What Is Rumination?

Medically Reviewed By Jeffrey Ditzell, DO
Was this helpful?
0

Rumination is a pattern of repeated negative thoughts that are hard to change and that can worsen cooccurring psychiatric conditions. The thoughts that result from rumination are typically intrusive and can make it difficult to engage in treatment. However, effective treatment is available, and it can help you manage your rumination.

This article will further define rumination. It will also discuss the symptoms, causes, and treatments for the condition.

What is rumination?

Female sitting in front of a pink background thinking
Guille Faingold/Stocksy United

Rumination is a persistent pattern of thought that is generally negative, intrusive, and difficult to change. A person with rumination may view these negative thoughts as the truth, even if they are not.

People with rumination often feel trapped in a spiral of negativity that they cannot escape. Thinking continually about a negative emotion or concern increases the negative emotion, which increases negative thoughts. This all results in a cycle that can become an entrenched pattern.

Rumination is a risk factor for developing or worsening other mental health conditions, like depression and anxiety disorders.

When you experience rumination, you may direct it toward yourself, and it may cause feelings of worthlessness and a negative self-image. However, you may also direct it toward other people or institutions, resulting in anger or aggressive behaviors.

If you have rumination or any related conditions, working with your mental health professional is especially important. Rumination itself is not typically an emergency, but it can have a connection to suicide, self-harm, and violence.

If you are having suicidal or self-destructive thoughts or behaviors, get emergency treatment immediately.

If someone you know is at immediate risk of harming themselves or others, or at risk of suicide: 

  • Ask the question, “Are you considering suicide?” even if it is tough.
  • Listen without judgment.
  • Call 911 or your local emergency number. 
  • Stay with them until emergency services arrive.
  • Try to remove any weapons, medications, or other potentially harmful items.

If you or someone you know is having suicidal thoughts, contact the National Suicide Prevention Lifeline:

  • Call 800-273-8255 (or 988 after July 16, 2022).
  • Chat with the lifeline.

This service is available 24-7. 

What are the symptoms of rumination?

Symptoms of rumination may include:

  • unwanted, intrusive, and persistent negative thoughts about personal problems, concerns, or experiences
  • impaired daily living functions such as sleep disturbances
  • history of other mental health conditions connected to rumination, such as anxiety, depression, bipolar disorder, or schizophrenia
  • history of self-destructive behaviors such as self-harm, eating disorders, substance misuse, or suicide attempts
  • history of aggressive behaviors such as bullying, violent acts, or property destruction
  • lack of active coping strategies or problem-solving behaviors

Click here to read 9 surprising facts about anxiety.

What causes rumination?

Both environmental and biological factors may cause rumination.

Examples of environmental factors include a childhood abuse history, peer bullying, or poverty. People who receive negative messages about their value or abilities from others can internalize those messages and ruminate on them.

Examples of biological factors include biological relatives with mental health conditions, sex hormone concentration, and genetic mutations that affect serotonin levels.

What are the risks of rumination?

Because rumination is both persistent and intrusive, it is a risk factor for other mental health conditions. These conditions can lead to self-destructive and maladaptive coping strategies like self-harm, suicidal behaviors, and substance misuse.

Anger rumination is a form of rumination that can contribute to antisocial behaviors such as violent crimes and cyberbullying.

H-EX-A-GO-N model

The H-EX-A-GO-N model suggests that certain characteristics of the mind may underlie rumination. These are:

  • (H)abit: This is when repeated patterns of thought become habits.
  • (EX)ecutive function: This is a decreased ability to regulate one’s own body, impulses, and emotions.
  • (A)bstract processing: This is a lack of understanding of important concepts, such as the relationship between rumination and mental health.
  • (GO)al discrepancies: This is when you have difficulty participating in treatment programs due to a “what is the point?” mindset.
  • (N)egative bias: This is when you have feelings of hopelessness and powerlessness.

These factors can make therapy challenging, since changing the mind’s habits requires both a commitment to work through the treatment plan and an ability to see that positive change is possible.

Cooccurring disorders

Rumination may occur alongside many mental health conditions. These include but are not limited to the following:   

Click here to read about 7 symptoms never to ignore if you have depression.

When should you contact a doctor for rumination?

If you feel trapped in a cycle of rumination and it makes you feel worse, or if someone you are close with recognizes that you have rumination symptoms, contact your doctor or mental health professional.

Certain conditions associated with rumination are emergencies and require immediate care. These include:

  • experiencing suicidal ideation
  • attempting suicide
  • harming or wanting to harm someone else
  • engaging in animal cruelty
  • destroying or wanting to destroy property violently

Some conditions associated with rumination are not urgent but may require care sooner rather than later. These include:

  • engaging in uncontrolled nonsuicidal self-injury or substance misuse
  • having increasing feelings of distress related to persistent negative thoughts
  • experiencing problems in relationships, employment, or education settings that disrupt personal or employment security

What are the treatments for rumination?

Treatments for rumination include:

  • Mindfulness-based cognitive therapy: This is a technique that combines mindfulness with techniques of cognitive therapy over an 8-week period.  It may decrease intrusive thoughts and reduce rumination.
  • Replacement of maladaptive beliefs: An example of this is when a 2020 study showed that beliefs such as “I can’t control my thoughts” resulted in increased anger rumination.
  • Compassion-focused therapy: This involves therapeutic techniques that may help promote feelings of compassion, kindness, and warm acceptance of oneself.

Self-care tips to manage rumination

Managing rumination requires conscientious self-care, but there are some ways you can help break the cycle of rumination. These tips include:

  • Distract yourself with activities that will take your mind off the negative thoughts and help you focus on positive ones instead.
  • Regular exercise and physical activity can help refocus your mind, especially when done in an environment that helps promote positive ideas and thoughts.
  • Deliberately focus on times when things went right or worked out despite challenges.
  • Try to separate large issues into individual smaller ones and find the distinction between your troubles in general. This way you can focus on one issue at a time.

Work closely with your mental health professional for other ways you can help manage your rumination.

Summary

Rumination is a repetitive pattern of negative thoughts that interferes with your daily activities. It may increase your risk of experiencing or worsening mental health conditions.

Treatment for rumination does exist, however. You and your mental health professional can work together to manage your rumination. You can do things independently to help manage rumination as well. Managing rumination will help you to minimize its negative effects.

If you experience rumination, or have concerns about it, contact your doctor or mental health professional.

Was this helpful?
0
Medical Reviewer: Jeffrey Ditzell, DO
Last Review Date: 2022 Jun 10
View All Mental Health and Behavior Articles
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Cladder-Micus, M.B., et al. (2019). Effects of mindfulness-based cognitive therapy on a behavioural measure of rumination in patients with chronic, treatment-resistant depression. https://link.springer.com/content/pdf/10.1007%2Fs10608-019-09997-8.pdf
  2. Coleman, S.E., et al. (2021). The relationship between rumination and NSSI: A systematic review and meta-analysis [Abstract]. https://bpspsychub.onlinelibrary.wiley.com/doi/10.1111/bjc.12350
  3. Horwitz, A. G., et al. (2018). Rumination, brooding, and reflection: Prospective associations with suicide ideation and suicide attempts. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726493/
  4. Hosie, J., et al. (2022). A study of the relationships between rumination, anger rumination, aggressive script rehearsal, and aggressive behavior in a sample of incarcerated adult males. https://onlinelibrary.wiley.com/doi/10.1002/jclp.23341
  5. Hosseinichimeh, N., et al. (2018). Modeling and estimating the feedback mechanisms among depression, rumination, and stressors in adolescents. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6160072/
  6. Kovacs, N. K., et al. (2020). Rumination in major depressive and bipolar disorder — a meta-analysis. https://www.sciencedirect.com/science/article/pii/S0165032720325842
  7. Palmieri, S., et al. (2021). Repetitive negative thinking and eating disorders: A meta-analysis of the role of worry and rumination. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8198834/
  8. Rumination: A cycle of negative thinking. (2020). https://www.psychiatry.org/News-room/APA-Blogs/Rumination-A-Cycle-of-Negative-Thinking
  9. Salguero, J. M., et al. (2020). Individual differences in anger and displaced aggression: The role of metacognitive beliefs and anger rumination [Abstract]. https://onlinelibrary.wiley.com/doi/10.1002/ab.21878
  10. Sansone, R.A., et al. (2012). Rumination. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312901/
  11. Savari, Y., et al. (2021). A preliminary investigation on the effectiveness of compassionate mind training for students with major depressive disorder: A randomized controlled trial [Abstract]. https://www.semanticscholar.org/paper/A-Preliminary-Investigation-on-the-Effectiveness-of-Savari-Mohagheghi/8f2335fffeda9906162fa09063ab8a2bf7e25e90
  12. Tousignant, O. H., et al. (2018). Rumination and sleep [Abstract]. https://www.sciencedirect.com/science/article/abs/pii/S0005789418301163?via%3Dihub
  13. Watkins, E.R., et al. (2020). Reflecting on rumination [Abstract]. https://www.sciencedirect.com/science/article/abs/pii/S0005796720300243?via%3Dihub