Therapy for the Overthinker
What Helps When You Can’t Turn Your Brain Off
Kelly Anderson
We all overthink sometimes. But for many of my clients, especially those who are anxious or neurodivergent, overthinking isn’t an occasional habit. It often feels like a constant burden that you can’t stop.
Overthinking can show up as mentally rehearsing a conversation before it happens and then replaying it afterward, wondering if you said something wrong or acted in a way that should cause embarrassment. It could be that you can’t stop analyzing every word and punctuation mark in an email you received. Or, one of the most common experiences, you try to go to sleep, but your brain picks that moment to run through every possible disaster scenario that could ever happen or every cringeworthy thing you’ve ever done.
Let’s talk about what overthinking is, how it shows up for different people, and how therapy can actually help you learn to change (or even stop) those thoughts.
Is Overthinking Always a Problem?
The short answer is, not necessarily. Some level of overthinking is completely normal, especially when we're facing uncertainty or high-stakes situations. Most people overanalyze now and then when making a big decision, replaying a tough conversation, or preparing for something important (like a job interview or difficult medical appointment).
However, when overthinking becomes your new normal, when it hijacks your ability to sleep, disrupts your focus, or leads you to question every interaction or decision, it’s problematic. This type of overthinking can interfere with work, family, school, enjoyment, and future goals.
Examples of problematic overthinking might include:
Replaying the same conversation over and over, wondering if you said something wrong
Making endless pros and cons lists, but still being unable to make a decision
Reading into someone’s tone or wording for hours afterward
Obsessively Googling symptoms or potential outcomes to “feel prepared”
This kind of mental spiraling is not only exhausting, but it can also be a sign of anxiety, trauma, or neurodivergence like ADHD.
Overthinking Often Feels Productive
Many clients tell me that they overthink because they want to get it right. They want to avoid mistakes, be prepared for any outcome, or not come across as awkward or careless. However, more often than not, though, overthinking doesn’t make us more accurate, and it almost always makes us more anxious. It can lead to:
Decision paralysis
Sleep problems
Burnout and irritability
Shame spirals or second-guessing ourselves
Overthinking can give the illusion of control, but that illusion is often short-lived before noticing increases in avoidance, self-doubt, and fear.
How Therapy Can Help
Overthinking isn’t just a cognitive problem; it’s a nervous system response. Therapy can help you:
Get curious about the root of your overthinking (is it anxiety? trauma? ADHD?)
Learn how to notice and interrupt unhelpful thought patterns
Develop regulation strategies to calm your nervous system
Practice more flexible thinking—not perfect thinking
There are so many different ways that you can learn to address, soothe, and change your overthinking. Some methods help calm the nervous system, others help you challenge thought patterns, and some give your brain something more helpful to focus on. The key is finding what works for you. These are a few types of therapies shown to work:
Cognitive-Behavioral Therapy (CBT)
What it does: Teaches you to identify and challenge cognitive distortions (like catastrophizing, mind reading, and "what if" spirals).
Why it works: Overthinking is often rooted in unhelpful thinking patterns. CBT breaks those loops with structured strategies.
Acceptance and Commitment Therapy (ACT)
What it does: Helps you observe thoughts without getting hooked by them. Focuses on values-driven action even when thoughts are loud.
Why it works: Overthinking often leads to avoidance. ACT increases psychological flexibility and reduces the struggle with intrusive thoughts.
Mindfulness-Based Cognitive Therapy (MBCT)
What it does: Blends CBT with mindfulness practices to help reduce ruminative thinking.
Why it works: Mindfulness helps interrupt the habit of mentally “time traveling” into the future or past.
Specialized Coaching or Therapy for Neurodivergent Clients
What it does: Addresses executive functioning challenges, sensory overload, or cognitive inflexibility that can drive thought spirals.
Why it works: Tailored support for ADHD, autism, or burnout can reduce the cognitive overload that fuels overthinking.
You Can Change Overthinking
If you’re stuck in your head all the time, it doesn’t mean that you’re broken. It often means your brain learned to scan for danger, predict outcomes, or mentally rehearse everything as a way to feel safe.
You may not be able to shut your brain off completely, but you can learn how to feel more in control of it, in a way that works for you.
Interested in starting therapy?
Wellness Therapy of San Diego has therapists who specialize in anxiety, trauma, and neurodivergence. Reach out today to get matched with someone who understands how your brain works.