion techniques:

• Name it: Naming intrusive thoughts is the first step. It involves naming thoughts as they arise. The first step is to notice the thought as it pops up in your mind. Secondly, to name the thought, and lastly, let it take its course. This helps separate you from the thought.
• Clouds of thoughts: Imagine a sky full of clouds, now put an intrusive thought in each cloud. Now, watch the clouds drift away. Remind yourself that intrusive thoughts are just like clouds; they come and go.
• External voice: Try saying, “I am having the thought that I am not successful.” instead of saying, “I’m a failure.” This helps separate the negative thoughts from yourself as a person.
• Write it out: Write difficult or intrusive thoughts on small cards or notebooks. Not only is this a great release, but it shows how we can carry our past without losing control of our lives.
• CTRL + ALT + Delete: Imagine your intrusive thoughts as an unwanted screen on your computer. Practice closing the window or deleting it.

2. Create a Strong Support Network

Having loved ones or supportive people in our corner is very helpful for managing PTSD intrusive thoughts. This can be family, friends, co-workers, or peers. You can join a PTSD support group, book club, or Dungeons and Dragons campaign to increase your support network. The key is connecting with others so as not to feel isolated with PTSD intrusive thoughts.

3. Focus on Self-Care

Self-care involves adding behaviors or activities to your daily routine that make you feel a bit better. Honoring your self-care routine, whatever it looks like, can help you to feel grounded and balanced. Simple self-care routines include eating nutritiously three meals daily, a good night’s rest, moving your body for 20 minutes, and practicing a mindful activity.

4. Try (Short-Term) Distraction

Short-term distraction is an effective way to cope with PTSD intrusive thoughts because it is an easily accessible coping skill. Distraction gives the mind a break and is very helpful for short-term relief. Many different distraction techniques exist, such as puzzles, crafts, funny movies, cozy video games, or art. The great thing about these skills is you can tailor them to your hobbies and interests.

It is important to ensure that distraction is not your only coping skill because, in the long-term, distraction can make PTSD intrusive thoughts worse. If you are in therapy and are actively working on healing your PTSD, then distraction can be a wonderful coping skill to use.

5. Try Grounding

Grounding techniques are great for managing PTSD intrusive thoughts. The main goal is to help you feel connected with the present time to alleviate the emotional response of PTSD intrusive thoughts. Some grounding techniques you can try are yoga, hiking, observing nature, walking barefoot on the grass, and meditation.

6. Learn Breathing Exercises

Breathwork or breathing exercises are another practical and fast way to aid distress caused by PTSD intrusive thoughts. It involves taking deep, mindful breaths that are more conscious than your regular breathing pattern. There are many different breathing exercises to accommodate what feels comfortable and diverse functioning. Breathing impacts your nervous system; therefore, using breathwork can help regulate the emotional and physical distress associated with PTSD intrusive thoughts.

7. Practice Mindfulness Daily

Mindfulness is a set of cognitive skills that help us stay grounded and connected to the present moment. The most known skill for mindfulness is meditation for PTSD. It involves intentionally being aware of the moment with no judgment. This technique is helpful actually to identifying PTSD intrusive thoughts and managing them.

When to Seek Professional Support

Having coping skills and a support system help navigate PTSD intrusive thoughts, but oftentimes, individuals with PTSD need professional support. If you are having intrusive thoughts constantly that make you feel overwhelmed, it might be time to seek help from a mental health professional.

There are different ways to find a therapist who might be a good fit for your needs. One way is verifying through your insurance provider therapists who specialize in PTSD near your area. Alternatively, you can use an online therapist directory, where you can filter your search for a therapist who specializes in PTSD. Another option is looking at online online therapy platforms.

If your symptoms are affecting your daily life activities such as work, school, relationships, sleep pattern & overall view in life, you might want to consider finding a psychiatrist to evaluate for medication management. An online psychiatry service is a great way to find a psychiatrist who is easily accessible.