Medically Reviewed By: Dr. Jahandar Saifollahi, MD
Medical Review: August 2026
Short answer: it depends on what your overthinking is actually doing, not just how often it happens.
What people commonly call “overthinking” can sometimes involve a pattern researchers describe as rumination, or repetitive negative thinking. The terms are related, but not perfectly interchangeable. It isn’t a diagnosis on its own. It’s also not the harmless quirk it often gets treated as.
Quick clarification: “rumination” here means the psychological pattern of repetitive negative thinking. It’s not rumination syndrome, an unrelated gastrointestinal condition.
Not a Diagnosis, But Not Nothing Either
Researchers call repetitive negative thinking a transdiagnostic process. That means it shows up across different mental health conditions, not just one.
There are two related patterns worth knowing. Worry tends to focus on future problems. Rumination tends to focus on the past. Both fall under the same broader umbrella.
A well-known study followed nearly 2,000 adults over three years. It found repetitive negative thinking was linked to the persistence and relapse of depression and anxiety. That’s a prospective association, not proof of direct cause and effect, but researchers take it seriously.
Studies have also examined rumination alongside eating disorders, PTSD, insomnia, and substance use. The strength of evidence varies across these areas.
The Difference Between Reflection and Getting Stuck
Not all repeated thinking is a problem. You can think about something more than once and still be genuinely reflecting.
The useful distinction isn’t “resolved vs. unresolved.” It’s direction. Reflection moves you toward understanding or a plan. Rumination loops in place, repetitive and negative, tending to maintain distress rather than ease it.
If thinking something through leaves you clearer, that’s reflection doing its job. If it leaves you circling the same thoughts, that’s the pattern worth noticing.
What the Research Says About the Body
Some research links rumination to inflammatory markers. This relationship is still being studied, and findings vary depending on how it’s measured.
Rumination can also make it harder to shift attention away from negative thoughts. That’s part of why the cycle can feel so hard to break, and why it’s difficult to talk yourself out of through willpower alone.
When Should Overthinking Become a Concern?
Consider talking to a mental health professional if overthinking:
- Makes it difficult to sleep
- Interferes with work or relationships
- Causes significant anxiety or sadness
- Makes it difficult to concentrate
- Feels impossible to control
- Keeps you stuck in the same thoughts without relief
None of these alone is cause for alarm. If several sound like your regular experience, that’s worth bringing up rather than waiting it out.
A Careful Note on Rumination and Suicidal Thoughts
I want to be exact here, not alarming.
Some research links rumination to suicidal thoughts or behaviors in certain populations. But rumination alone doesn’t mean someone will develop suicidal thoughts.
A 2024 systematic review and meta-analysis found no statistically significant association between rumination and suicidal ideation specifically among people with existing psychiatric disorders. It did find a link to suicide attempts in some studies of depressive disorders. The research here is genuinely mixed, not a settled cause-and-effect relationship.
If overthinking has come with thoughts of self-harm or suicide, please reach out for support: call or text 988 (Suicide & Crisis Lifeline), available 24/7.
What Actually Helps
CBT can reduce repetitive negative thinking. Rumination-focused CBT specifically targets these patterns, rather than treating them as a side effect of anxiety or depression alone.
Our CBT program uses this kind of targeted approach. Rumination often needs its own attention, not just treatment for whatever condition it’s attached to.
Quick Answers
Is overthinking the same as rumination?
Not exactly. Overthinking is an everyday term. Rumination refers more specifically to repetitive, negative, past-focused thinking.
How do I know if I’m reflecting or ruminating?
Reflection moves toward understanding or a plan. Rumination loops without resolution.
Can overthinking affect physical health?
Some research links rumination to inflammation and disrupted sleep, though these relationships are still being studied.
What treatment helps with chronic overthinking?
CBT, including rumination-focused approaches, has evidence behind it, often alongside treatment for related anxiety or depression.
Sources & Further Reading
- Ehring T, Watkins ER. Repetitive negative thinking as a transdiagnostic process. International Journal of Cognitive Therapy, 2008.
- McLaughlin KA, Nolen-Hoeksema S. Rumination as a transdiagnostic factor in depression and anxiety. Behaviour Research and Therapy, 2011.
- Spinhoven P, van Hemert AM, Penninx BW. Repetitive negative thinking as a predictor of depression and anxiety: A longitudinal cohort study. Journal of Affective Disorders, 2018. (The 1,972-adult, 3-year study referenced above.)
- Moulds ML, Bisby MA, Wild J, Bryant RA. Rumination in posttraumatic stress disorder: a systematic review. Clinical Psychology Review, 2020.
If the Loop Won’t Stop
If persistent overthinking is affecting your sleep, mood, relationships, or daily life, talking with a professional can help. Our Michigan team can help you understand what’s behind the pattern, and what to do about it.
Talk With a Michigan Psychiatrist About Overthinking Schedule an evaluation with Dr. Saifollahi or Dr. Rouhani for a clear picture of what’s driving the pattern, and a specific plan, whether that’s rumination-focused CBT, treatment for an underlying condition, or both.
Credentials: Board-Certified Psychiatrist; Member, American Medical Association and American Psychiatric Association; Former Past-Chair, Psychiatric Department, Bronson Battle Creek Hospital; Geriatric Psychiatry Fellowship, Beth Israel Medical Center, Albert Einstein College of Medicine