Intrusive Thoughts & Overthinking: When Your Brain Won’t Hit “Stop”
- Revive Mental Wellness
- 9 hours ago
- 3 min read
Intrusive thoughts can feel alarming: a sudden image, urge, or “what if” that shows up out of nowhere, followed by hours of mental replay, reassurance-seeking, or spiraling. Overthinking often feels like problem-solving, but it usually turns into a loop that increases anxiety and keeps your nervous system on high alert.
If this is happening to you (or your teen), you’re not broken, and you’re not alone. Intrusive thoughts and overthinking are common in anxiety disorders, OCD-spectrum symptoms, PTSD/trauma, depression, and ADHD. The right treatment plan can reduce the intensity and frequency of these symptoms and help you get your life back.
Intrusive thoughts vs. “real intent”
One of the most painful parts is meaning-making: “If I thought it, does that mean I want it?”
In most cases, intrusive thoughts are ego-dystonic, they clash with your values and feel unwanted. The distress you feel is often evidence that the thought is not aligned with who you are.
Why your brain gets stuck
Overthinking is often driven by the brain’s attempt to create certainty and safety. Common patterns include:
Mental reviewing (“Did I do something wrong?”)
Checking and re-checking
Reassurance-seeking
Avoidance (“If I don’t think about it, it can’t happen.”)
Unfortunately, these strategies teach the brain that the thought is dangerous, so it sends the thought more often.
Where medication management fits in
Medication isn’t about “erasing thoughts.” It’s about reducing the volume of symptoms, so you can think more clearly, sleep better, and actually use coping skills and therapy tools.
Medication management may help when intrusive thoughts/overthinking are:
Frequent and distressing
Disrupting sleep, school, work, or relationships
Triggering panic, compulsions, or avoidance
Connected to depression, trauma symptoms, or significant anxiety
What we evaluate first:
At Revive Mental Wellness, medication management starts with a thorough psychiatric evaluation.
We look at:
Symptom pattern (anxiety vs. OCD features vs. trauma vs. ADHD vs. depression)
Onset and triggers
Sleep, appetite, energy, concentration
Medical history and current medications/supplements
Family history and past medication responses
Safety concerns (including self-harm thoughts)
This matters because the “right” medication approach depends on what’s driving the loop.
Common medication goals (in plain language)
Depending on your diagnosis and needs, medication may be used to:
Lower baseline anxiety so intrusive thoughts don’t hijack your day
Reduce obsessive rumination and mental “stuckness”
Improve sleep (sleep loss can dramatically worsen intrusive thoughts)
Support attention and emotional regulation when ADHD is a factor
Stabilize mood when bipolar symptoms are present
What medication management looks like (the process)
Start low, go slow when appropriate, especially if you’re sensitive to side effects.
Track symptoms over time using tools like PHQ-9 and GAD-7, plus your real-life functioning.
Adjust thoughtfully: dose changes, timing changes, or medication switches based on response.
Prioritize safety and sustainability: a plan you can realistically follow.
Medication often works best alongside evidence-based therapy (like CBT/ERP for OCD features, trauma-focused approaches for PTSD, and skills-based strategies for anxiety).
A quick skill while you’re getting support
Try this when a thought hits:
Label it: “That’s an intrusive thought.”
Allow it to be there (without debating): “My brain is producing noise.”
Return to the next right action: one small step aligned with your values.
The goal isn’t perfection, it’s reducing the power the thought has over you.
How Revive Mental Wellness can help
I provide psychiatric evaluations and medication management for ages 10–60, with most visits available via Telehealth (and In-Person options in Meridian, Idaho). If intrusive thoughts and overthinking are impacting your daily life, we’ll build a treatment plan together, thorough, personalized, and grounded in shared decision-making.
Ready to feel more in control?
Phone: 208-398-3351
Fax: 888-388-2271
Website: www.revivementalwellness.com
Address: 1047 S. Wells St, Meridian, ID 83642
If you’re in immediate danger or thinking about harming yourself, call 911 or go to the nearest ER. You can also call or text 988 for the Suicide & Crisis Lifeline.
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