By Tim Aiello, MA, LPC, NCC, ADHD-CCSP, ASDCS
There are thoughts that drift, thoughts that echo, and thoughts that barge in like a wrecking ball—intrusive, intense, and completely uninvited. For many of us who are neurodivergent, especially those with ADHD, Autism, or both (AuDHD), intrusive thoughts aren’t a rare occurrence. They are a daily, sometimes hourly, event—relentless, vivid, and emotionally destabilizing.
I’m no stranger to this. My brain has painted scenarios so real I could feel the grief in my bones. I’ve imagined tragic accidents involving the people I love most. I’ve seen the worst unfold in high definition—complete with sound, movement, and the full sensory overload that makes it hard to breathe. And then I’ve had to sit there with it, knowing logically it wasn’t real, but feeling like it was anyway.
Intrusive Thoughts Aren’t Just “Negative Thinking”
Let’s start by busting a myth: intrusive thoughts are not just “pessimistic thinking.” They’re not “bad vibes” you can sage away. They’re not evidence of a moral failing or dangerous intent. They’re a neurobiological response that becomes intensified in neurodivergent brains.
For ADHDers, the mind races. There is no off-switch—just a volume knob turned permanently to loud. Thoughts intrude because our executive function is often too overworked to filter them. For Autistic individuals, especially those with co-occurring anxiety or trauma (which is common), these thoughts can loop endlessly. Combine both—AuDHD—and it’s a perfect storm of emotional reactivity, sensory sensitivity, and internal chaos.
The Neurobiology of the Storm
So what’s actually happening in our brains?
ADHD and Default Mode Network (DMN) HyperactivityThe DMN is a network in the brain responsible for self-referential thought—daydreaming, internal dialogue, memory retrieval. In ADHD, the DMN can remain active even when we’re trying to focus on tasks. This contributes to a constant mental noise, and often, that noise includes distressing images, worries, or worst-case scenarios.
Autism and Cognitive RigidityMany Autistic people experience cognitive inflexibility—difficulty shifting attention or letting go of thoughts. Combine that with hyperfocus and a heightened sensitivity to distress, and you get a mind that grabs onto an intrusive thought like a dog with a bone. Even when we know it’s irrational, the thought sticks. It loops. It spirals.
Dopamine Dysregulation (ADHD) + Hyperarousal (Autism)ADHD brains often lack efficient dopamine pathways, making emotional regulation harder. Autism, on the other hand, can involve heightened autonomic responses—meaning the nervous system is more likely to go into fight-or-flight. Together, they create a feedback loop: an upsetting thought triggers an intense emotional and bodily reaction, which fuels more thoughts, and the cycle continues.
Polyvagal Theory and Perceived ThreatFrom a Polyvagal Theory perspective, our nervous systems are scanning for danger all the time. For neurodivergent folks, especially those with histories of trauma or chronic dysregulation, our “neuroception” (the brain's subconscious threat detector) is on high alert. A passing thought doesn’t stay passing—it gets tagged as a threat. And that’s when our bodies start reacting.
When the Imaginary Feels Terrifyingly Real
I’ve sat in sessions with clients who tell me things like:
“I keep imagining getting into a car accident. I see it happen—over and over—and I can't stop.”
“What if I accidentally hurt my dog? I’d never do it, but the image keeps flashing in my mind.”
“I feel like a monster for even thinking this.”
And I nod, not just as a therapist, but as someone who gets it. Because I’ve thought those thoughts too. I’ve cried over people who were still alive. I’ve felt guilt over things I never did. I’ve grieved fictional tragedies that my nervous system treated like fact.
That’s the kicker: our bodies respond to imagination as though it’s reality. The nervous system can’t tell the difference. So when you're Autistic or ADHD—and your brain paints a vivid mental image of disaster—your heart rate spikes, your stomach churns, and your muscles tense up like it’s actually happening.
What’s Even Harder with AuDHD
Having both Autism and ADHD—AuDHD—means experiencing the intrusive thoughts and the inability to pivot away from them. ADHD throws them at you fast and unfiltered. Autism glues you to them. They stick. They repeat. And because of co-occurring alexithymia (difficulty identifying and articulating emotions), you might not even be able to name why the thought is so distressing. You just know that you feel awful—and you can’t get out of it.
This is where a lot of self-blame and shame creep in. You start wondering:
“What’s wrong with me?”
“Why can’t I control my brain?”
“Am I broken?”
And I want to tell you—you’re not broken. Your brain is just doing its best to protect you in a world that’s overwhelming and often unsafe for neurodivergent folks.
What Helps (From Someone Who’s Been There)
I won’t pretend there’s a magic fix. But there are tools that can help soften the edges of these experiences:
1. Co-Regulation Before Self-Regulation
If you’re deeply dysregulated, you probably can’t talk yourself out of the spiral. Start with the body:
Weighted blankets
Deep pressure touch (hugs, squishes)
Slow rocking
Cold water or holding ice
2. Polyvagal-Informed Grounding
Vocal tones: humming, chanting, singing
Long exhales
Eye movement exercises (look left and right slowly while breathing)
Vagus nerve stimulation tools (if accessible)
3. Sensory Diets
Build a menu of “safe” sensory experiences that ground you. This is especially crucial for Autistic folks who need regulation via input. Think:
Textures (fidget toys, soft fabrics)
Sounds (brown noise, nature)
Movement (repetitive or rhythmic)
Smells (lavender, citrus, familiar scents)
4. Externalizing the Thought
Write it down.
Draw it.
Speak it aloud to a trusted person.
Externalizing helps separate you from the thought. You are not your thought.
5. Compassionate Reframing (When You’re Calm)
“This is my brain trying to protect me.”
“This thought is intense, but it’s not reality.”
“I’m allowed to feel discomfort without assigning meaning.”
6. Therapy with a Neurodivergent Lens
Working with a therapist who understands ADHD, Autism, and Polyvagal Theory is a game-changer. We don’t start with “let’s challenge the thought.” We start with “let’s regulate the nervous system first.”
Final Thought: You Are Not the Villain in Your Story
Intrusive thoughts often carry shame. We ask ourselves: Why did I think that? Does this mean I’m bad? Especially for those of us raised to mask, to behave, to suppress anything “too much,” these thoughts feel like proof that we’ve failed.
But let me say this plainly: Intrusive thoughts are not reflections of your character. They are not predictions. They are not warnings. They are just loud, sticky thoughts amplified by a neurodivergent brain doing its best in a world that often overwhelms it.
If you’re AuDHD, Autistic, ADHD—or just someone living with a mind that doesn’t know how to rest—you’re not alone. And you’re not doomed. You can learn to listen to your nervous system, to gently untangle the noise, and to build a relationship with your thoughts that’s rooted in compassion, not fear.
You are not the villain in your story. You are the survivor.