I think in both words and pictures, like 'audio video'.
However, my thoughts are rarely linked to my surroundings, unless I'm working very hard, when something related comes in along with the unrelated. I have looped thoughts of music/sound effects/words, snippets of cartoons/anime I have watched, and pictures I have seen, usually all melded into one mishmash thought, and this thought sticks, until another one comes along. I also think about my own ideas for TV show 'episodes' or a song with music video on a regular basis, and I experience them like I'm actually in front of a computer watching what I'm thinking about on YouTube. I cannot spare a moment without thinking of just words, just pictures or just sounds.
If I was to think about
A family member's face:
I would think about a memory I had with them, in footage with audio.
A Maths problem:
I would think of a 'mishmash' along with the problem (which is in verbal words).
Spelling a difficult word:
Some random cartoon guy saying the word, along with a mishmash.
What love is:
I think about the things I love: a MASSIVE mishmash of words, pictures, videos, music, shapes, smells, tastes, faces etc.
How to give directions to a place nearby
I'd think of driving in a car, blasting out music, around the place I am talking about.