Category: Depression

Rumination is the habit of going over depressing events from the past in the mind and it can be very bad for mental health.

Rumination — thinking about the causes and consequences of depressing events — is common in depression.

Repetitive thinking like this 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, repetitive thinking about 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.”

Rumination plays a large role in how depression arises and is maintained.

Signs of rumination

The main signs and symptoms of rumination and repetitive thinking 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 are the single largest cause of depression and anxiety, the next largest causes are a family history of mental illness and low income and low education levels.

Both social factors and relationship status have smaller effects on the risk of depression and anxiety.

How to stop ruminating

It can be hard to get out of a pattern of rumination.

However, here are some techniques that may be helpful to stop ruminating:

1. Plan for the time when you start ruminating. Decide how you will deal with it in advance.
2. Distract yourself: choose to do something else instead of ruminating. Have activities ready to hand.
3. 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?
4. Try mindfulness meditation: it can help to control ruminative thoughts.
5. Spend time in nature: a 90-minute walk in nature can reduce rumination.
6. Avoid triggers: media or people who are likely to set off rumination should be avoided.

Therapy for repetitive thoughts

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 percent 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).

This small change to your diet could be enough to reduce the risk of depression.

A Mediterranean diet including fruits, vegetables and legumes can prevent depression, a large study finds.

People only had to make relatively small changes to see the benefits.

The scientist think that depression could be partly down to a lack of essential nutrients.

The study included 15,093 people who were followed over 10 years.

People who reported eating more nuts, fruits and vegetables were considered to be following the Mediterranean diet more closely.

Those who ate more meats and sweets were considered to be moving away from the healthy diet.

The benefits of the diet are likely related to higher levels of omega 3 and other essential nutrients.

Dr Almudena Sanchez-Villegas, who led the research, said:

“We wanted to understand what role nutrition plays in mental health, as we believe certain dietary patterns could protect our minds.

These diets are all associated with physical health benefits and now we find that they could have a positive effect on our mental health.

The protective role is ascribed to their nutritional properties, where nuts, legumes, fruits and vegetables (sources of omega-3 fatty acids, vitamins and minerals) could reduce the risk of depression.”

Relatively small dietary changes were enough to reduce depression risk, Dr Sanchez-Villegas explained:

“A threshold effect may exist.

The noticeable difference occurs when participants start to follow a healthier diet.

Even a moderate adherence to these healthy dietary patterns was associated with an important reduction in the risk of developing depression.

However, we saw no extra benefit when participants showed high or very high adherence to the diets.

So, once the threshold is achieved, the reduced risk plateaus even if participants were stricter with their diets and eating more healthily.

This dose-response pattern is compatible with the hypothesis that suboptimal intake of some nutrients (mainly located in low adherence levels) may represent a risk factor for future depression.”

The research was published in the journal BMC Medicine (Sánchez-Villegas et al., 2015).

Gene for depression has a surprising upside.

The same gene that may cause depression in some, is linked to a better mood in others, a study finds.

This suggests that depression isn’t just ‘in your genes’: it is also about the environment.

The research challenges the idea that certain genes are risk factors for depression.

Instead, certain genes seem to make people more susceptible to life experiences.

Dr Chad Bousman, an expert on gene-environment interactions who led the study, said:

“Our results suggest some people have a genetic makeup that makes them more susceptible to negative environments, but if put in a supportive environment these same people are likely to thrive.”

The study followed 333 people over five years.

Their genes and levels of depression were tested.

They were also asked about any childhood sexual or physical abuse.

Almost one-quarter had a particular type of gene that has been linked to depression.

Those with the gene who had also suffered childhood abuse were much more likely to have severe depression in middle age.

Those with the gene, but without the abuse, were likely to be happier in middle age.

The gene — known as SERT — affects serotonin, a neurotransmitter which helps regulate mood.

Dr Bousman said:

“You can’t change your genotype or go back and change your childhood, but you can take steps to modify your current environment.

It also means that it’s not as clear-cut as telling a person that because they have a risk gene, they’re doomed.

This research is showing that’s not the case at all.

A person’s genes alone are not enough to determine how they might experience depression.

This research tells us that what may be considered a risk gene in one context, may actually be beneficial in another.

So this directly opposes the notion of genetic determinism, the idea that your genes define your fate.”

Related: 4 surprising benefits of depression.

The research was published in the British Journal of Psychiatry Open (Nguyen et al., 2015).