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We all experience negative thoughts sometimes, but when we spend *too* much time dwelling on them, it can create distress and even contribute to mental health problems. Rumination involves repetitive and passive thoughts focused on the causes and effects of a person’s distress. The problem is that these negative thoughts don’t lead to solutions.

We often slip into this type of thinking when we’re faced with a problem we want to solve. They tend to creep in when we’re stressed or dealing with something overwhelming. Instead of inspiring us to engage in active coping mechanisms or problem-solving strategies to relieve distress and improve mood, we often get stuck in a negative, self-sabotaging loop.

While it seems like solving the problem will resolve the stress, rumination does not lead to any solutions. Examining memories, situations, and feelings can be an essential part of processing our experiences, but processing and ruminating are different things, and learning how to distinguish between the two can be important for your mental well-being.

Signs of Rumination

What does rumination look like, and how is it different from productive emotional processing? Rumination and emotional processing both focus on problems and usually on emotions surrounding these problems.

As a general rule, the following can be indicators that you may have fallen into the trap of rumination:

• Focusing on a problem for more than a few idle minutes
• Feeling worse than you started out feeling
• No movement toward accepting and moving on
• No closer to a viable solution

Likewise, with a conversation with a friend, if you both end up feeling worse afterward, you’ve likely just engaged in co-rumination.

How Rumination Works

Most people don’t set out to ruminate over their problems. Most of us want to be happy and want to focus on thoughts that make us happy. The problem occurs when something frustrating, threatening, or insulting happens to us—something that is difficult to accept—and we can’t let it go.

We may be trying to make sense of it in our minds. Or we might be attempting to learn from it. In other cases, we may be seeking validation that this should not have happened. Whatever the reason, though, we can’t stop thinking about it, and when we think about it, we become upset.

Rumination vs. Emotional Processing

As you look at the difference between rumination and emotional processing, you might have several concerns:

• If we don’t think about our problems, how can we hope to solve them or learn from the process?
• Should we focus only on the positive?
• Don’t we sacrifice growth and solutions if we don’t focus on unpleasant situations from time to time?

These are important questions because knowing the happy midpoint between ignoring problems and engaging in rumination can save us a lot of stress.

Rumination involves negative thought patterns that are immersive or repetitive. Many people slip into rumination when trying to process their emotions, but they become “stuck” in negative patterns of replaying past hurts without moving toward solutions or feelings of resolution.

What distinguishes rumination or “dwelling on problems” from productive emotional processing or searching for solutions is that rumination doesn’t generate new ways of thinking, new behaviors, or new possibilities. Ruminative thinkers repeatedly go over the same information without change and stay in a negative mindset.

What Causes Rumination?

It is normal to ruminate on things from time to time, particularly if you are thinking about a stressful or upsetting experience. People may ruminate because they believe they can solve a problem or gain insight by thinking about it repeatedly. Having a history of trauma or dealing with stressful situations in the present can also contribute to rumination.

Some factors that might cause rumination:

• Certain personality traits such as perfectionism or neuroticism
• Stressful events such as job loss or a relationship break up
• Poor self-esteem
• Stressing about something you fear
• Traumatic events
• Worrying about upcoming events like a work presentation or exam
• Worrying about a health condition

Negative Impacts

Rumination is connected to a variety of mental health conditions, creating a relationship where each can influence the other. While these conditions can lead to rumination, those persistent thoughts can also make the symptoms of these conditions even more challenging to handle. 

Mental conditions that can cause rumination or be worsened by it include:

• Anxiety is often marked by worrying or ruminating over specific fears or anticipated situations. Research has shown that rumination is a risk factor for anxiety.
• Depression can cause people to ruminate over negative thoughts. Numerous studies have linked rumination as a significant risk factor for the onset of depression. Research suggests that rumination can be a maladaptive way of responding to a depressed mood, leading to more feelings of depression.
• Eating disorders can cause people to ruminate about food, dieting, and exercising. Research has found that people who exhibit eating disorder psychopathology are more likely to experience ruminating thoughts, and such thoughts tend to decrease mood and cause more negative body-related thoughts.
• Obsessive-compulsive disorder (OCD) causes intrusive, obsessive thoughts that may lead to compulsive behaviors to relieve distress. One study found that rumination plays a role in maintaining OCD symptoms that can also contribute to depressed mood.
• Post-traumatic stress disorder (PTSD) often involves ruminating about traumatic memories. Researchers believe that rumination may be an intentional way to understand and process the trauma, although the results are ultimately ineffective.

How to Stop Ruminating

Rumination can be difficult to give up, especially if you don’t recognize it as rumination or don’t know how to stop. Letting go of stress and anger can help with ruminative thinking.

Some strategies that might help you learn to let go of repetitive thoughts include:

• Try meditation: Meditation can help relieve feelings of stress and redirect thoughts toward less negative patterns.
• Distract yourself: When you ruminate on negative thoughts, break out of the pattern by doing something to distract yourself from your thoughts. Try doing a puzzle, reading a book, calling a friend, or watching a movie.
• Challenge your thoughts: Remind yourself that thoughts are not facts. Instead of accepting a negative thought as reality, actively challenge it and look for alternative explanations.
• Engage in exercise: Physical activity can be a great way to distract from negative thoughts, but research has also found that it can significantly reduce rumination in people with a mental health diagnosis.
• Go outside: Research has also found that spending time in nature can significantly reduce rumination. Try combining exercise and nature exposure by walking in a park or natural setting.
• Cull your social media feeds: It is also important to avoid or minimize contact with things that trigger rumination. For example, if scrolling through your social media feeds leaves you with negative thoughts about your life, relationships, or appearance, consider unfollowing accounts that lead to these negative thoughts and feelings.
• Cultivate social support: Having people you can lean on is important in times of stress. Your social connections can be an essential source of support and help distract you from negative thoughts.

If self-help strategies are not providing enough relief, consider talking to a mental health professional. Therapy approaches such as cognitive-behavioral therapy (CBT) can help you change the negative thought patterns associated with rumination and develop new ways of coping.

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The beginning of August can signal the final days of summer, college move-in preparations, and squeezing in a final family vacation. But on August 1, 2023, it signaled something altogether different for Mary Beth Brault. Her life shifted. It was the day that she was diagnosed with PH+ B-cell acute lymphoblastic leukemia.

For the then-55-year-old, it was “a long, complex name for an aggressive blood cancer that hit like a freight train,” she says. “It shattered everything and rocked the foundation of our world. At the beginning of July, I was working, traveling, and going to concerts with my kids. By July 31, I could barely walk into the emergency room. Overnight, my whole life changed. But the worst moment—far and away—was telling my children. That broke me.”

According to the National Cancer Institute, approximately two million people will be diagnosed with cancer in 2025. Most people know that the disease takes a physical toll on the body, including fatigue, pain, nausea, and vomiting. But they may not factor in the mental and emotional toll of the disease.

“Being diagnosed with cancer can bring on a wide range of strong emotions in the period after diagnosis. Immediate reactions can vary – but many people feel shocked or numb, finding it hard to believe or fully process the news,” explains Michael A. Hoyt, PhD, professor and chair of Population Health & Disease Prevention of UC Irvine’s Joe C. Wen School of Population & Public Health.

From anger to anxiety, guilt to determination, a cancer diagnosis takes a toll on the person with the disease, as well as their family and friends.

Initial Reactions and Emotions

Brian Koffman, MDCM, is the co-founder, chief medical officer, and EVP of CLL Society Inc., an organization that addresses the needs of leukemia and lymphoma patients. His connection is intensely personal.

“I was diagnosed with chronic lymphocytic leukemia (CLL) in 2005,” he says. “My cancer diagnosis was a complete shock and raised disbelief. I was feeling well and was surprised when the leukemia was discovered on routine blood work,” he notes. “It was a gut punch.”

“Cancer is a thief, upending your sense of safety in your own body and your plans and hopes for the future. Depending on the type of treatment you need, you may have to give up the routine and activities you built your life around. It can feel like you’ve lost control over your life as you pivot your attention to battling cancer and coping with the uncertainty it brings,” says Hannah Holmes, PhD, clinical health psychologist at Holmes Psychology.

Forging an unknown path can also lead to unexpected emotions. These include:

• Stress and anxiety. “Fear and anxiety are also very common — people often worry about what will happen next, how they’ll get through treatment, and what it means for their future,” says
  Dr. Hoyt.
• Depression and sadness. One in four cancer patients struggle with depression. Unfortunately,
  only 5% of those struggling see a mental health professional, according to the National
  Cancer Institute.
• Anger and denial. “Some people feel angry — at the situation, the healthcare system, or just at the unfairness of it all. Others may go into denial, telling themselves it can’t be true, as a way to cope with the overwhelming news,” Dr. Hoyt notes.
• Guilt. People can experience guilt if they feel like the cancer is their fault, or they feel bad about burdening their family and friends.

Dealing With Misconceptions

You may also find yourself dealing with common misconceptions others have about walking through the cancer journey, such as:

• You shouldn’t be secluded. “The biggest misconception in my case was isolation—and why it’s necessary,” states Brault. “Once chemo started and my immune system was gone, I was essentially on lockdown. So was my husband. One random virus could [have] killed me.”
• Cancer patients need additional advice. “Another common issue: unsolicited advice. ‘Drink green juice.’ ‘Avoid sugar.’ ‘Try this herb.’ Let’s be honest — by the time you’re diagnosed, the ship has sailed. And I hate to state the obvious, but the chemo they are dumping into my body is exponentially more toxic than any cookie. People mean well, but it’s exhausting,” Brault says.
• All cancers behave the same way. “[It’s] a common misconception that a particular cancer diagnosis is predictable in its behavior and prognosis. There are always ‘outliers’ who beat the odds and live far beyond their ‘predicted’ life expectancy,” says Dr. Koffman.

Finding Hope and Joy

While research doesn’t necessarily show there is a correlation between a positive attitude and cancer treatment outcomes, for some, it can make a difference in the journey.

“What I love about the focus on hope involves taking a step back and asking ourselves what hope really is… and the way I have considered hope in my own work is to think of hope as a possessing the belief, skills, and actions to identify and pursue the things you value most in life,” says Dr. Hoyt.

Hope can help shift focus – from the difficulty and pain of cancer to things in life that bring joy or pleasure. And research does show that positive thinking builds resiliency and combats the stress’ inflammatory process. And joy can be found in regular, everyday activities, or things that give you a new sense of purpose.

Coping Mechanisms and Support Systems

Whether it’s a group of people walking through the same journey, friends, or a spouse, a support system is a critical part of your mental and emotional health when dealing with cancer. In addition to having people who care about you and help you, it’s beneficial to have other methods of coping.

Ideas include:

• Seeking out professional counseling. A mental health professional who is trained to help you navigate the emotions that come with a cancer diagnosis can offer critical support.
• Journaling. Getting your feelings out on paper can be a cathartic experience.
• Establish boundaries. “Saying no to energy-drainers and the people that never gave support [helps to protect] my peace,” Brault notes.
• Take part in hobbies you enjoy.
• Be patient with yourself. Learn to rest when you need it.
• Check out cancer support groups: Finding like-minded people is a great way to relate through lived experience, get guidance, and have a place to talk with others who understand the process.
• Prioritize rest. it is more important than ever to take care of yourself.
• Find ways to reduce stress. Techniques that involve nervous system regulation and mindfulness may be helpful.
• Practice vulnerability. Learn to express emotions with people who know how to listen without attempting to ‘fix’ you. Bottling up emotions can increase feelings of stress, anxiety, and depression.

People think they know what they will do when challenges strike. But often, you don’t truly know until you are experiencing it. Give yourself grace as you walk through your cancer journey, and care for yourself physically, emotionally, and mentally.