Tormenting thoughts that are constantly repeated and never find a solution: Rumination not only worsens the mood, but also has a negative effect on the body. They usually occur in combination with depression and keep sufferers in a passive victim role. However, there are therapeutic treatment options and self-help methods that can end unhealthy thinking in an endless loop.
What is rumination?
Ruminating is understood to be a negative form of thinking. In this case, tormenting thoughts impose themselves on the affected person in the form of an endless loop that cannot be suppressed. Science also speaks of rumination (ruminating) of thoughts. They often revolve around topics from the past or worries about the future. Among the most common triggers for rumination are disputes, decisions, philosophical questions and one’s own person. Rumination compulsions are accompanied by self-reproach, feelings of inferiority, and hopelessness and usually occur in episodes. These are triggered by current events, although these do not necessarily have to be the object of rumination. In contrast to healthy ruminating, the focus is not on finding action- and future-oriented solutions, but on compulsively repeating unpleasant experiences or expectations. Instead of asking “how,” it asks “why.” Thus, rumination represents a certain “search into the void.”
Causes
Rumination often underlies another mental illness, usually depression, generalized anxiety disorder, or obsessive-compulsive disorder. The nonspecific feeling of unhappiness leads to the impulse to seek improvement by ruminating about one’s situation. Rumination is said to open up insights into the reason for dissatisfaction and thereby provide relief. Many psychotherapists have found that this approach disguises the fear of active intervention. The sufferer does not run the risk of failure, criticism, or rejection through passive persistence and rumination. In addition, obsessive thoughts are an indication of lack of self-worth, indecision and insecurity. Doubts about oneself are expressed in exaggeratedly self-critical and derogatory thoughts. Past injuries and traumas that have not been dealt with appropriately can also lead to ruminations. Since these can no longer be undone, however, those affected feel like helpless victims. Constantly thinking about the negative past and blaming oneself or others leads to the downward spiral of rumination.
Diseases with this symptom
- Depression
- Anxiety disorder
- Obsessive-compulsive disorder
Diagnosis and course
Only when rumination occurs outside of depressive episodes is it diagnosed as a separate disorder. If, on the other hand, it occurs in the form of worry about everyday events or possible future misfortunes and persists for more than six months, it is indicative of generalized anxiety disorder. In most cases, rumination increases toward evening. Due to the endless loops of thinking, general mood deterioration, lack of energy and malaise occur. If the compulsion to brood is not recognized and treated in time, it can lead to severe depression and anxiety even in people without any previous psychological disorders. Over time, physical symptoms such as tension, concentration problems, sleep disturbances, loss of appetite, stomach ulcers and digestive problems can also occur. In addition, negative thinking is mentally stressful to the body, causing increased release of the hormone cortisol. This has a dampening effect on the immune system, increasing the risk of disease.
Complications
Rumination can lead to a number of psychological and physical problems. Chronic rumination initially makes people unhappy and leads to frustration and anxiety. This is accompanied by insomnia, feelings of powerlessness, and tension. As a further complication of persistent ruminating, self-confidence decreases and sometimes severe stress and its consequences occur: Blood pressure and heart rate increase, physical tension occurs and the quality of life sometimes decreases sharply. Further complications of brooding can be depressive moods or even full-blown depression.In the long run, brooding makes you sick and causes various obsessive-compulsive and anxiety symptoms, which in turn lead to an increase in brooding – a vicious circle develops. Ruminating also has a physical effect: Teeth grinding, stomach ulcers and fatigue are among the most common symptoms; in addition, stress can also affect the heart and internal organs or the immune system, leading to a variety of other complications. In extreme cases, the symptoms develop into severe depression or lead to another mental illness such as burnout. The consequences and their intensity vary greatly from person to person, which is why rumination, especially if it develops into a chronic problem, should be countered promptly by talking to a therapist, medication and other methods.
When should you see a doctor?
Ruminating with possible disease value is obsessive thought circling in which the focus is on the ruminating itself, rather than on finding a solution. The brooding carousel often revolves around rather banal things. Often, this type of brooding is about negatively perceived events from the past: sad childhood, divorce or lack of success. Philosophical questions can also trigger a real compulsion to brood. In such a case, therapeutic advice is urgently needed, because if left untreated, brooding can lead to an anxiety disorder, depression or even suicide. In psychological or psychotherapeutic treatment, brooding can be countered with behavioral therapy. Those affected must leave their passive victim role. Together with their psychologist or psychotherapist, they analyze their motivation for brooding. The therapist makes them aware that some things can no longer be changed and that even the most intensive brooding does not bring a solution, but pulls the brooding person into a psychological downward spiral. In addition to psychological problems, brooding can also cause physical impairments and thus produce a psychosomatic clinical picture. Typical symptoms of this are sleep disturbances, lack of appetite, digestive problems, tension and concentration problems. A therapist with a psychosomatic orientation is a good choice in treating obsessive ruminating.
Treatment and therapy
If episodes occur frequently, it is recommended that psychotherapeutic treatment be initiated. This involves techniques such as problem-solving training, relaxation techniques, psychoeducation, mindfulness-based approaches, and classical behavioral therapy. If rumination is a symptom of depression, antidepressants are often used. If the course of the disease is not yet long and also accompanies therapeutic treatment, a number of measures can be taken by oneself. The prerequisite for this is the ability to recognize pathological thoughts as such. Under no circumstances should these be taken as facts, but purely as thoughts. A distanced attitude makes it possible to perceive them, but not to take them too seriously. In order to be able to break out of the vicious circle, the method of the stop word is used: As soon as brooding is noticed as such, a fixed word is spoken aloud to interrupt the thoughts. After that, one should take up a distracting activity that is enjoyed and that makes the person happy. Focusing attention on the outside world is another way to keep from obsessive thoughts. This involves consciously directing one’s awareness to something outside for a few minutes several times a day. Keeping a brooding diary can also help: In a limited time frame, the tormenting thoughts are dealt with. This gives them a controlled amount of attention that is not exceeded.
Outlook and prognosis
Brooding is part of a person’s normal and healthy moods during temporary periods. Brooding mood can be good and meaningful when it is triggered by an event that requires reflection and decision-making. A person takes the time he needs as an individual to become clear about his desires and needs and to regain direction. That he may feel depressed, sad and disoriented in the process is normal. The brooding mood fades in healthy people as soon as it has led to a result or as soon as the trigger of this mood changes or disappears.However, brooding can also become an increasingly frequent mood state and cause suffering. The affected person ruminates more and more frequently about increasingly insignificant things and notices for himself that this affects his basic mood and diminishes his sense of well-being. In these cases, they may be harbingers or indications of a possible depression. This means that brooding does not resolve on its own, as it does in healthy people, but either recurs or becomes a permanent condition. If this condition is not treated, it can continue – depending on what is behind the brooding. It may be the onset of depression or burnout, which will get worse if left untreated.
Prevention
To prevent obsessive thoughts and ruminations from arising in the first place, it is advisable to repeatedly look at one’s thoughts from a detached perspective. If questions such as “Did I understand something through ruminating that was not clear before?”, “Did I get closer to a solution through this?”, or “Do I feel less depressed through ruminating?” cannot be answered with “yes”, a ruminating compulsion is probably present. Recognizing such thinking patterns is the first step in being able to take appropriate action. Strengthening self-esteem and accepting the past as completed also remove the breeding ground for brooding.
What you can do yourself
In everyday life, occupation is a good way to avoid prolonged brooding. As a distraction, especially tasks that are at least a slight challenge for the head. This diverts attention away from brooding. One technique from cognitive behavioral therapy is the thought stop. This can also be applied well in everyday life. As soon as thoughts go round in circles and brooding begins, the person concerned interrupts himself with a “stop”. Depending on the situation, the word can be thought or spoken aloud. The aim of this measure is to interrupt the brooding and to recognize it as early as possible. In doing so, a significant improvement can usually be seen over time. Applied mindfulness also comes into question as a self-help for brooding. Mindfulness is based on the principle of consciously noticing one’s thoughts, emotions and physical sensations without judging them. If brooding occurs as a symptom of a mental disorder (for example, depression), self-help groups can also be a useful complement to therapy. In such groups, those affected exchange ideas, support each other and learn more about themselves and their problems. In addition, practical aids can make everyday life easier – for example, an alarm clock that interrupts long periods of brooding. Relaxation techniques from yoga or autogenic training also help to “switch off the head.”