You said one slightly awkward thing at 2 pm. It is now 11.47 pm. Your brain has replayed it 74 times. Welcome to rumination.
Rumination is not healthy reflection. It is repetitive, negative thinking that goes nowhere. You circle the same thought without moving toward insight or resolution. With ADHD, this “mental replay mode” is common. And it isn’t a personality flaw. It has biology behind it.
What Rumination Actually Is
Rumination is repetitive, negative, emotionally intense and unproductive. It usually makes your mood worse. It rarely produces solutions.
Healthy processing feels different. You might feel upset at first, but you move toward understanding or acceptance. Rumination, however, keeps you stuck.
Why ADHD Brains Are Prone to It
ADHD has been shown to occur more often in ADHD. There are three main reasons: executive functions, the brain networks incolved in self-reflection, and our brain chemistry.
Firstly, ADHD impacts executive functions. ADHD affects executive functions, including task switching, inhibiting unwanted thoughts, regulating emotions and task initiation.
If attention shifting is harder, disengaging from intrusive thoughts is harder. So, the thought loops.
The default mode network (DMN) (a brain network active during daydreaming and internal thought) also plays a key role. In ADHD, the DMN often fails to switch off when we need to focus. Think of it like this: In many brains, the “task network” and “daydream network” take turns. But in ADHD, they overlap. That means internal thoughts keep interrupting real life.
Because the DMN connects to memory and emotion centres, those thoughts are often emotional and past-focused. This is perfect fuel for rumination.
There is a chemical angle to rumination, too. ADHD involves altered signalling of dopamine (a neurotransmitter linked to motivation and reward) and noradrenaline (a neurotransmitter involved in alertness and focus).
It is not simply a “dopamine deficiency.” The system itself is dysregulated. Emotionally charged memories feel important to the brain. Shame, regret, and anxiety are very “sticky.” When attention regulation is unstable, the brain can latch onto them. And refuse to let go.
Two Common Types of Rumination
Rumination in ADHD tends to fall into two patterns. Negative rumination, which is ‘Past-focused.’ This can be thoughts like “Why did I say that?” or “I always mess things up,” and anxious rumination, which is more ‘future-focused.’ Often, these thoughts can be “What if I fail?” or “What if they’re angry?”
Both feel urgent. Neither usually helps.
Research suggests ADHD symptoms are linked to anxiety and depression indirectly through excessive mind wandering and rumination.
In simple terms:
ADHD → more mental wandering
More wandering → more rumination
More rumination → worse mood
Rumination is not just a side effect. It is part of the pathway to emotional distress.
That matters because if we reduce rumination, we may reduce anxiety and low mood too.
The Cost of Rumination
Chronic rumination can have a negative effect in ADHD. It can lead to:
- Mental fatigue
- Poor sleep
- Lower self-esteem
- Decision paralysis
- Irritability
Stress hormones like cortisol impair executive function further. So, the loop drains the very mental skills you need to escape it.
It’s like trying to steer with a flat tyre.
What Actually Helps?
There is no single fix. But several evidence-based approaches can help.
- Cognitive Behavioural Therapy (CBT)
Cognitive Behavioural Therapy (CBT) teaches people to identify and challenge unhelpful thought patterns. It includes monitoring thoughts, testing assumptions and behavioural activation (doing rather than looping)
CBT has shown benefit for ADHD symptoms, anxiety, and depression in some people, but it isn’t effective for all.
2. Dialectical Behaviour Therapy (DBT)
Dialectical Behaviour Therapy (DBT) focuses on emotional regulation and distress tolerance, and it also has evidence showing effectiveness in ADHD symptom management.
One useful skill is STOP:
- Stop
- Take a breath
- Observe
- Proceed mindfully
It sounds simple. It is not always easy. But it creates space between thought and reaction.
3. Acceptance and Commitment Therapy (ACT)
Acceptance and Commitment Therapy (ACT) encourages observing thoughts without trying to control or suppress them. Instead of fighting the thought, you notice it. “I’m having the thought that I’m useless.” That small shift reduces the ‘stickiness’ of the thought. For ADHD brains, which struggle with suppressing thoughts directly, this can be powerful.
4. Mindfulness
Mindfulness strengthens present-moment awareness and attentional control. Lower mindfulness is linked to greater rumination and worse anxiety in ADHD. You do not need to sit cross-legged for an hour. Even 2–3 minutes of focused breathing can interrupt a loop.
Simple tools also help:
- Write the thought down
- Change physical location
- Move your body
- Set a 10-minute “worry window”
- Do one small action step
Rumination is passive. Action breaks passivity.
A Final Reframe
Rumination in ADHD is not a sign of weakness. It reflects differences in attention regulation, emotional processing, and brain network activity. Your brain is trying to protect you by analysing threats. It just gets stuck.
The goal is not to eliminate thinking. It is to regain steering.
And if you are currently replaying something from 2014, you are not broken. Your brain just needs better tools than “watch it again.”
Author: James Brown, PhD.
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