Sep-08-2010

When You Can’t Stop Worrying – Tips for the Ruminator

World Suicide Prevention DayDo you lie awake at night hashing over and over the things you messed up? Do you worry so much about what could go wrong in the future that you can’t seem to move forward? Or maybe you can’t let go of something someone said to you, and the more you think about it, the worse you feel about yourself?

This constant cycle of negative thinking is called rumination. It could be commonly confused and even dismissed as feelings of worry. But ruminating and worrying are different because a ruminator not only worries about her problems, she worries about all her feelings about her problems and is not able to develop strategies to solve them.

Research has shown a strong link between rumination and depression, especially in women. Depression is one of the most common risks of suicide.

Dr. Susan Nolen-Hoeksema, a psychologist and professor at Yale University, found that women are more prone to rumination, and that rumination is strongly associated with anxiety, substance abuse and bulimia in teenage girls. There’s even some evidence that links rumination to suicidal thinking. Ruminators are frequently more pessimistic about life and see fewer options to solve problems. While they desire more social support, ruminators often end up driving people away and actually develop fewer emotional connections, which can lead to more depression and loneliness.

You can see how rumination can create a cycle that seems impossible to break out of.

But there is some good news. While rumination can cause clinical symptoms, it’s also a behavior that can be changed—with the right help. It’s not enough to just talk about your problems. You need to learn techniques to halt the ruminating thoughts. That’s how long-term change can take place.

Here are some tips for ruminators –and you know who you are–gleaned from Dr. Nolen-Hoeksema and my own experience in helping those who seem to let their worries control them.

Worry the right way

Who hasn’t been told by well-meaning friends, “Oh, stop worrying so much?”

Besides not being very helpful, this kind of advice often makes someone feel worse. I have developed a strategy for my ruminating patients that often works: Teaching them a more efficient way to worry.

Pick a time everyday when you’re free to worry uninterrupted for 15-20 minutes. This could be in the shower in the morning, on the bus on the way to work, at lunch or after dinner. The only time that’s not good is before bed. No cheating allowed, so set a clock or kitchen timer.

When your time is right, start your worry exercise by closing your eyes and imagining that you’re taking your worries out of a file cabinet or drawer. Open your eyes and start worrying (many people find it’s helpful to write these worries on a notepad). Let yourself go to town with your worries! But at the end of the prescribed 15-20 minutes, you must stop.

Close your eyes again, imagine your worries going back in the drawer, only to be opened again the next day.

Open your eyes and go on with your day.

The idea is to lasso up your worries, rather than letting your worries or ruminations control you.

With regular practice, this technique works. For the first few weeks you might have a stray worrisome thought outside the time you give yourself to ruminate. That’s normal. Tell yourself you’re not going to give. Tell yourself that you must only worry during your allotted time, even if you’ve already done your worry time for the day. Like Scarlett O’Hara said, “Tomorrow is another day” … and plan to worry the next day. After awhile, you’ll probably surprise yourself at just how well you can control your ruminations.

Get up and move

 Exercise distracts your mind and focuses more on activating the body’s healthy responses like pumping up the feel- good neurotransmitter, endorphin, lowering your blood pressure or promoting healthier sleep. 

Breathe

 Meditation, deep diaphragmatic breathing, biofeedback, yoga and other mind/body approaches help you relax. I recommend any of these techniques to my patients because they not only decrease anxiety and rumination but also slow down brain waves and restore a sense of calm and well-being.

Know that solutions are not simply black or white

 Ruminators often get stuck in all-or-nothing thinking and have a hard time seeing anything positive or hopeful in any situation. They’ll think, “I have to either stay in this dead end job and be miserable the rest of my life or quit and lose my house.”  But there are other solutions too.

Enlist the help of a trusted friend or therapist to help you problem solve other solutions to your worries. They exist–you’re just not seeing them. Stay focused on your immediate worries and don’t get caught up in the past, which of course, you can’t change.

By taking control of your worrisome thoughts and your ruminations, you’re  letting yourself live and feel better in the present. And that means you’re beginning to have more in control of your life.

Photo by  spaceodissey (via flickr)

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