Ruminations in depression as an avoidance coping

One of the main features of depression is negative cognitions about self.  It is common for us to see people in a depressive episode to engage in continuous negative thought process.  They sometimes told us that they were unable to stop themselves from this thinking mode even they knew that it was not conducive to their recovery process.  One of my clients was in a depressive episode and he kept thinking about his family members and friends were distancing from him.  He claimed that he did not receive any phone calls or text messages from his family and friends for one month.  He felt being isolated and abandoned.  Due to his continuous thinking about the possibility of his contacts disliking him and the likelihood that he might have done something wrong in interpersonal relationships, he started to engage in a downward spiral of thoughts about himself being a failure and his future being lonely and gloomy.  As a result, he avoided initiating connection with his family members and friends.  He kept thinking that they might reject him if he invited them out for gatherings.

One of the possible functions of ruminations in depression is avoidance.  It is possible that ruminations, though unpleasant in itself, may serve as a strategy to avoid what the person considers an even more aversive consequence.  The client above might use rumination to avoid overt action of contacting his family members or friends.  This serves as a function of avoiding the possibility of being rejected or facing his unwanted personal characteristics, such as being quite arrogant in the past when he was very successful in his career.  This also prevents him from facing the possible less than satisfactory outcome of initiating gatherings with his contacts due to various reasons.  For example, he might find out his group of friends had gatherings themselves without inviting him in the current one month and feel upset about comparing interpersonal satisfaction of his friends and himself.  In this case, he might realise that due to some of his personal characteristics, his group of friends are not so close to him.

If people in depressive episodes engaged in continuous thinking process about negative aspects of the situations or themselves, this might prevent them from handling the core problems of the situations.  This avoidance lowered the chance of these people to fix the problems and obtain a more favourable outcome of the situations.  This might also prevent the exposure to new information about the situations that might disconfirm ones’ hypothesis or enhance ones’ learning.  For instance, if the client above reached out to initiate gatherings with his friends, he might find out that many of his friends are busy with taking care of their children during summer holiday and they did not have the time to host a gathering for meeting those without children.  Furthermore, as they thought that my client was busy with his work and very capable in his career, they might feel intimidated sometimes to socialize with him.  His friends might also tell him that they also wanted to meet him as it was insightful to talk to him sometimes given his knowledge and wisdom.

The downward spiral of thinking of people with depression also causes the individuals to focus on his own thoughts and internal state.  This prevents them to have direct contact with ones’ environment and engage in obtaining new information of the situations.  To step out from ones’ ruminations, it is important for us to have the realisation that we are engaging in it.  We can enhance this self-awareness by practicing mindfulness meditation regularly.  When we are being aware of our ruminations, we may be able to step out from it by engaging in overt actions to face and analysing the problems we are facing.  Once we know that we are avoiding by ruminating during our depressive episodes, we can choose to let go of the avoidance and face the reality for a more favourable outcome.

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