Break the cycle

If you've ever gone through your day with a song running through your head, you know those "earworms" can be either amusing or annoying. But when a single intrusive thought is circling round and round, that's called rumination — and it's seldom pleasant.

An endless repetition of a negative thought or theme that spirals downward, tanking your mood, rumination often involves replaying a past scenario or conversation in your head or trying to solve a maddening problem. "I think it's quite common, and some people do it all the time — like picking a scab," says Dr. Jacqueline Olds, a psychiatrist at Harvard-affiliated Massachusetts General Hospital.

But rumination isn't harmless. It can disrupt your ability to get things done and can even damage your psychological or physical health. "Rumination is like getting stuck in a conversation with yourself," Dr. Olds says.

Triggers and consequences

Almost no issue, large or small, is off-limits for rumination. We might go in a mental circle if we believe we've made a mistake, looked foolish, said something wrong, or been responsible for a bad outcome.

"Maybe you have a conversation where everything seems to be going well, but when you go home, you think, 'Why did I say that?' You go over and over some minute incident that no one else probably even noticed, and blow it all out of proportion," Dr. Olds says.

Those feelings then dig in deeper. "You start thinking, 'I have no social sense. I'm always putting my foot in my mouth, and now I've probably alienated people for life.' Basically, you feel horrible about yourself," she adds.

By far, however, people who ruminate continue to do so because they feel they'll gain hoped-for insight into a vexing problem. In essence, your brain is tricking you into believing you're figuring out something useful. But it's usually a trap: thinking endlessly about a problem often doesn't solve anything — it just proves exhausting, stealing your focus from things you'd rather be doing.

"It's just harder to navigate your way through life," Dr. Olds says. "Every day we have about a hundred decisions thrown at us. If someone is ruminating too much about every single thing, it slows them down and makes them have trouble with life's ordinary problems."

Mental and physical ramifications

Rumination isn't a psychological disorder in itself, but it can pose or be linked with mental and physical threats. An April 2020 study in Behavior Research and Therapy highlighted how rumination heightens our vulnerability to anxiety, depression, insomnia, and impulsive behaviors; interferes with psychotherapy and limits its effectiveness; and worsens and sustains the body's stress responses, such as inflammation.

"It can definitely get in the way of sleep," Dr. Olds says. "If you're in bed for seven-and-a-half hours and spend two-and-a-half of it ruminating and only five hours sleeping, that's a problem."

Often a major symptom of obsessive-compulsive disorder (OCD), rumination becomes an unseen compulsion that may feel productive in the moment but sustains OCD over the long term.

"People have the faulty assumption that there's a right way and a wrong way to do things, and they have to get it right," she says. "It leads people with OCD to think there's also a right way to think."

Rumination can also create an insidious loop that ropes in both depression and anxiety, Dr. Olds says. A January 2020 study of nearly 6,000 adults published in the Journal of Affective Disorders enhances that perspective, suggesting rumination both increases the risk of developing depressive symptoms and results from those same symptoms.

"The isolation depressed people experience often leads to more rumination, and then ruminating makes people feel anxious," she says. "It's a loop of its own."

Seeking help

Unlike some mental challenges that are evident to others, rumination largely happens in the shadows. No one can watch you do it, and they may never know you're prone to it if you don't tell anyone what you're going through. This "invisibility cloak" can pose barriers to seeking help, since you may be the only person who knows the true toll rumination is taking on your well-being.

When is it time to seek professional advice? If you feel your looping thoughts are blocking out everything else and you can't function normally, Dr. Olds recommends psychodynamic therapy or cognitive behavioral therapy (CBT). Psychodynamic therapy focuses on developing insights into the roots of your behavior, while CBT emphasizes behavioral change.

"How much does rumination slow your forward progress?" she asks. "How carried away are you getting? How much sleep are you losing, and how weary and depressed have you become?"

A therapist can help you identify why you ruminate, as well as address the underlying issues and help break the cycle. With therapy, Dr. Olds says, "you'll gradually start correcting your self-destructive assumptions."

Disrupt the cycle

But even before therapy — or alongside it — you have the power to disrupt your thought cycle and thwart rumination. Dr. Olds suggests these tactics:

Find a distraction. You're less apt to ruminate if you're busy doing something else. Try exercising, calling a friend or family member, cleaning out a drawer or closet, listening to music, watching a movie, or reading a book.

Change locations. Do you have a "happy place," such as a park, the beach, a book store, or a favorite coffee shop? If you can, head there to occupy a new headspace.

Rely on relaxation techniques. Mindfulness meditation and deep breathing can help clear your mind, which may derail rumination. Find a quiet space, breathe deeply, and notice your surroundings.

Confide in a friend. A pal can offer a sanity check on runaway thoughts, helping put your worries in perspective. But choose wisely, veering away from dramatic personalities. "You want to choose a person who can talk you down," Dr. Olds says.

Take action. Do one small thing that might push you past your circular thoughts. If you really think you offended someone at last weekend's cocktail party, send your regrets in an email — but temper yourself. "Take some reasonable action, but don't prostrate yourself on someone's doorstep," Dr. Olds says.

Be patient. Expect to revisit some looping thoughts before you're able to break the cycle completely.

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