Not Everyone Who Overthinks Has an Anxiety Disorder

Someone replies to your carefully written message with “okay.”

You read it again.

Usually, they say “okayyy.” Sometimes there’s an emoji. Today, apparently, you don’t qualify for either.

“Maine kuch ghalat keh diya?”

You check the conversation. Remember something you said yesterday. Consider asking whether they’re upset, then worry that asking will make you look insecure.

The other person might be buying vegetables.

Meanwhile, you have reviewed the entire relationship.

It’s a familiar experience. So is lying awake before an interview, replaying an awkward conversation or imagining several ways a decision could go wrong.

But does that mean you have an anxiety disorder?

I think we need to make room for a more careful conversation. One where we take distress seriously without turning every difficult thought into a diagnosis, and where “everyone worries” doesn’t become an excuse to overlook someone who needs help.

What Do We Actually Mean by Overthinking?

“Main bohat overthink karti hoon.”

It sounds specific until you ask what happens.

One person means they struggle to choose anything without consulting three people. Another keeps revisiting a mistake. Someone else spends hours imagining problems that haven’t happened.

“Overthinking” is an everyday description, rather than a diagnosis in itself. It tells us that thinking feels excessive or difficult to leave alone. It doesn’t tell us enough about the cause.

Two patterns help explain what people may be describing.

Worry often looks ahead: “What if something goes wrong?”

Rumination often circles around distress, its meaning or its causes: “Why did this happen? Why am I like this?”

They can overlap. Yesterday’s conversation becomes tomorrow’s fear of rejection.

There is also a difference between thinking carefully and getting stuck. Reviewing a decision might help you notice a risk or choose a next step. Repeating the same questions may leave you more tired without making the decision clearer.

A useful question is:

Why Do We Keep Thinking When It Isn’t Helping?

Sometimes, more thinking feels like the responsible thing to do.

If you examine every possibility, perhaps you won’t make a mistake. If you understand someone’s tone perfectly, perhaps you can prevent an argument. If you prepare for disappointment, perhaps it won’t hurt as much.

That can be an appealing bargain.

“Bas ek dafa aur soch loon, phir decide kar loon gi.”

Except the decision still doesn’t feel safe enough.

Consider someone choosing between two jobs. Comparing pay, working hours and travel is useful. Trying to establish which choice guarantees that they will never regret anything is a much harder assignment.

Their mind may keep working because the certainty they want isn’t available.

It does give us something worth considering: sometimes the thinking is happening alongside a persistent sense that whatever we do will not be good enough.

Sometimes the Situation Really Is Uncertain

I wouldn’t tell someone waiting for an overdue salary that the problem is simply their thinking.

Rent is due. Bills exist. The person asking when they will be paid has a reasonable question.

The same applies to someone awaiting medical results, facing family pressure or trying to understand a relationship where the other person’s behaviour keeps changing.

Before asking why someone worries so much, it helps to ask what they are dealing with.

In some Pakistani households, a decision can also involve several people’s expectations. You may be choosing a career while anticipating your parents’ disappointment, relatives’ questions and the practical consequences of financial dependence.

As we discussed in “Log Kya Kahenge?”, anticipated judgement can become part of the decision before anyone has spoken.

That context matters.

It doesn’t mean every feared outcome will happen. It means advice needs to address the actual situation as well as the person’s response.

Someone may need clearer information, practical support, a difficult conversation and help managing anxiety. We don’t have to choose only one explanation.

When Does Worry Become an Anxiety Disorder?

Feeling anxious before something important is common. Anxiety disorders involve patterns of fear or anxiety that persist and can interfere with work, relationships and ordinary activities. There are different types, including generalised anxiety disorder, social anxiety disorder and panic disorder. They are not all identified by the same symptoms.

For this article, generalised anxiety disorder, or GAD, is particularly relevant because excessive worry is central to it.

What a GAD assessment considers

In the DSM diagnostic framework, GAD involves excessive anxiety and worry about several areas of life, occurring more days than not for at least six months, with difficulty controlling it.

For adults, associated symptoms include at least three of the following: restlessness, fatigue, concentration difficulties, irritability, muscle tension and disturbed sleep. Assessment also considers significant distress or interference with life and whether another condition, substance or medical problem better explains the symptoms. Read the diagnostic criteria.

This is more than “I think a lot.”

The six-month criterion is also not an instruction to wait six months before seeking help. It belongs to the diagnostic assessment of GAD, not to every anxiety disorder or every decision about support.

If worry is already making life difficult, you can discuss it now.

Look at the Pattern, Not One Difficult Evening

Imagine two people who both say they overthink.

One has an interview tomorrow. They rehearse answers, sleep badly and worry about making a poor impression. Once the interview is over, their attention gradually returns to other things.

The other has been struggling for months. Work, health, money and family all become sources of persistent worry. Even after one concern is resolved, another quickly takes its place.

Both deserve understanding. Their needs may be different.

Rather than counting how many thoughts you have, consider:

• How often does this happen? Occasionally, during a difficult period, or most days?
• How difficult is it to disengage? Can you return to other activities, even with some discomfort?
• What is it costing you? Sleep, concentration, relationships, time or opportunities?
• What do you do because of the worry? Avoid decisions, repeatedly check things or keep asking for reassurance?

These are reflection questions, not a self-diagnostic test.

And “I still go to work” doesn’t settle the matter. Someone may meet deadlines while spending their evenings distressed or losing hours of sleep.

It is worth asking how much effort ordinary functioning is taking.

Why an Anxiety Score Is Not the Same as a Diagnosis

You complete an online questionnaire. The result says “moderate anxiety.”

What does that mean?

It may indicate symptoms worth discussing. It doesn’t, by itself, establish which condition you have or explain why those symptoms are happening.

That is useful. Being able to describe distress in a familiar language matters.

But a questionnaire cannot ask every follow-up question a clinician might need.

What changed recently? Are you sleeping? Is there an ongoing threat? What happens when you feel anxious? Are there physical symptoms that need medical assessment?

The same care applies when reading research headlines. A percentage of students scoring above a questionnaire threshold should not automatically be described as the percentage with a clinically confirmed disorder.

Why “Bas Sochna Band Karo” Usually Leaves Us Stuck

Most people struggling with repetitive thoughts have already considered stopping.

They may have tried quite hard.

So when someone says, “Itna mat socha karo,” the advice can feel a little like being told to sleep when you have spent two hours trying.

The intention may be kind. The instruction gives the person very little to work with.

We can make the conversation more useful:

“Kis baat par tumhara dimagh baar baar wapas ja raha hai?”

Or:

“Is mein koi cheez hai jo hum abhi solve kar sakte hain?”

There is a difference between listening and promising that nothing bad will happen. We cannot guarantee the interview result, another person’s feelings or the outcome of a medical test.

We can help someone separate what they know from what they fear.

That also means avoiding the opposite shortcut: confidently telling them they have a disorder because their experience sounds familiar.

Recognition can open a conversation. It shouldn’t end the assessment.

What Can Help When You Keep Overthinking?

Start with one recurring situation. Trying to change every thinking habit at once can become another demanding project.

Separate the problem from the prediction

Write down the concern as plainly as possible.

“My application is incomplete” gives you something to work on.

“What if I never become successful?” contains a much larger prediction.

The NHS recommends distinguishing practical problems from hypothetical worries, then identifying specific actions for problems you can address.

For an application, that action might be checking the deadline, preparing one document or asking for clarification.

You do not need to solve your entire future before completing the form.

Give worry a limited appointment

If the same concerns keep interrupting your day, you could try a short, planned period to write them down and consider what needs action.

The NHS suggests around 10 to 15 minutes of “worry time”. When a concern returns outside that period, note it and gently bring your attention back to what you were doing. This takes practice; it isn’t a promise that thoughts will disappear on command.

The aim is to make some room in the day, rather than hold an emergency meeting every time a thought arrives.

Notice what happens after checking

You reread the message. Ask a friend what it means. Feel better briefly. Then wonder whether your friend understood the situation properly.

Before repeating the process, notice whether checking is providing information or simply another short period of relief.

With an ordinary, low-stakes message, you might practise leaving it alone while you return to dinner or finish a task.

This does not mean ignoring genuine warning signs, medical advice or necessary safety checks.

Leave room for an imperfect decision

For a low-risk choice, decide what information is enough and when you will choose.

Perhaps you need to compare three options. Perhaps one conversation will answer the relevant question.

After that, some uncertainty may remain.

You can choose a course without knowing whether you will love every class. You can send a respectful message without controlling how it will be received.

A decision can be reasonable before it feels completely comfortable.

When Should You Speak to a Psychologist?

Consider professional support when worry keeps disrupting sleep, concentration, relationships or daily activities, or when your attempts to manage it aren’t helping.

You can also seek help because the pattern is tiring and you want to understand it. You don’t need to arrive with a diagnosis already chosen.

A clinician can explore the wider picture and whether psychological treatment, medical assessment or both would be useful. Cognitive behavioural therapy is one established treatment for GAD; treatment choices depend on the person’s needs and circumstances.

New or concerning physical symptoms should not automatically be dismissed as anxiety.

If you would like to discuss recurring worry, a psychological consultation can provide space to understand what is happening and consider appropriate next steps.

You can begin with ordinary words:

“Mera dimagh rukta nahi, aur ab main thak gayi hoon.”

That is enough to start a conversation.

You Don’t Have to Diagnose Every Difficult Thought

I think the most helpful response to overthinking begins with curiosity.

What keeps returning? What feels unresolved? Is there something you can do, something you need help with, or an answer you cannot obtain yet?

Sometimes the worry will ease when the situation changes. Sometimes a familiar thinking habit needs attention. Sometimes a fuller assessment will identify an anxiety disorder.

We should leave room for each possibility.

The person replaying a conversation doesn’t need to be laughed at. They also don’t need a diagnosis handed to them before anyone has understood the pattern.

And if you recognise yourself here, perhaps tonight’s task can be smaller than figuring out everything about your mind.

Write down the concern. Decide whether anything needs doing now. Notice when you have reached the limit of what another round of thinking can tell you.

You may still feel uncertain.

“Abhi mujhe jawab nahi pata.”

That can be an honest place to pause.

You are allowed to return to your evening before every question has an answer.

Sources & further reading

• Ijaz and Khalid (2020). Perfectionism and Academic Burnout: The Mediating Role of Worry and Depressive Rumination in University Students. Pakistan Journal of Psychological Research.
• Ahmad and colleagues (2017). Urdu translation and validation of GAD-7: A screening and rating tool for anxiety symptoms in primary health care. Journal of the Pakistan Medical Association.
• National Institute of Mental Health (2024). Anxiety Disorders. National Institute of Mental Health.
• National Institute of Mental Health (2025). Generalized Anxiety Disorder: What You Need to Know. National Institute of Mental Health.
• Substance Abuse and Mental Health Services Administration. DSM-IV to DSM-5 Generalized Anxiety Disorder Comparison. DSM-5 Changes: Implications for Child Serious Emotional Disturbance. NCBI Bookshelf.
• NHS. Problem solving. Every Mind Matters.
• NHS. Tackling your worries. Every Mind Matters.