🔄 ADHD and Rumination: Why Your Brain Replays Everything (and How to Stop It)By Charles Thornton, PMHNP-BC — ADHD Philadelphia

Do you ever replay a conversation from three days ago?
Or obsessively think, “I should’ve said this differently”?
Or lie awake at night replaying moments you wish you could edit?

This is rumination, and it is extremely common in adults with ADHD.

It isn’t overthinking in the traditional anxiety sense — it’s a neurobiological loop tied to executive function, emotional regulation, and dopamine imbalance.

Research from Barkley, Nowell, and Wilke-Deaton shows that ADHD brains struggle to shift thoughts once activated — which makes rumination sticky and persistent.

At ADHD Philadelphia, we help adults across Pennsylvania and Delaware understand why rumination happens and how to quiet the mental noise.

🧠 Why Rumination Happens More With ADHD

1️⃣ The Brain Can’t “Let Go” Easily

The ADHD brain has difficulty with cognitive shifting — moving from one thought to another.
Once a thought activates, the prefrontal cortex struggles to disengage.

You don’t stay stuck because you want to…
Your brain gets locked in.

2️⃣ Emotional Intensity Fuels the Loop

Adults with ADHD feel emotions more intensely, which makes certain moments emotionally charged.

Strong emotion → More mental replay
More replay → Stronger emotional memory
And the loop continues.

3️⃣ The Default Mode Network (DMN) Hijacks Your Mind

The DMN — the mind-wandering network — becomes overactive in ADHD.

When this network takes over, the brain:

• Replays conversations

• Analyzes past mistakes

• Imagines negative future outcomes

This is why rumination often hits at night or during downtime.

4️⃣ Low Dopamine Creates “Mental Static”

Rumination increases when dopamine is low because the brain struggles to shift into goal-oriented thinking.
This leads to:

• Mental replay

• Over-analysis

• Getting stuck in “why did I do that?” loops

Rumination is often worst when you’re tired, bored, or overwhelmed.

🔧 3 Research-Based Ways to Reduce Rumination

1️⃣ The 90-Second Reset

Emotions last 90 seconds unless we feed them with thoughts.

When rumination begins:
Pause → Breathe → Redirect

This allows the emotional surge to pass before the loop takes over.

2️⃣ Use “Cognitive Offloading” to Break the Loop

Write the thought down.

Rumination loses power once it’s moved out of your head and onto:

• A notes app

• A journal

• A sticky note

• A voice memo

This technique is recommended by both Nowell and Wilke-Deaton.

3️⃣ Use Pattern Interrupts

Rumination is a mental loop — so break the loop physically.

Try:

• Standing up

• Splashing cold water

• Changing rooms

• A 20-second stretch

• Starting a simple task

This sends a “reset signal” to the nervous system.

💊 How Medication Helps

Medication improves dopamine stabilization and reduces DMN overactivation, making it easier to:

• Shift thoughts

• Control emotional loops

• Stop replaying conversations

• Transition into sleep at night

Many adults say medication makes rumination feel like “background noise” instead of the main soundtrack.

🌱 You Can Quiet the Mental Replay

Rumination doesn’t mean something is wrong with you — it’s a brain pattern that can be changed.

With the right tools and treatment, adults with ADHD can finally:

• Let go of past moments

• Stop replaying conversations

• Reduce nighttime overthinking

• Feel mentally lighter

👉 Schedule your ADHD evaluation today
Serving adults across Pennsylvania and Delaware.