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Rumination: A Maladpative Coping Style that Fosters Depression


Rumination is a maladaptive style of responding to stressful situations in which a person repetitively and passively focuses on the symptoms of distress and the possible causes and consequences of these symptoms. Ruminators mistakenly believe that by focusing on their past feelings, they can somehow have a better understanding of their emotions and this will help them solve their problems. The opposite is true: rumination makes people more fixated on their problems and feelings without leading to any active problem-solving to change the circumstances around these symptoms. Research shows that women are more likely to engage in rumination compared to men, which also makes them more prone for depression (Nolen-Hoeksema et al., 2008). Rumination fosters inactivity and can come in the way of getting things done. Many people confuse rumination with worry, but these two entities differ in the following ways (Lyubomirsky et al., 2015):
  1. Rumination is focused on the past while worry is focused on the future.
  2. Rumination revolves around themes of loss, meaning, and lack of self-worth whereas worry revolves around anticipated threats.
  3. Rumination involves viewing events as certain and uncontrollable while worry involves viewing events as uncertain and potentially controllable.
  4. Ruminators seek to gain insight while worriers seek to anticipate and prepare for anxiety.
To illustrate this difference, a person thinking about what went wrong at a meeting and trying to figure out the reasons for it is ruminating. In contrast, a person thinking about how they are going to prepare for a meeting and whether they are going to deliver during the meeting is worrying.

Rumination is an avoidance behavior that predicts the onset of depression and maintains and exacerbates it (Nolen-Hoeksema et al., 2008). It builds a case for a depressed person that they are facing a hopelessly uncontrollable situation and, therefore, they are not able to take action to overcome the situation. Compounded by irrational thought patterns such as jumping to conclusions, disqualifying the positives, or blowing things out of proportion, rumination makes a depressed individual come up with evidence that only supports why a certain situation is hopeless and that they might as well give up. This then provides them with a justification for inactivity and withdrawal because working on the solution for the situation is more painful than avoiding it (Nolen-Hoeksema et al., 2008). Other ways by which rumination worsens depression is by interfering with problem-solving abilities, reducing motivation to implement solutions, and by reducing social support (Lyubomirsky et al., 2015).

A related psychological construct is co-rumination. Co-rumination involves extensive self-disclosure between peers and rehashing the negative causes, implications, and feelings around problems. Although the discussion in co-rumination may encompass stress in an individual's life, what makes co-rumination a maldaptive style is that this communication is void of neutral or positive topics or activities. This in turn leads to people internalizing stress (Rose, 2002). Similar to rumination, research suggests that co-rumination is related to depressive symptoms and children with a higher level of co-rumination are more likely to have a diagnosis of a depressive disorder (Stone et al., 2010).

To summarize, rumination is a well-established risk factor for the onset of depression and also tends to make it chronic. There are proven techniques that target rumination and Mindfulness-Based Cognitive Therapy (MBCT) is one such modality. 

To learn more about evidence-based self-management techniques that promote mental health and well-being, check out Dr. Duggal's Author Page.

HARPREET S. DUGGAL, MD, FAPA

REFERENCES

Nolen-Hoeksema, S., Wisco, B. E., & Lyubomirsky, S. (2008). Rethinking rumination. Perspectives on Psychological Science, 3(5), 400-424.

Lyubomirsky, S., Layous, K., Chancellor, J., & Nelson, S. K. (2015). Thinking about rumination: the scholarly contributions and intellectual legacy of Susan Nolen-Hoeksema. Annual Review of Clinical Psychology, 11, 1-22.

Rose, A. (2002). Co-rumination in the friendships of boys and girls. Child Development, 73, 1830-1843.  

Stone, L. B., Uhrlass, D. J., & Gibb, B. E. (2010). Co-rumination and lifetime history of depressive disorders in children. Journal of Child and Adolescent Psychology, 39(4), 597-602.

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