Short answer: yes. Yes, depression can be treated. “I am happy that I found some…
Do you ever find yourself lost in rumination?
What I was 34 I fell in love with a fella at the place where I was doing some voluntary work.
I filled an entire A4 exercise book with my thoughts and feelings about this bloke, blow-by-blow accounts of what happened each time I saw him and what he said to me and how I reacted, minutiae of my feelings about what was happening, what had already happened, what could happen in the future.
On and on and on.
I was attempting to build a bricks and mortar business, out of money, volunteering at a refugee centre (which sounds very altruistic but was rather foolish as I had no money and should have been focussing on my business) and obsessing about this bloke.
I was depressed.
And I was doing something very dangerous.
I spent hours wallowing in my thoughts and feelings, and not only about that fella.
Day after day I moped and brooded, languished in my own misery, pined, grieved and generally felt very, very bad.
“Why didn’t I have any money? Why did I live in such a crap house? Why couldn’t I get more clients? Why was I always feeling just a bit panicked? Why was I always dissolving in tears? Why wasn’t I married? Why couldn’t I get a grip? Why was life so bad? What’s wrong with me? Why am I such a loser?
Why couldn’t I just feel better?”
On and on and on.
It’s a nasty, nasty habit which can lead to depression and can maintain our experience of depression over a long period of time. It’s a vicious cycle.
Let’s say you’re not depressed, but something has happened, an unpleasant situation at work, the stress of an illness, an unexpected accident of some kind. You’re feeling bad.
You begin to go over and over in your mind how this could have happened.
“I should have spoken up about it…I should have said…why did this happen to me? What did I do to cause this? Why is he so horrible to me? What if ….doesn’t get better?”
Your mood drops. You begin to feel consumed by this issue and it spreads to the way you feel about other aspects of your life and yourself.
But doesn’t everyone think about things that are going on in their life? Isn’t it normal?
Yes, it’s absolutely normal to think through problems. Our marvellous brains use thinking processes to help us sort through problems and find solutions. We use our cognitive abilities to consider different aspects of a difficult situation and decide on different methods and approaches which we believe might help.
In non-depressed people, thinking is used to find solutions, or to work towards solutions which for complex problems may take weeks or months, but we use our cognitive skills to set goals and set action plans to move towards those solutions.
In depressed people, the amount of value generated through rumination is quite low. Rumination does not push us to identify solutions. Rumination is fixation on the problem as a problem, not as a challenge which needs a solution.
Rumination is quite disempowering. We flounder, lost and drowning in our own thoughts. Our thinking is not clear, logical or solution-focussed. We are lost in the emotion of the situation, unable calm our feelings so that we can concentrate to finding a way out.
Rumination is quite generalised and abstract.
We may ruminate on past events and conversations, going over and over not only what happened or what was said, but also on what we believed was meant by the other person or event.
For example, a colleague did not spend the usual few minutes chatting with you in the tea room. You decide it means they no longer like you, that you are not worth knowing, that you are horrible, that maybe nobody likes you at work, that you are doing a bad job, that maybe they are going to sack you, and so on.
Maybe your colleague was just running late for a meeting and intended to chat with you at lunch time.
We may ruminate on our low mood. How did I get like this? Why can’t I get moving in the morning?
We may ruminate about our Selves, our character and our perceived flaws. Why am I such a loser? I’m hopeless, pathetic, no-good, useless, waste of space.
Parts of the brain which are involved in rumination are the prefrontal cortex, amygdala, and the anterior cingulate. Studies have shown that these regions of the brain are active when we ruminate.
The prefrontal cortex is the centre of brain’s planning and decision-making circuit and is a large region that sits behind the forehead. Our motivation and decision-making originate in the prefrontal cortex.
However, when we are experiencing chronic and profound despair, it is also a source of problematic thinking such as worrying, guilt, shame, indecisiveness and ‘fuzzy-headedness’.
The amygdala and anterior cingulate are part of the limbic system and are located deep in the brain. This is the brain’s emotional centre and is where feelings such as excitement, fear, anxiety, memory and desire emerge. In particular, the amygdala is responsible for anxiety and the anterior cingulate is concerned with focus and our ability to pay attention.
You can see how, when you have a very low mooc, an overly active amygdala will create a very emotional reaction to a situation, and problems with functions in the prefrontal cortex with affect how clearly you can make decisions.
In 2010, researchers at Stanford University looked at the difference in activity in the brains of people who had been diagnosed with depression and those who were not depressed. The participants were asked to think about different topics, such as ‘What people notice about my personality’, ‘a row of shampoo bottles on display at the supermarket’.
The first question was designed to cause rumination. Pondering this question produced greater activity in the anterior cingulate cortex, amygdala, and prefrontal cortex of the people with depression than in the non-depressed participants.
What that means is that the rumination of emotionally disordered people is quite an emotional activity rather than logical or solutions-focussed. Also, the increased activity in amygdala mean that those emotions tend to be negative. Finally, malfunction in the prefrontal cortex means that decisions around problems are difficult to reach.
The regions of the brain need to be exercised to maintain their effectiveness. To engage the prefrontal cortex in a positive way, we need to practice decision-making, which of course is quite difficult in chronic low mood because rumination gets in the way. “What’s the right thing to do? I can’t even think straight let alone make decisions”.
Depending on the subject of your rumination, make a decision to find out if what you’re thinking is actually true or not. Recall the example above in which your work colleague didn’t stop to chat at the water cooler or staff kitchen.
Could you decide that next time you see your colleague you give him or her a big smile and ask how they are? Don’t mention how their behaviour affected you. You are just testing your theory that they don’t like you anymore. If your colleague returns your greeting warmly, you have just proved yourself wrong and short-circuited the negative emotions in your brain.
The first step in stopping ruminating is to notice when it’s happening. Set an alarm to go off, say, every 30 or 60 minutes. Sit for a short time and reflect on what you have been thinking about. Were you ruminating?
Then, take action to distract yourself from that train of thought. Take a deep breath, practice mindfulness, go for a walk and observe what you see around you, have a chat with a friend or do some exercise.
Ruminating is a dangerous downward spiral into low mood and depression. It can keep you down. Stopping rumination is a very powerful and essential strategy in feeling better.
Start noticing your rumination habit and make defeating it a priority today.
 Cooney, RE, Joormann, J, Eugene, F, Dennis, E and Gotlib, IH, “Neural correlates of rumination in depression”, in Cognitive and Affective Behavioural Neuroscience. 2010 December ; 10(4): 470–478. doi:10.3758/CABN.10.4.470.
If you'd asked her 15 years ago if she believed life could be a wonderful as it is today, Vickie would have answered, 'I just don't know, but it doesn't seem likely.' Now she knows that if she can turn her life around, it's possible for you too. Ask Vickie how she can help you design the life you'd really love to live and say goodbye to depression forever.