How Rumination and Obsessive Thoughts Are Linked to Anxiety and Depression

Rumination and obsessive thoughts can send you on a negative spiral where the only place to go is down. Here's what you can do.

It’s normal to stew over things from time to time. To replay that conversation you had with your boss in your head. To still be mad about that thing a stranger said to you. To reel with embarrassment because you said something you shouldn’t have.

Sometimes, though, these thoughts can tip into the obsessive and put you on a hamster wheel of negativity. It’s called rumination.

What is rumination?

Rumination is a mind that spins—and often into catastrophic thinking.

“Rumination isn’t just thinking a lot about something,” says Stephanie Parmely, a behavioural health psychologist with Dignity Health in Folsom, California. “It’s akin to a cow chewing cud. You’re wrestling over and over again with a thought that tends to be negative.”

Getting lost in this sort of negative brain swirl is related to low levels of the neurotransmitter GABA. The presence of GABA in the hippocampus in your brain inhibits unwanted obsessive thoughts, says Parmely.

Of course, we all have intrusive thoughts on occasion, but pay attention to how often they’re hijacking your thinking patterns and how much mental space they’re taking up. “I don’t think healthy people ruminate a lot,” she adds. “If it happens continually, that’s possibly a symptom of a mental health problem.”

(Related: How to Know If Your Anxiety Is “Normal”)

5 situations in which rumination may take hold

1. You can’t let go of something trivial

It doesn’t matter what it is, but it’s really not that important. And yet, you can’t let it go.

“This is a function of some stress in your brain that’s making it hard to inhibit thoughts,” says Parmely. This, in turn, feeds anxiety. “When you entertain thoughts, it reinforces the connections in your brain that allows those thoughts to happen,” she adds.

2. Did you turn off the stove?

Intrusive thoughts about whether you did or didn’t turn off the stove (and then continually worrying or checking that you did) falls under an obsession that’s identified with obsessive compulsive disorder (OCD), says Thea Gallagher, assistant professor with the Center for the Treatment and Study of Anxiety in the Perelman School of Medicine at the University of Pennsylvania in Philadelphia.

Once in a while if you fret about turning off the stove (or locking your front door or closing your garage), that’s normal. But obsessions are problems when they interfere with your life and activities you like to do, according to the International OCD Foundation.

3. You said something offensive

Maybe you were an insensitive jerk to your friend. But maybe you weren’t. Rumination might mean continually replaying that conversation in your head, thinking about what you should or shouldn’t have said, and how that would have changed the outcome—and scolding yourself for it.

Face the source of these thoughts and you’ll quiet them down, says Gallagher, who uses exposure therapy as one way to deal with anxiety.

“If you feel like you did something wrong, go to the source and ask,” she advises. If someone says that what you said did not bother them, then consider that your interpretation of the situation may be unduly harsh.

These thoughts may stem from social anxiety disorder. A type of anxiety that arises during social situations,  it’s characterized by fears of humiliation, judgment, or rejection, according to the National Institute of Mental Health. In this situation, it’s important to challenge your beliefs.

“Even though you may think people are thinking about you in a negative way, that’s not the case,” says Gallagher.

4. You wake up worried

Morning anxiety is real. Rumination may actually be a bid for productivity or a tool to help you figure something out, says Gallagher. “But ruminating is a spiralyou don’t get anywhere except down.”

Often this involves worrying about things you can’t control (or expecting the worst) either in the day ahead or far in the future, which only worsens anxiety or depression.

5. Someone said something rude to you

If you’re triggered by a rude comment from your boss, a family member, friend, or someone on social media, stop to think about the deeper reason behind the mental replay, suggests Gallagher. For instance: Do you feel taken advantage of by people?

Once you’ve identified that, you can think about what, if anything, you want to do about it. Do you want to confront your sister but are normally conflict-avoidant?

“Either push yourself to do something about it or radically accept the situation for what it is and move onto something else,” she says.

Again, this takes practice and perhaps a professional to help you develop the skills to tackle problems head-on, or move on.

(Related: How to Stop Worrying and Have a Happier Life)

Strategies for managing rumination and obsessive thoughts

When you find yourself overcome by obsessive thoughts or caught in a pattern of rumination, here’s what you can do:

Focus on what you can control

Is there something that you can do to take action? Doing that will help reduce your anxiety because it may help resolve the situation. If it’s completely out of your control, try accepting the uncertainty. This is far harder than it sounds, and so connecting with a therapist can help give you the tools to do this.

Maintain perspective

Depression is about the past, while anxiety is rooted in what can happen in the future, says Gallagher. If you’re ruminating over what could be in the future or stewing in the uncertainty of the unknown, she recommends thinking about the worst-case scenario, the best-case scenario, and the middle ground.

Try mindful meditation

A stronger prefrontal cortex will help you tune out things you don’t want to think about, says Parmely. Mindfulness meditation exercises your brain to help buffer it against obtrusive, distracting thoughts, as well as foster acceptance.

Distract yourself

Start thinking with a different part of your brain. Mindfulness will help with this, but so will other activities like colouring, knitting, crocheting, or taking a walk, says Parmely.

Start a math problem

Crunching numbers in your head will get you out of the emotional part of your brain, says Parmely. And the math problems don’t have to be complicated. Add 2 plus 2, 4 plus 4 (and so on). Or try a series of subtractions such as 100 minus 7, 93 minus 7 (and so on).

Stand on one leg

The cerebellum is the part of your brain that senses balance and it can get you out of the running thoughts in your head, says Parmely. Stand on one leg or try a yoga pose. A 10-minute yoga routine every morning can help you start off the day in a more mentally balanced mindset.

When to seek help

If you feel like you can’t control your thoughts and the coping skills above aren’t helping with rumination or obsession, consider talking to a therapist, suggests Parmely. Treatment may include cognitive behavioural therapy, support groups, anxiety medication, or antidepressants.

Next: 3 Tips to Help You Cope With Covid-19 Anxiety

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Originally Published on The Healthy