What's the difference between impulsive and intrusive thoughts?

In the song "Serotonin" by singer-songwriter Girl in Red, she sings, "I get intrusive thoughts like cutting my hands off. Like jumping in front of a bus. Like how do I make this stop."

This is what intrusive thoughts are, but sometimes, people get "intrusive" and "impulsive" confused. 

Intrusive thoughts are defined as sudden, involuntary thoughts that are often repetitive and can be disturbing and distressing, while impulsive thoughts and behaviors aren't inherently dangerous. They are spontaneous ideas or quick actions with no thought to the consequences.

"People tend to refer to intrusive and impulsive thoughts interchangeably. The phrase, 'My intrusive thoughts won today,' is even trending on social media, but most of the time it’s not used correctly," writes licensed clinical psychologist Dr. Sarah Gaumer on The Psychology Group

"Intrusive thoughts are more severe, graphic, and frightening than impulsive thoughts. If someone would act on their intrusive thoughts or if they came true, the consequences would be dire. ... People that have impulsive thoughts may actually like the thought or would find some type of pleasure, satisfaction, or humor from engaging in them. Simply, they do not feel guilty, ashamed, or frozen in fear at having these impulses."

So, if your "intrusive thoughts won," you'd probably be dead or in a hospital or in jail, but if your "impulsive thoughts won," you may just have ragged bangs that you cut yourself. 

I've definitely acted impulsively my fair share of times. I've been out with friends and decided, "I want a tattoo," then immediately went to a nearby tattoo shop and got one. While maybe I should've thought more about something that was going to be on my body forever, it's not like my impulsive act was dangerous.

On the other hand, when I get an intrusive thought, it's something like "You should take a kitchen knife and drive it into your chest" or "You should walk into traffic" or "You should put your hand in the garbage disposal." This is obviously completely different than, "I'm gonna get a tattoo!" Intrusive thoughts are dangerous and something I should never ever ever ever ever act on. 

For the longest time, I thought it meant something was wrong with me. But, as Kelly Bilodeau, former executive editor of Harvard Women's Health Watch, says, "While intrusive thoughts may be disturbing, they aren’t harmful or a sign that you have a secret desire to do the things that popped into your mind."

Why impulsive and intrusive thoughts are misunderstood

Intrusive and impulsive thoughts do have similarities, so it's understandable why they're often mistaken for one other. They are both fairly common, they can be symptoms of various mental illnesses, they're usually spontaneous thoughts, and they both start with the letter "I" and end with "sive." 

If you've experienced either or both of these, know you're not alone. Everyone behaves impulsively sometimes, and intrusive thoughts affect about six million Americans, according to the Anxiety and Depression Association of America. 

But, when intrusive or impulsive thoughts start affecting your daily life, it's important you seek help because it can be a symptom of a mental health disorder. Impulsivity is a symptom of borderline personality disorder, bipolar disorder, and attention deficit hyperactivity disorder, while intrusive thoughts are more likely to be a symptom of anxiety, depression, or obsessive-compulsive disorder. 

When to seek help

If your intrusive thoughts are affecting your ability to perform daily tasks and, especially, if you're ever worried you're actually going to act on these thoughts, it's crucial that you seek help from a mental health professional ASAP. Talk to your health care provider to find out what therapy is best for you. 

The Mighty contributor Fairley Lloyd said that a combination of medication and therapy helped her when intrusive thoughts were affecting her daily life and even her will to live. 

"One of the most important things I learned with therapy that I still take with me today is that not every thought reflects your beliefs. Thoughts are often random and come out of nowhere, but that doesn’t mean you have to entertain every thought you have. And, though it is difficult to ignore them when you have an anxiety disorder, it is possible to overcome the insurmountable responsibility you assign yourself to every thought you have that is not necessarily your own," she writes.

While I've talked a lot about how harmful intrusive thoughts can be, impulsive behaviors can also be harmful. It's not just getting a random tattoo or cutting your hair (although if you're getting so many tattoos that you can't afford basic necessities — yeah, you should probably get help for that too).  

For instance, one time when I was angry, I impulsively threw a TV remote across the room. This action didn't hurt anyone — except for that piece of plastic — but it was definitely not a healthy coping mechanism. It led to a huge argument with my fiancĂ©, and was something I regretted immediately after doing it. 

If you lack impulse control, you are more likely to have anger and aggression issues, and it can also be a risk factor for addictive and other self-destructive behaviors. Of course, when this happens, that's when impulsivity becomes a problem. 

Because impulsivity stems from disrupted neurochemistry in the prefrontal lobe of the brain, medication can help decrease impulsive tendencies, and cognitive therapy can also be beneficial. For more tips on how to handle impulsive behavior, click here to read on article on The Mighty.
If you are struggling with impulsivity or intrusive thoughts, talk to your primary care physician, who can treat mental health issues or refer you to a psychiatrist or therapist for additional help. If you or someone you know is considering suicide, call the 988 Suicide and Crisis Lifeline. 

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