Rumination — thinking about the causes and consequences of depressing events — is common in depression.
It is often driven by the desire to understand what is happening to us and how that can be changed.
What is rumination?
Rumination can be thought of like the brain’s problem-solving mechanism gone wrong.
When people ruminate, they can find it very difficult to stop.
It differs from problem-solving as no problem is ever solved.
Unfortunately, thinking about the stressful events means reliving them, which is depressing.
Professor Roger Hagen, an expert on rumination, explains:
“Anxiety and depression give rise to difficult and painful negative thoughts.
Many patients have thoughts of mistakes, past failures or other negative thoughts.”
Signs of rumination
The main indicators of rumination are:
- Focusing on a problem for a long time
- Feeling worse afterwards than before
- Failing to accept or move on
- Not reaching a solution
The causes of rumination
Traumatic life events are the single largest cause of anxiety and depression.
However, whether a person becomes anxious or depressed depends on their mental approach to these events.
After traumatic life events, which were the single largest cause of depression and anxiety, the next largest causes were a family history of mental illness and income and education levels.
Both social factors and relationship status had smaller effects on the risk of depression and anxiety.
Tips to avoid ruminating
It can be hard to get out of a pattern of rumination.
However, here are some techniques that may be helpful:
- Plan for the time when you start ruminating. Decide how you will deal with it in advance.
- Distract yourself: choose to do something else instead of ruminating. Have activities ready to hand.
- Challenge your thoughts: ask whether the thoughts you are having are really accurate and how another person who is fresh to the situation would view them. Are they reasonable thoughts?
- Try mindfulness meditation: it can help to control ruminative thoughts.
- Spend time in nature: a 90-minute walk in nature can reduce rumination.
- Avoid triggers: media or people who are likely to set off rumination should be avoided.
Ultimately, the most effective way of dealing with rumination that will not go away is therapy.
During therapy, people learn to deal with rumination more effectively.
One strategy is learning that thoughts are just thoughts and do not reflect reality.
Like any thoughts, they can be allowed to float away without causing distress.
Metacognitive therapy is one option for dealing with rumination.
One of the problems in depression is that people…
“…think too much, which MCT [metacognitive therapy] refers to as ‘depressive rumination’.
Rather than ruminating so much on negative thoughts, MCT helps patients to reduce negative thought processes and get them under control.”
Taking control of your thoughts is an important part of many modern cognitive therapies.
One study found that when people learned to reduce how much they ruminated, 80% had recovered after six months (including 10 weeks of therapy).
Simply realising that you don’t have to ruminate can be liberating.
Professor Hagen said:
“Instead of reacting by repeatedly ruminating and thinking ‘how do I feel now?’ you can try to encounter your thoughts with what we call ‘detached mindfulness.’
You can see your thoughts as just thoughts, and not as a reflection of reality.
Most people think that when they think a thought, it must be true.
For example, if I think that I’m stupid, this means I must be stupid.
People strongly believe that their thoughts reflect reality.”
Many patients who took part in the study were pleasantly surprised, said Professor Hagen:
“The patients come in thinking they’re going to talk about all the problems they have and get to the bottom of it, but instead we try to find out how their mind and thinking processes work.
You can’t control what you think, but you can control how you respond to what you think.”
The study was published in the journal Frontiers in Psychology (Hagen et al., 2017).