Content note: this article contains descriptions of intrusive thoughts (including thoughts about harming a child) and suicidal thoughts that readers may find upsetting.

For the majority of parents with young children, bedtime can be a challenge of epic proportions. Getting your two-year-old to allow you to brush their teeth without screaming the house down and lie down after an hour of mattress gymnastics is enough to leave any person on the verge of tears. But I have another challenge added to my toddler’s bedtime routine: horrible intrusive thoughts about harming him.

I am no stranger to intrusive thoughts. I have suffered from multiple forms of OCD over the past 25 years and my intrusive thoughts began 17 years ago, during my first year of university, when I would get blasphemous thoughts and sexual mental images every time I tried to perform my five daily Islamic prayers.

Intrusive thoughts are unwanted thoughts or mental images that pop into your mind involuntarily and on repeat, and are often distressing in nature because they are taboo and ego-dystonic, ie in complete contrast to your beliefs and values. They can be about anything, including things that are violent, sexual or deeply offensive in nature.

They can feel like having a loud radio in your head that you can’t turn down, and the compulsions can be mental as well as physical.

In 2021, when I became pregnant for the first time, I was in a period of remission from OCD and no longer needed the antidepressants I had been taking previously. It came as a massive shock the day after I gave birth when all my OCD and anxiety symptoms came back with a vengeance. I even experienced depression for the first time.

I told myself maybe this was a reaction to childbirth and that my adrenaline levels and hormones would settle down. But on the third day of being home from hospital, I started getting intrusive thoughts about throwing my son, Ammar, down the stairs, and I knew something was seriously wrong.

I didn’t just think about throwing Ammar down the stairs – imagery played out in my mind like a scene from a horror movie. The thoughts felt so strong that I was convinced that if I could think it, then it meant there was a possibility I could lose control and do it. I refused to carry Ammar up or down the stairs out of fear. 

With my long history of OCD, it was clear I was having a relapse, and I quickly got in touch with the local perinatal mental health team. Within two weeks they put me back on my antidepressants, but this time around I got worse before I got better. My intrusive thoughts would fixate on one theme and then tire themselves out and move on to something new. 

Ammar would lie on his play gym and I would have an intrusive thought about stamping on him. I would be so convinced that my feet would suddenly act out that I would not go anywhere near him. When I finally got the courage to take him outside in the buggy for a walk, I would get intrusive thoughts about letting the buggy loose in the road. I would grip the buggy handles so hard my hands turned white. I was too scared to go out or be in the house alone with him. What I did not realise at the time was the more I reacted to intrusive thoughts by avoiding situations, the worse the intrusive thoughts became.

These intrusive thoughts robbed me of what should have been a time of joy and made me believe that I was going crazy, that I was dangerous, and that everyone would be better off if I left.

I decided that while I waited for the antidepressants to fully take effect, I would do my own research, and that is when I came across acceptance and commitment therapy (ACT). The idea was that whenever an intrusive thought came into my head I would accept it, allow it to be there in the background and carry on engaging in whatever activity I was doing instead of stopping that activity or carrying out avoidance behaviour. 

It was difficult at first – it meant allowing all the horrible physical sensations of anxiety that came with the intrusive thoughts to just be there – but with time I began to feel that I was managing my intrusive thoughts better and could brush them off more easily. My recovery wasn’t linear – for four months I went through a loop of feeling better one week and having a setback the following week. But slowly, the better days started to outnumber the bad days.

It took me a year to fully recover from my postnatal OCD. By the start of this year, I felt that while the medication saved me, there was work I needed to do because I was still experiencing setbacks. I used the NHS’s IAPT service to make a self-referral and was put on the waiting list for CBT.

In August, I was assigned a therapist who was highly experienced with OCD; something I had needed all along. For the past two months, we have been exploring the reason I have these intrusive thoughts about harm: after having a child, a mother’s threat response goes into overdrive to the extent that her own brain incorrectly detects itself as a threat to the child. I have been keeping an OCD log, which has helped us to identify triggers and patterns – my intrusive thoughts always make a return during my period so may be linked to hormones, and they are always worse when Ammar is unsettled and I am feeling overwhelmed.

I have also just begun exposure therapy: intentionally thinking about my intrusive thoughts without trying to block, reason or mentally neutralise them, so that eventually I desensitise myself to them.

It has taken two years of hard work to get to where I am today – a place where I am able to settle Ammar down at night without my intrusive thoughts making me want to cry, have an anxiety attack or believe I am better off dead. Most nights I can practise what I have learned during CBT and say to my intrusive thoughts: You’re allowed to be there, but you won’t ruin the rest of my night. Once Ammar has fallen asleep, I catch up on social media.

You can only imagine my anger when scrolling through TikTok I kept spotting comments along the lines of: ‘You let your intrusive thoughts win.’ These appeared on videos of people shaving their head, getting tattoos, dunking a hand in a friend’s freshly bought iced latte or poking their girlfriend with a crab stick. 

These are not examples of letting intrusive thoughts win. 

What has happened here is that people have confused intrusive thoughts with impulsive thoughts. Impulsive thoughts, when acted upon, engage the brain’s reward system, cause a rush and encourage feelings of excitement – they don’t tend to result in any real harm. Intrusive thoughts, on the other hand, cause anxiety, panic and anguish – and those who struggle with them do not act on them or ‘let them win’. 

Working hard to dispel misinformation about intrusive thoughts and OCD is Alegra Kastens, a therapist, OCD specialist and fellow intrusive thought warrior who has 100,000 Instagram followers and over 27,000 TikTok followers. I have been following her for the past six months, and I like the fact that she speaks so openly about the nature of intrusive thoughts. It has really helped seeing other people in the comments on her posts share their experiences; it’s proof that I am not abnormal or alone.

Kastens is also concerned about the way intrusive thoughts are spoken about online. “A trend that we are seeing online – one that is highly inaccurate – is people saying ‘I let my intrusive thoughts win’ when they’re talking about dying their hair pink or going to Taco Bell at 2am,” she tells Stylist. “In these situations, the person might be acting impulsively, but it is not acting on an intrusive thought.

“Impulsive behaviour occurs when we act hastily without thinking it through. We might get the urge to dye our hair blue and act on it without fully thinking through whether blue is the colour we actually want. We might get the urge to get a drastic haircut and act on that without taking a few days to consider it. Impulsive behaviour is not the same as an unwanted intrusive thought. People do not want to act on their intrusive thoughts and mislabelling impulsive behaviour as intrusive thoughts does a lot of damage to folks who experience intrusive thoughts.

“It runs the risk of people wrongly assuming that having unwanted sexual thoughts about kids or animals means that people act on them or desire acting on them, which is the furthest thing from the truth,” says Kastens.

The conflation of experiencing intrusive thoughts and acting on impulse isn’t just irresponsible; it can be incredibly harmful. There have been cases of teachers confiding in their therapists about their intrusive thoughts only to then be suspended from teaching and mothers telling their GPs about their intrusive thoughts and then being reported to social services and having their children taken away from them. 

This all further discourages those who experience intrusive thoughts from seeking the treatment they require, worried that a medical professional will think they will act on those thoughts and report them to local authorities.

There was once a time not so long ago when all I wanted was to be rid of my intrusive thoughts and the idea I never will be would cause me to tip back over into depression. It has taken a full two years to accept that the day I had Ammar, my brain chemistry changed. Rather than trying to get rid of my intrusive thoughts and feel like a failure when I can’t, I have learned to take my OCD along with me in life. 

I hope that my openness around OCD and the intrusive thoughts it brings will help other people to access the help they need. I also hope that as people hear the reality of this experience, they’ll learn that intrusive thoughts and impulsive ones are very different and distinct things. Intrusive thoughts do not result in a vibrant dye job or an expensive latte. They can be debilitating, and those going through them deserve support. 

Frame Of Mind is Stylist’s home for all things mental health and the mind. From expert advice on the small changes you can make to improve your wellbeing to first-person essays and features on topics ranging from autism to antidepressants, we’ll be exploring mental health in all its forms. You can check out the series home page to get started.

Images: courtesy of Yousra Samir Imran