Do Depressed and Anxious People Ruminate and Worry?

Rumination and worry are at the heart of anxiety and depression

Posted Jun 13, 2016

Ebrahim via Wikimedia Commons
Source: Ebrahim via Wikimedia Commons

Anxiety and major depression are common.  In the United States, as many as 18% of the population may be affected by an anxiety disorder and/or depression at any given moment, and over 30% of people are likely to experience an episode of anxiety disorder or depression in their lives.  Anxiety and depression are often discussed together, because in many people major depression and anxiety disorder occur together.

Research on depression and anxiety has looked at many factors underlying these disorders.  One important factor that has emerged in many studies is rumination. The word rumination has the same basis as the word for animals that chew their cud.  The idea is that people with anxiety and depression are often plagued by uncontrollable sad thoughts about the past that help to maintain the depressed or anxious state.

As important as rumination is thought to be for anxiety and depression, it has been observed mostly in laboratory studies and self-reports of past behavior.  To address this limitation, a group of researchers used an experience sampling method.  This work was presented in a paper in the November, 2015 issue of Clinical Psychological Science by Kathaina Kircanski, Renee Thompson, James Sorenson, Lindsey Sherdell,a nd Ian Gotlib. 

Experience sampling involves catching people at random times of the day and asking them about their behavior at that moment rather than relying on self-report from the past.

In this study, four groups were tracked (each with about 20 people in it).  One group had Major Depressive Disorder, but not Generalized Anxiety Disorder (as diagnosed with a clinical interview).  A second group had Generalized Anxiety Disorder, but not Major Depressive Disorder.  A third group had both, and a fourth group was a control that had neither disorder.

Each group was given a device that would alert them 8 times per day for 7-8 days.  Each time they received an alert, they rated how much they were ruminating and worrying at that moment.  They also rated several factors that are thought to be associated with rumination and worry like whether their thoughts were unpleasant, repetitive, uncontrollable, specific, focused on the self, and focused on uncertainty and lack of control.

The results suggest that rumination and worry are common in the daily lives of people with anxiety and depression.  The groups with depression and/or anxiety reported ruminating and worrying at about half of the times that they were sampled.  In contrast, the control group was ruminating or worrying on only about 20% of the occasions in which they were sampled.

In addition, the results suggest that rumination and worry have many of the characteristics that have emerged in previous laboratory work.  Rumination and worry were unpleasant and repetitive.   Worries also tended to be very specific.  These thoughts were also focused on the self and on past events.  Ruminations tended to focus on a lack of control in the past, while worries focused on a lack of control as well as uncertainty about how things would turn out. 

What is nice about a study like this is that it takes findings from laboratory research and ensures that they hold in people’s daily lives.  One problem with self-report in the lab about rumination and worry is that people with and without anxiety and depression might ruminate about the past and worry in equal amounts, but the disorders might differ in how strongly people remember their thoughts later.  These findings suggest that the actual rate of rumination and worry differ between those suffering from depression and anxiety and those who are not.

This research is particularly important, because people have suggested that one way to intervene on depression and anxiety is to try to stop the cycle of rumination and worry.  Teaching people techniques to focus their thoughts on other people and on more pleasant events, for example, may be one part of a treatment to help people to combat their depression and anxiety. 

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