Overthinking and constant worry: is it anxiety?

Is overthinking a disease?

No, overthinking is not a disease or a medical diagnosis. It is an everyday word for thinking that goes round in circles without reaching a decision or a solution.

Researchers call this repetitive negative thinking, and they describe two main forms. Worry is about the future, such as “What if I fail?” Rumination is about the past, such as “Why did I say that?” Both can occur in anxiety and depression, and in other mental health conditions.

Overthinking can feel useful, as if you are preparing for trouble or solving a problem. Many people keep doing it for that reason. Research suggests it tends to work the other way: rather than settling difficult feelings, worry creates and prolongs them.

When is it more than everyday worry?

It is more than everyday worry when it is intense, difficult to control and has gone on for months. Everyone feels anxious sometimes. The World Health Organization describes anxiety disorders as fear and worry that are intense and excessive, hard to control, and present for at least several months.

One example is generalised anxiety disorder, where worry spreads across many parts of daily life. In the UK, the NHS says a doctor may diagnose it if you have felt anxious a lot of the time for at least six months.

Anxiety is also felt in the body, and many people simply call it “tension”. It can bring restlessness, tiredness, poor sleep, irritability, stomach problems, palpitations and dizziness.

What helps with overthinking?

Simple, regular habits can help many people, whether or not they have an anxiety disorder.

• Set a worry time. The NHS suggests setting aside 10 or 15 minutes to write your worries down. If a worry comes up at another time, tell yourself it can wait until then.
• Sort the worry. Ask, “Is there anything practical I can do about this?” If yes, plan one small step. If not, notice the worry and let it go for now.
• Change “why” to “what next”. Therapies for overthinking help people move from “Why am I such a failure?” to “What exactly happened, and what is my next step?”
• Move your body. Walking, running, swimming or yoga can reduce anxiety and stress and help you sleep better.
• Calm your body. Slow breathing, muscle relaxation and a few minutes of mindfulness can help.
• Watch caffeine and alcohol. A lot of tea, coffee, cola or energy drinks can disrupt sleep and make anxiety harder to control, and alcohol can make anxiety worse.

If your mind gets busiest at bedtime, the insomnia guide has more on breaking that pattern.

How is anxiety treated?

Anxiety disorders are mainly treated with talking therapy, medicine or both, and talking therapy is often tried first. The usual therapy is cognitive behavioural therapy (CBT). It helps you understand how worry works, question anxious beliefs, face what you have been avoiding and plan for setbacks. Indian guidelines also include explaining the condition to you and your family.

Research reviews find that CBT reduces symptoms of generalised anxiety, and that the benefit has been seen for up to two years after treatment, though not everyone benefits fully.

If medicine is suggested, it is often an antidepressant from the group called SSRIs. The World Health Organization says benzodiazepines are generally not recommended for anxiety disorders because of their high potential for dependence. If you already take a medicine for anxiety, please do not stop or change it by yourself. Your doctor can plan any change with you.

The choice between therapy and medicine depends on your preference, any other conditions, side effects, cost, time and what is available near you.

Can anxiety go away for good?

Anxiety can ease a great deal, but nobody can honestly promise that it will never come back. It is a normal human feeling, so the aim of treatment is not to never feel it. Indian guidelines describe the aim as relieving symptoms and reducing how much they interfere with your life.

Research describes generalised anxiety disorder as long-lasting and fluctuating, which means it often eases and returns over time. The NHS says treatment can help you manage symptoms, but that it may take time. Indian guidelines also note that treatment may be long-lasting for some people.

If worry returns after a good spell, it does not mean you have failed or gone back to the start. The skills you learnt still apply, and you can go back to your doctor for support. A realistic aim is worry that takes up less of your day and gets in your way less.

When should I see a doctor about overthinking?

See a doctor if worry has been hard to control for a few weeks and is affecting your work, studies, relationships or sleep. Please also seek help if you are avoiding things because of it, using alcohol or tablets to cope, or feeling low or hopeless.

A doctor will want to understand the pattern, because overthinking can have different causes. You can expect questions about:

• how long it has lasted and what it stops you doing, which shows how much it is affecting your life
• your mood, because rumination can come with depression, which needs its own plan
• whether unwanted thoughts push you to repeat checks or rituals, which can point to obsessive-compulsive disorder
• your physical health and medicines, because conditions such as an overactive thyroid can look like anxiety
• alcohol and other substances, which can make anxiety worse

If you are not sure who to approach, this guide on who to see first can help.