Rumination and Mental Health

Ruminating is when you repeatedly go over and over things from your past. It’s a bit like your mind continuously pressing replay on your past; it keeps going on and on and on. I guess you could say its obsessive thinking. It would be lovely if those thoughts going around and around in our minds were positive, but unfortunately, it’s all those negative events, or things we would have preferred to happen differently, that we ruminate or obsess over.

What’s the Difference Between Worry and Rumination?

Worry focuses on the future, tends to use “what if” type thoughts, and we feel anxious or afraid. For example, “What if people don’t like my speech” or “What if I make a fool of myself”. Whereas rumination focuses on the past, involves “I should have” or “if only” type thoughts, and we feel guilt or remorse.

Is Rumination Normal?

To some extent everyone ruminates or dwells on problems or concerns they have with work, relationships, and life in general. Thinking about our problems can be helpful especially if we reach a solution and put it into action. Hence for most people, ruminating is time-limited, it stops when they have solved their problem. However, excessive use of rumination can become problematic.

Unhelpful Rumination

Rumination tends to focus on what has gone wrong in the past and can lead to negative thinking. It can become a fast track to feeling helpless as it paralyses problem solving skills. We become so preoccupied with the problem that we’re unable to push past our cycle of negative thoughts. Unhelpful rumination tends not to be solution focused. Instead it focuses on causes and consequences e.g. “What did I do to deserve this”; “Why do these things always happen to me” and “Will my life get any better?” Instead of “How can I make my life better?”. When people who are depressed ruminate, they remember more negative things that happened to them in the past, they interpret situations in life more negatively, and they feel more hopeless about the future.

Stopping the Rumination Cycle

The first step to gaining control over rumination is to recognise when it happens. Once you think you may be ruminating, continue what you’re doing for two minutes, then stop and ask yourself three questions:

1. Am I making progress toward solving a problem?

2. Do I understand more about my problem or my feeling?

3. Do I feel less self-critical, or less depressed than before I started thinking about this?

Unless the answer to one of these questions is a clear yes, chances are you’re ruminating. Once you catch yourself rumination, try and get some distance from your thoughts. The simplest way to do this is by saying to yourself “I notice I’m ruminating about …”. Gaining distance from your ruminating thoughts will be difficult at first, especially if you are and excessive ruminator. However, like anything, the more you practice, the easier it becomes.

Take the time to notice what’s around you (ground yourself), using your five senses, when you catch yourself ruminating. What can you see, touch, hear, smell, and, taste? You can also use your rumination as a cue to do get active. For example, if you catch yourself ruminating while driving, turn on the radio and start singing. It’s very difficult to ruminate while you are singing. You could also use rumination to cue you to read a book, exercise, garden or watch a movie.

Sleeping Well

Are you having trouble falling asleep, getting back to sleep or having difficulty getting up in the morning? If so, you are not alone. Approximately 35% of people report their sleep as ‘poor’ or ‘only fair’.

The benefits of getting a good nights rest are endless. Sleep is associated with having a better mood, lower levels of anxiety and depression, better skin and physical health, as well as improved concentration and driving ability.

On the flip side, having ongoing difficulties with sleep is associated with some pretty nasty consequences. These include memory problems, moodiness, depression, hallucinations and increased risk of type 2 diabetes, high blood pressure and heart disease.

Fortunately, there are several steps you can take today to improve your sleep:

No Napping

Napping in the day may be satisfying at the time, but often means that you aren’t tired enough to go to sleep at night. Consequently you go to bed late despite the need to get up early for work or school. The next day you may feel exhausted, take a nap, and the cycle continues. The most useful thing you can do to improve your sleep is to get up at the same time each day and to stop napping. Within a few weeks your sleep pattern will improve. If you feel tired then splash your face with water or go outside and stand in a cool breeze. If you have to nap make sure it is before 3pm and less than an hour.

No Caffeine After 3pm

Did you know that although caffeine’s strongest effects are felt 30 minutes after drinking it, it takes 6 hours to leave your system? In fact, research shows that consuming caffeine less than 6 hours before bed reduces sleep by one hour. Caffeine can affect how long it takes to fall asleep and how many times you wake up a night. Remember that caffeine doesn’t just mean coffee. It also includes caffeinated drinks (coke, energy drinks), dark chocolate and some teas (black, green or white tea).

Avoid Watching the Clock

Checking the clock when you are having trouble falling asleep can cause anxiety. You may have thoughts like ‘I’ve been awake for 2 hours now and only have 4 hours till I have to get up!’’. This can make it harder to fall asleep. Remove or cover any clocks in your room at night and keep your phone out of arms reach.

Restrict Use of Technology Before Bedtime

When it starts to get dark, our bodies begin to produce melatonin, which makes us feel sleepy. Often the light from technology(often called ‘blue light’) can disrupt this production of melatonin as it tricks your brain into think it’s still daytime. If you need to use your phone in the evenings, make sure you turn down the brightness and use an app that filters out the ‘blue light’ your phone emits.

Write Down Your Worries

Due to our busy lives, often the time when worries come to surface is at night. Instead of letting worries go round and round in your head like a washing machine, write down your worries as they arise and set aside 30 minutes each day to work through and problem solve them (e.g. at 7 pm in the evening). Make sure you limit your worry period to 30 minutes or less, and that you reward yourself after your worry period (e.g. eat your favourite food or watch your favourite TV show).  It should be noted that excessive rumination (dwelling or worrying about negative events) can be a symptom of depression or anxiety. If you feel this may be the case, it is important to speak to your GP about seeing a psychologist to help you cope.

Remember that that if you have had difficulties sleeping for a number of years, it will take a few weeks or months of adhering to the above advice for your sleep patterns to change. You’re re-training your brain and body. The good news is if you follow the advice mentioned above, it is possible to change negative sleep patterns for good.

Breathing For Anxiety

Often when a person experiences anxiety they notice changes in their breathing.

These changes can include breathing faster, feeling a tightening or pain in the

chest area and feeling dizzy or light-headed.

When we breathe, we breathe in oxygen and breathe out carbon dioxide.

Typically the average person takes about 10-12 breaths a minute. How many

breaths per minute do you take? Set a timer on your phone or laptop, try not to

change your breathing from normal and then count your breaths. One breath is

counted as breathing in and out.

If you’re breathing more than 10-12 breaths per minute you may be subtly

hyperventilating. When we breathe too much air in, the balance between oxygen

and carbon dioxide becomes disturbed. We end up with too much oxygen and

too little carbon dioxide.

If you’re breathing more than 10-14 breaths per minute you may be subtly hyperventilating.

This reduction in carbon dioxide signals to our blood vessels that they are

getting more oxygen then they need. The blood vessels try to help us by

constricting and narrowing so that we don’t get too much oxygen in our brain. A

side effect of this narrowing of the blood vesicles in the brain is that we feel

dizziness or light headed. You may feel like you cannot get enough air in. In fact,

the problem is you have too much oxygen. Although this feeling is unpleasant

and intense, it is completely harmless.

Although for the most part breathing is automatic, the good news is we can also

control it consciously. For instance, think about the fact that you can hold your

breath whilst underwater. The unpleasant (but harmless reaction) will go away

once the levels of oxygen and carbon dioxide are rebalanced.

The following strategies can be useful for reducing hyperventilation:

Thriving During Year 12

Does the beginning of the school year fill you with excitement or dread?

Especially for those in Year 12, many students can find the prospect of their final year overwhelming. So many of my patients fit in this category, but I'm always excited when Year 12 students come in to see me at the start of the year. That way, we can work together to set them up in a way that not only protects their wellbeing, but sets them on a path to thrive.  

High school pressure can be too much at times. If you, your child, or someone you know is struggling to cope, let them know that there is help available.

Here are 5 Top Tips for Making the Most out of your Final Year at School:

Dr. Amanda Hale is the Principal Clinical Psychologist in a team with offices in Bondi Junction and Killara. The practice specialises in working with children and adolescents, using evidence-based techniques and client-centred care to maximise wellbeing.