Rumination: A Problem in Anxiety and Depression

Rumination is one of the similarities between anxiety and depression. Ruminating is simply repetitively going over a thought or a problem without completion. When people are depressed, the themes of rumination are typically about being inadequate or worthless. The repetition and the feelings of inadequacy raise anxiety, and anxiety interferes with solving the problem. Then depression deepens.

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Brain function plays a role in rumination in several ways, but one significant aspect relates to memory. People remember things that are related to each other in neural networks. And when people enter a woe-is-me network, the brain lights up connections to other times they felt that way. Ruminating is worsened by another difficulty of the depressed and anxious brain—an inability to flexibly generate solutions. Brain chemistry makes it hard to switch to another perspective to find the way out of problems, so rumination intensifies. Both anxiety and depression are then reinforced.

Rumination can be switched off by two good methods:

1. Get out of the negative neural networks.
2. Tackle one problem at a time with planning.

End rumination by exiting the negative memory network

First, stop ruminating on negatives and activate a neural network of times when everything worked out okay. These might be hard to remember. Neural networks are triggered by mood, and your mood might have connected to other moods when you were afraid of bad outcomes. You can deliberately decide to recall instead the times when things worked out even though you had been afraid. Those networks of anxiety can lead to remembering positive outcomes. However, ruminating may get you too negative to shift into a network of positive thoughts without a memory jogger. What can shift you into a different network?

1. Use family or friends to help you remember. Ask them to help you think of times when things turned out fine. Conversation with encouraging others can shift your attention to a different memory network, and when others point out positive outcomes at your request, you start down a different neural path.
2. Interfering with rumination may be helped with a memory jogger for times you were feeling good by going over pictures of happy memories. As you look them over, try to recall not just what you were thinking then but what your body felt like. You might be surprised that joy and happiness are physical sensations. To get in touch with a body memory, scan your senses. What you see? Taste? Touch? Smell? Hear?
3. Music holds the power to put us directly back into to a place when we listened to it, usually entering into the mood we were in when we listened and then the pieces of memory fill in with people and situations. As one rather depressed person I know put it, "I like to listen to songs from high school and college, from before things started getting complicated. Maybe life was not perfect, but the music makes me feel good when I hear it." Is there a time frame or type of music that puts your memory back into a good place?
4. Another rumination interrupter is to put yourself literally into a place you connect with things turning out for you — taking a walk in a location that helps you enter a positive frame of mind can only be helpful.

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The idea of going into another network is not to get lost in old memories but to find a way into a positive neural network from which you may springboard into a solution to your problem.

Separate the problems and make plans

Rumination might prevent you from solving the problem or from moving on if you do not have a solution at the moment. Try to unhook problems from each other to see if you have an actual problem you can solve or just a worry to eliminate.

One example of this is a man who was decidedly depressed and anxious about his work life, which was fraught with debt, angry colleagues, and overwhelming reports for expenses and hours put in. He actually knew what to do about the debt, but rather than saying to himself, "I know what I will do," and setting that problem aside, he tangled it up with a different problem. "I know what to do about the debt, but everyone will find ways to tell me they are angry about it."

Now he was ruminating on what to say to make them less angry. Then he thought, "I wish I could walk away from them. If I can get caught up with my expenses and reports, I could consider looking for another job," and he began ruminating about whether he could find a different job.

The debt problem had nothing to do with how he wanted everyone to be happy, and neither affected finding the time to do his paperwork and none connected to how hard it is to find new work. But he connected unrelated problems and now could not let go of any of them. If this kind of rumination sounds like the way you go from one problem to another:

1. Make a list of problems on your mind and put them in columns, side by side so you can see if there are any connected parts.
2. Identify: Can you make a plan for the first one? If so, write it down, with action steps.
3. Do the same thing for each problem.
4. Look across the columns. Are any action steps connected to each other? If so, which step comes first? That is where you will direct your first effort. If they are not connected, then pick which action plan you will attend to first.
5. See if any one problem in any one column has no solution. Then write down a date when you might have more information to make it useful to think about it again. This is now just a worry, and until it is possible to find a solution you do not need to think about it in the meantime.
6. When any of these problems come up, say to yourself, "Stop! I have a plan." Refusing yourself the permission to re-think a plan is hard but worth the effort.

The better you get at interrupting rumination, the lighter your depression will become. It is possible to stop brain patterns that contribute to anxiety and depression by stopping rumination. It gets easier the more you practice, so stick with it and you will soon be able to do it automatically.