Stuck in your head? ADHD, overthinking, and getting “unstuck”

Ever catch yourself spiraling over a decision and feeling like your brain won’t stop replaying every possible “what if”?

Dr. J is joining us to talk about rumination, overthinking, and getting caught in a mood spiral as a woman with ADHD. We’re breaking down why we get stuck and practical ways to interrupt those thought loops. 

For more on this topic

• Try: ADHD Unstuck (a free self-guided activity)

• Listen: How to climb out of mental rabbit holes (from Hyperfocus)

• Read: ADHD and mood swings

Episode transcript

Cate Osborn: Hi everybody and welcome back to "Sorry, I Missed This," the show where we talk about all things ADHD and relationships, intimacy, communication, and more. It's me, your host, Cate Osborn. In this episode, we talk about rumination, overthinking, and how to shift into actually making decisions and getting stuff done. And I am joined by Dr. Monica Johnson, aka Dr. J, a clinical psychologist and host of "ADHD and..." right here on Understood.org.

I'm going to be so honest with you, dear listener. I really pushed for an episode on rumination and overthinking because I personally had no idea how much rumination and overthinking became a way for me to cope with the symptoms and struggles of my ADHD. When I finally went to therapy to start unpacking all of the different ways that ADHD was impacting me on a day-to-day basis, I realized that a lot of what I was dealing with wasn't even related to ADHD at all.

(00:41) Cate's personal journey with rumination and overthinking.

Cate: It was related to rumination. It was related to these cycles of overthought and overanalyzing and overcomplicating things over and over and over and over again. And what I would do is I would fill the time when I would be feeling anxiety or boredom or self-doubt or self-esteem issues with these rounds and rounds of overthinking and rumination.

And it really impacted my ability to thrive and to make decisions and to even be confident in the decisions that I was making. And so when I found out that rumination and overthinking is really common in women with ADHD, I got curious and I wanted to learn why and what could we do about it? And since I learned to recognize those cycles of overthinking, when I started really naming all of the places in my life when I was ruminating instead of acting or instead of taking active steps to improve my situation, it really made me aware of how much it was happening, how often it was happening. And I had to learn how to break the cycle. And so I'm so excited to be having this wonderful conversation today with Dr. J. She is a fellow podcast host here on Understood. She is brilliant. We have such a great conversation. I'm really excited to bring it to you. Before we begin, I also wanted to mention Understood.org's new tool, "ADHD Unstuck."

(02:19) Introducing "ADHD Unstuck": a tool for women with ADHD.

Cate: "ADHD Unstuck" is a free, self-guided activity designed by women with ADHD for women with ADHD that meets you where you are with personalized action plans to help you boost your mood on your terms. There's no pressure, there's no appointments, and no big life overhauls required. "ADHD Unstuck" gives you small, doable steps forward. It's built around your brain, your needs, and your version of stuck. And the best part is that it takes just 10 minutes to start feeling more like yourself.

We talk about it a little bit in this episode, but we'll also link to it in the show notes and the description below. Dr. Monica Johnson, welcome to the show.

Dr. J: Yeah, I'm happy to be here.

Cate: Thanks for co-hosting a secondary Understood show. I appreciate you so much.

Dr. J: I feel like it should have happened sooner.

Cate: I know. The crossover episode the world needed.

Dr. J: Yes.

Cate: Well, your show's great, by the way. If you haven't checked out Dr. J's show, please do. It's so wonderful. Do you want to talk a little bit about your show? Just like, what it is and what you talk about?

Dr. J: Oh sure. I host "ADHD and..." where we talk about everyday life and ADHD. So the whole point is to cover a variety of different topics that are relevant to those who are living with ADHD and I give my fun tips and perspectives on how to view these things, how to manage them, and how to have a good time.

(03:49) What is rumination and how does it affect people with ADHD?

Cate: And it's really, really good. You forgot that part, too. It's really, really good. So, one of the reasons why I'm so excited is because today we are talking about rumination. And rumination is a fascinating topic for me, one, because I do be ruminating. But then also, like I didn't even know what rumination was. Like, I spent so much of my life just thinking everybody thinks this way, everybody gets trapped in these kind of like thought spirals. And so I thought we should just probably start off the show by just saying, what is rumination and how does it affect people with ADHD?

Dr. J: Basically, rumination is repetitive, like passive thinking. And typically what you can tell that it's rumination is because what happens is you're dwelling on the problem, the negative emotion, or like a past event that occurred without moving towards any real solution. So this is why we have this concept of like rumination is like being a hamster in a wheel. Like you're spinning, but you're not going anywhere.

Cate: Yeah. So, just to give some examples, if you're the type of person who ruminates about like past conversations that you've had. And I want to be clear, none of this is like ADHD specific. Anyone can like ruminate. I've definitely been awkward socially and then ruminated about the thing I said or didn't say or like, "Why did my body do that?" That's rumination.

So worrying about something you could have done differently, or another popular thing is like, "What if?" scenarios. So like, "What if this and what if that?" And it's like, "Yeah, what if?" There's a thousand what-ifs in any sort of situation. So like, if you catch yourself in those sorts of patterns, that's typically rumination, which is very different from when you're actually researching something or like engaging in any sort of productive thought.

Cate: Okay. So, I know that for me, I create a sense of safety around decision-making in knowing that I have researched enough. Now what enough is or is not is, you know, that can be up for debate. But the sense of, "I really want to make sure that I've thought things through. I really want to make sure that I am making the most informed choice." And so that feels like a slippery slope into rumination, or at least it can be, right?

Dr. J: Yeah. I mean, it can because my first question that comes up in my head is, how are you defining these things?

Cate: Yeah.

Dr. J: Right? Like, when you say, "Oh, I'm going to make the most sound decision," or like, it's like, "Okay, but how is that defined based on the circumstance that we're trying to make a decision around?" So, one of the things I will say is, a lot of times we use a lot of fancy words in our head that allow us and convince us that what we're doing is actually like healthy or the right thing to do or whatever it is, and it's all surface level and there's no substance to it. And so I think the first thing in terms of definitions, which is one of my things I'm always talking to my patients about, definitions and how we define things because that's the starting point for everything we do going forward.

So like, when you are actually researching or engaging in decision-making, one of the biggest contrasts and how you can tell like rumination from productive thought is it's active and goal-directed. So like you're gathering information, you're like weighing options, you're moving toward some sort of conclusion or action. And so there's a feeling of progress, even if that progress may be slow.

So, one of the key differences is that productive thinking has an endpoint, or it generates a new insight versus you are always circling back to the same thought, the same emotion, and that sort of thing. Now, with ADHD, what makes this complicated is you struggle with hyperfocus.

Cate: Yeah.

Dr. J: And the thing about hyperfocus, it latches onto the loudest thing. So, I think a lot of times we think about being hyperfocused on things that we're interested in, but you also hyperfocus on things you're worried about. So, because that's like the thing that's like jumping for attention. And so sometimes when you have ADHD, it can be a harder process of being stuck on something because like the hyperfocus aspect of it has gotten activated.

Another thing that can come up is you have difficulty switching tasks. So again, like if you have a worry or you have a rumination, it's difficult to say, "You know what? I should stop this right now and go do something else." And so you just kind of get weighed down in it. And when you have ADHD, you also have a lived experience of messing up a lot.

Cate: Yeah, yeah.

Dr. J: So like, you can also, this goes into like the what-ifs and also kind of rejection sensitivity, fear of failure, all of those things. And so this goes into what I mean by productive thought versus rumination, right?

Cate: Yeah. You want to know what your goal is.

(09:16) Breaking free from rumination cycles.

Dr. J: If you're trying to figure out how to not feel a certain way, like right now, it's like that's not really possible in most circumstances. And that's what sometimes gets people caught up in the rumination piece because like they're thinking once I find the right answer, I'm going to feel something.

Cate: Yeah, you're going to feel better. You're going to feel like, "Oh, if I think it hard enough, then it's going to unlock me out of this kind of cycle." But you're really just like continuing in that, I don't know, like I don't want to say masturbatory because that's not like the, but it kind of can be sometimes that like, "Oh, I'm just going to keep coming back to like the bad emotion and the bad emotion and the bad emotion." Like I get stuck in that so often, and I get so frustrated with myself when it happens.

Dr. J: So there are a couple things I'll say about that. One is remove the judgment from the emotion. There's no such thing as a good or a bad emotion. There are definitely emotions that are more wanted or desirable than like others. You know, like I would prefer to feel elation over despair. But like, all emotions are necessary and the emotion is there to communicate something to you.

So sometimes just reframing that, like understanding that about emotions can change some of that perspective because what's going to happen is, let's say I feel like stuck in my career and I feel like I need to make a major change career-wise, right? I'm going to have a lot of feelings around that, including like, you know, maybe feeling disappointed in myself, being terrified, having anxiety, all of that, right? You can then make a decision to say, "Okay, this is the thing I'm going to do to change my career trajectory."

You're still going to feel terrified. The difference is you're terrified now about something different. Before you were terrified about being stuck and not engaging in any forward movement. Now you're terrified about the decision that you've made and how it's going to go. And that's normal. That's like everybody. Like I've never made a major decision where I was like, "Okay, cool, like that's 100% going to work out and I can hang back and like everything's going to go smoothly." So, you have to stop treating your emotions like they're an enemy. They're just an element of the decision-making process.

So when we're talking about what do I do, so much of what you do is just like understanding what something is and is not. I'm feeling a lot of anxiety, and that does not necessarily mean that I'm making a bad decision or that the decision I made will somehow ruin my entire life. All it means is like right now I'm anxious about making a decision and like that's it. And sometimes just labeling your experience makes it smaller.

(12:54) From brain dump to body doubling: tools to combat rumination.

Dr. J: In terms of the rumination, something you can do is like a brain dump. So like everything that you're thinking and feeling, you can just like write it down. And this isn't about it being organized or like you're not trying to do anything right now other than get what's inside outside. If writing things down is a bit of a barrier for you, you can do the same thing with like a voice note, like talk it out.

I tell my patients all the time, play the tape through to the end because as soon as you hear it or you see it, eight times out of 10, you go, "Oh, that doesn't like, that doesn't make sense. This is not like a thing." So another common Dr. J quote is, "When you keep things inside, it is only limited by your imagination. When you bring it into your physical world, it is now bound by physics."

And so it will shrink. It's kind of like, I'm really into horror movies. So like the remake that they did of the movie "It," like Pennywise the Clown. The whole thing at the end was like, "Why is Pennywise so strong?" It's because he subsists on the imagination of these children. But as soon as they go, "Well, wait, you're just a stupid little clown," you know, like it he automatically shrinks because that's, that's a way in which you take your power back. It's your brain that is drumming up all of these thoughts.

Cate: When you say imagination, immediately I start thinking about rejection sensitivity and how so much around rejection sensitivity is that notion of real or perceived rejection. And a lot of times, we're just sort of filling in the blanks and we're creating that sort of imagination-based rejection that doesn't necessarily exist. So I feel like if we're not being super cognizant around the sort of lies and stories and imagination that rejection sensitivity tells us, it'd be really easy to lean into rumination as kind of a solution to those uncomfortable feelings.

Dr. J: You know, when you have a lived experience where you have experienced a lot of negative things, especially negative things that relate to an aspect of yourself that you really cannot change, it's not like you're being 1,000% illogical. You likely have been rejected like in the past. I think part of it is radically accepting that that's a part of life. And as you continue to build healthy, supportive communities, that rejection will actually happen less, but it's not going to go away completely.

And when people ruminate about things, you remove yourself from the equation. You act as though all of these things are going to just happen to me and I am just going to be a victim of whatever that circumstance is. Be a problem for your problems. Like why are we acting like, you're never not going to have a problem in life? But when a problem shows up, let it know who it's showing up to.

(24:08) Reclaiming agency: Cate's journey beyond ADHD and rumination.

Cate: One of the things that I really discovered about myself, like once I started, I mean, understanding that there's like a difference between doing it sometimes and doing it all the time, 10 hours a day, you know, like I was doing it all the time. And for me, a lot of the rumination came from the place that I was using it like a worry stone. It was soothing to just come back around and run it through and run it through and run it through again and again and like, "Okay, am I thinking about this specifically? Am I seeing every facet of the issue and every facet of the problem?" But I really wasn't actually creating any solutions. I was really just sort of giving myself permission to worry and worry and worry.

And that worry became the soothe. And once I started recognizing that, I started realizing how much time a day — and I like hours, like hours and hours and hours of my day I was doing this just in my head, but it didn't look like anything. It didn't seem like an external problem. And so it didn't feel like something that I had to solve.

Dr. J: Yeah, I think if you have an awareness that it's like occurring, like all the things I've already kind of talked about, there are a lot of physical things you can do to kind of break the rumination pattern. And some of it can just be like, "Get up and go for a walk." Or I love telling my patients to take a cold shower because I'm, unless it's something you do on a regular basis, the moment that freezing, frigid water hits your body, the only thing you're thinking is, "Ah," like,

Cate: Like, "Never mind."

Dr. J: If you're literally caught in the rumination loop, it's like, what can I do right now to just disrupt it? Even if it's just disrupt it for like five minutes, what can I do right now to disrupt it? And if you engage in that sort of habit. Even what you said about getting relief from the worry and things like that, sometimes I have people set a worry timer or a rumination timer. Like you can say, "Okay, I get one hour today to ruminate." And then go ruminate about whatever you want to ruminate about. And then at the end of that hour, it's like, "Well now I have to go shift into something else."

Cate: Yeah.

Dr. J: If you can't help but think about it sometimes, put boundaries on it. It when you put boundaries on it, you can know if you're doing too much or not.

Cate: Yeah.

Dr. J: If it's like, "Where are we going to eat for dinner?" I would say, "Okay, well how much time do you want to allocate to that?" Okay, like 30 minutes? So you can go, "Okay, I'm going to research dinner for 30 minutes. I'm going to find three choices and at the end of that like 30 minutes, I will pick one of those choices and accept the consequences of that choice."

(27:30) How writing and externalizing thoughts can break the cycle of rumination.

Cate: No, like for me, honestly, setting a timer was like one of the most important things. Like my this is a true story. So I got a new phone case and I'm not joking when I say that I think I looked at easily 15,000 phone cases and I spent like four days. And finally my husband was like, "I don't, they're, just pick one." And I was like, "But you don't understand, I have to pick the perfect one." And he was like, "What happens if you don't?" And I was like, "Well, I won't like it." He's like, "Okay." Then what happens? I'm like, "I don't know." Like and you know? And so like being able to be like, "Okay, I'm going to spend an hour on picking out a phone case. And like whatever I find in that hour," and then it becomes like a fun little game.

I love also what you mentioned earlier, the like writing stuff down and externalizing. A lot of my rumination comes from overwhelm. And so I often times I find myself ruminating about like, "Oh, I need to get this done and that done and this thing and this thing." It's like once I make a list, I go, "Oh, well, now it's just like four things that I have to do. And it's not a day's worth of rumination." And then you feel a little silly. And so I feel like a big part of rumination is just also learning to be like, "Hey, it's okay that this happens. And I forgive myself and I love myself and it is an okay thing to be sometimes."

Dr. J: Absolutely. You have to lead with compassion because if you don't, you won't be willing to be adventurous, to make a mistake, to engage with the idea of the failure or the like what if?

Cate: Yeah.

Dr. J: There's a Samuel Beckett quote and it's like, "Ever tried, ever failed, no matter. Try again, fail again, fail better." And like each iteration of it is like I'm getting closer approximation to whatever the ideal system is for me. But you're not going to find that if you're not willing to go on a journey with yourself. And that's one of the saddest things that I see people do is they cut themselves off from like fully exploring who they are and their full internal experience and learning to manage your ADHD is a part of that of like, "Let me fully embrace myself. And what does it look like for me to live and be happy with ADHD or with whatever it is I have going on in my life?"

(29:17) Final thoughts and wrap-up.

Cate: And while we're talking about different tools and different structures, I would be remiss if we did not mention Understood's new tool that they have just built called "Unstuck," which is a really cool web page that they've designed around, um, sort of navigating through moments in your life when you're stuck and different directions that you might be able to go from there. It's a super handy, useful tool. It's free to use. But yeah, you should check it out, dear listener.

Dr. J: Yeah, you absolutely should. I've used it before already, like testing it out, and I think it's great. It's a useful free tool for anyone who's looking for more things to kind of put in their toolbelt.

Cate: Awesome. Well, thank you so much for being here. Rumination is such a fascinating topic, and I love being able to learn while also realizing how much it impacts my own life. So thank you so much for sharing your knowledge and your expertise. Uh, dear listener, thank you so much for listening to "Sorry, I Missed This," and we will see you again soon. Hey, and that's our episode.

Thank you for listening! Anything mentioned in the episode will be linked in the show notes, with more resources. Have a question, comment, burning story you'd like to share? Email us at SorryImissedthis@understood.org. 

This show is brought to you by Understood.org. Understood.org is a nonprofit organization dedicated to empowering people with learning and thinking differences, like ADHD and dyslexia. If you want to help us continue this work, donate at understood.org/give.

"Sorry, I Missed This" is produced and edited by Jessamine Molli.

Video is produced by Calvin Knie and edited by Jessie DiMartino. Our theme music was written by Justin D. Wright, who also mixes the show. Production support provided by Andrew Rector.

Briana Berry is our production director. Neil Drumming is our editorial director. From Understood.org, our executive directors are Laura Key, Scott Cocchiere, and Jordan Davidson.

And I'm your host, Cate Osborn. Thank you SO much for listening!