Rumination and Depression: 4 Ways to Break the Cycle

This is the third in a five-part series about the most common mental mistakes that can lead to depression, keep you depressed, or make you more vulnerable to relapse. The five patterns were presented by Dr. Michael Yapko, an internationally known expert on depression, to the Australian Psychological Society.

In the last article, we focused on depression and decision-making—or what Yapko calls “stress generation.” That’s when the “don’t care” or “don’t know” of depression leads to choices that create more stress, which can then lead to more depression.

The third mental mistake is rumination.

 

What is rumination?

Rumination is when you have one negative thought—or a string of thoughts—that repeats itself over and over and over…and over. I’ve heard it called a negative spiral or “letting myself drown in bad thoughts.”

It’s a terribly destructive habit, and it’s often paired with the “what ifs” or “whys” you can ask yourself:

“What if my parents had been happy?”

“What if Jenny hadn’t broken up with me?”

Or perhaps you focus on much more serious experiences that you believe, rationally or not, held you back from who you could’ve become.

It’s not that those things weren’t true or that the difficulties they caused weren’t very real. Rumination is when you continue focusing on them when it’s no longer helpful to do so.

Rumination is considered a “transdiagnostic” symptom, meaning that it doesn’t belong to only one diagnosis. You can be depressed and ruminate. You can have OCD and ruminate. You can have PTSD or Complex PTSD and ruminate. Rumination can also be part of grief as you try to understand why, how, or when something happened.

The question is not simply whether you think about the past. It’s how much time you spend there…and what that thinking does to you.

Rumination, worry, or healthy self-reflection?

Rumination generally involves excessive time and mental energy spent thinking about the past. You realize rationally that there’s nothing you can do to change it, but you continue pondering the “why,” “why not,” or “what if.”

Worry, on the other hand, is generally focused on the future. Both worry and rumination can become excessive and unhelpful.

But not all extended thinking is unhealthy. Sometimes you’re looking back over your life and trying to learn from past mistakes or recognize patterns you hadn’t seen before in your own behavior or someone else’s. Maybe this self-reflection is the healthier side of rumination.

You might spend an afternoon journaling or talking with a friend and come away feeling that something important has come to light. That’s different from asking yourself the same painful questions repeatedly and never arriving anywhere new.

Rumination also isn’t problem-solving, which has much more of a present and future-focus.

You may have been treated unfairly. That unfairness may have involved racism, misogyny, religious abuse, financial inequality, LGBTQ discrimination, or something else entirely. It wasn’t right. Acknowledging that truth isn’t the problem.

But spending too much time ruminating about it doesn’t fix it. Instead, rumination can turn into resentment, deepen a sense that you’re always getting the bad end of the stick, and increase the likelihood of depression or relapse.

Moving from rumination to self-awareness

I worked with a man years ago whom I’ll call Billy. He had two children: one was severely autistic, and the other had significant physical disabilities. He often felt completely overwhelmed in every area of his life. He’d been treated unfairly in his job and was having to restart his career. His marriage was in trouble, with both partners incredibly busy with work and their children.

Billy became depressed, and I think most of us would agree that he had damn good reason.

When he first came in, he tried to hide how overwhelmed he felt, glad-handing everyone and smiling. But the façade finally broke, and he recognized how down he felt, even suicidal.

In therapy, Billy moved from being ruminative to being self-aware and self-reflective. An antidepressant helped give him a little more mental space in which to work. And he worked hard.

Self-awareness can lead you toward compassion and understanding without allowing you to fall into rumination which, in Billy’s case, had become devastatingly dangerous.

That’s the power of moving from rumination to self-awareness and self-reflection. You begin moving away from feeling like a victim and toward recognizing what you can do now.

Four ways to interrupt rumination

Keep a rumination journal

Write down the things you’re ruminating about at about the same time every day, perhaps for ten minutes or so.

If you catch yourself getting stuck on “why me?” or “what if?” questions at another time, jot the thought down somewhere and return to it during your next journaling session.

The point is to honor what you’re thinking about while also corralling it so it doesn’t take over your entire life. You may find that writing helps you move into the healthier mode of self-reflection.

Redirect your attention

When you catch yourself asking the same old questions about the past, distract yourself. Go for a walk. Do something useful. Call a friend who’s been sick. Find something that focuses your mind on the present, and maybe even on someone else.

Count your “why me?” and “what if?” questions

Start noticing how often you hear yourself say or think, “Why me?” or “What if I had…?”

Recognize how often you bring the past into your mind rather than staying in the present. When you do that repeatedly, you’re taking enjoyment and attention away from the life that’s happening now.

This isn’t about scolding yourself for having the thought. It’s about becoming aware of how frequently the pattern occurs.

Ask yourself two vital questions

When you catch yourself ruminating, ask:

“Is this really helpful?”

Maybe it is. But likely, it’s not. If you’re grieving that day, call it grief and let yourself feel it. Grief involves emotions and doesn’t remain only in your head the way rumination can. The same consideration applies to trauma. The goal isn’t to deny your experience; it’s to notice when repeatedly thinking about it is no longer helping you process it.

Next ask:

“What do I actually have control over that could lead me to a healthier state of mind?”

That’s a huge question.

Billy couldn’t change the fact that he’d been financially mistreated in the past. But he could develop a financial plan that slowly gave him some hope for his future…and he did.

He couldn’t take away the stress of having two children with special needs. But he could accept the help others were offering, and he and his wife could spend some time alone together processing their feelings. Not hours and hours. But enough. He did that as well.

These changes are possible. They’re harder when you’re depressed, yes. But this series is about recognizing how depression can worsen when these mental habits assert themselves too strongly in your thinking.

Rumination keeps asking, What could have been?”. Healthier self-reflection asks, “What do I understand about this and what can I do do now?”

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