Why do people with depression cannot stop ruminating?

Rumination is actually common for most people when we face difficulties, challenges or crisis.  For instance, when we face an unexpected termination of a job, a coming meeting with an aggressive person or a sudden death of our loved one.  In fact, dwelling on these could help us to come up with strategies and plans to cope and come to term with the loss.  It is a way for us to make sense of an event or to come up with a solution of a problem.  However, when we have unrealistic expectations and do not want to abandon our unattainable goals, we may ruminate excessively and cannot leave the vicious cycle of dwelling on the issues or the event.

For example, a client of mine with chronic mild depressive mood tended to ruminate about her procrastination of starting to write her dissertation.  She kept criticizing herself for procrastinating and kept thinking about the possible shame she might need to face if she failed to write a perfect dissertation.  She had unrealistically high expectation on her academic performance.  She told me that, “I want to rank the first among all those who get first class honour in our class.”  As her goal was very difficult to attain because she was studying in a very prestigious university, her fear of failure caused her to have severe procrastination and frequent ruminations about her self criticism and possible catastrophic consequences.  Furthermore, she also had great difficulty in abandoning her unrealistically high goal.  As a result, her rumination became her way of avoiding the risk of facing actual failure for not ranking first in her class.  The more she cannot abandon her goal, the more she ruminated about all the possible consequences, such as being humiliated by her classmates for not being able to rank the first in class.

This example illustrated rumination as a form of avoidance.  For those who ruminate in a concrete and problem-solving mode, rumination may not be considered as an avoidance, as it may lead to further execution of an action or a plan.  For those who ruminate in abstract and evaluative thinking, rumination becomes maladaptive and unproductive.  For instance, the client above ruminated about the possible humiliation she might face and about herself being a failure if she could not rank first in class, it is more likely that she may not be able to come up with a constructive solution or an action plan for writing her dissertation.  She may be stuck in chronic mild depressive mood due to her ruminative habit.  The more she ruminated, the less likely that she got started with her writing.  This led to a vicious cycle of being trapped in a depressive mood and a procrastination mode.

Avoidance is only one of the possible functions underlying persistent rumination in people with depression.  If someone you know seemed to be trapped in his or her rumination due to avoidance, it is useful for him or her to reflect on one’s unrealistic expectations and unwillingness to abandon such expectations.  It is useful to ask oneself, “Is my goal unrealistically high?” or “Is my goal unrealistic?”  If the answer is yes, it is important for us to ask ourselves if our persistent rumination could lead to useful decision or plan.  If not, we better learn to let go of our rumination and make some concrete plan and feasible solutions.  It is also important for us to learn to face the reality and abandon our unrealistically high expectation on ourselves.

To step out of our persistent rumination is easily said than done.  For those who had difficulty in letting go of the rumination, practicing mindfulness meditation may be one of the useful way to help ones to detach from those ruminative thoughts.  In fact, the non-judgmental and accepting stance of mindfulness could also help ones to let go of the unattainable goals and unrealistic expectations.  If you or your loved ones had persistent difficulty in letting go of ones’ ruminations, it may be beneficial to seek professional help.

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