Is there a relationship between depression and psychological rumination (the tendency to have recurrent thoughts that we cannot get out of our heads)? Several studies have tried to reveal the answer to this question. In this article we bring you a theory that explains in detail what relationship exists between depression and a rumination style, the theory of Susan Nolen-Hoeksema.

In addition, we went to a review that analyzes the conclusions of 59 functional neuroimaging studies, and we specified the results they reached on this issue.

Relationship between depression and rumination: the Nolen-Hoeksema theory

If we investigate within the group of explanatory theories of depression, we find one that establishes a relationship between depression and rumination. This is the theory of response styles, proposed by Susan Nolen-Hoeksema (1959 – 2013) in 1991. Nolen-Hoeksema was an American professor of psychology at Yale University (USA).

Specifically, what Nolen-Hoeksema says in his theory of response styles is that there are certain factors that determine the course of depression; these factors have to do with the way in which the subject responds to the first symptoms of depression . This response, also called “ruminative style”, influences how long the depression lasts and how severe it is.

Thus, further specifying, the author explains that a ruminative response style in depression, maintains or exacerbates the symptoms of it.

In other words, according to this author, the relationship between depression and rumination is as follows: rumination of depressive symptoms chronifies depression, in addition to exacerbating its symptoms on certain occasions . The opposite occurs with an active style based on distraction or problem solving.

Rumination response style

But what is a ruminative response style? It’s the mental process of focusing our attention on the symptoms of the disorder and their implications for us, without doing anything to alleviate those symptoms.

In other words, it is a process from which no coping strategies are implemented; in simpler words, it is a matter of “going around” things, without stopping thinking about them , worrying about them, without taking care of them or doing anything to change them. It would be like “going on a loop”.

On the other hand, the author of the theory that postulates a relationship between depression and rumination, attributes the origin of the ruminative style to an infantile learning by modeling (through models, for example the parents, who also manifest a ruminative style), added to socialization practices that do not provide the person with a repertoire of more adaptive behaviors, necessary to face depression. Thus, these two factors would explain the origin of the ruminative style.

How does rumination influence depression?

S. Nolen-Hoeksema goes further with his theory to understand the relationship between depression and rumination, and proposes a number of mechanisms that would explain the negative effects of rumination style on depression. What are these mechanisms? There are four of them:

1. Vicious circles

The first mechanism that explains why a ruminative style in depression has negative effects for the person has to do with the vicious circles, which occur between depressed mood and negative cognitions .

Thus, we enter “in a loop” in the following way: our mood is depressive, which affects our thinking with more negative cognitions; in turn, these cognitions increase the depressed mood (and both elements feed back).

2. Non-generation of effective solutions

On the other hand, another mechanism that explains the relationship between depression and rumination is the decrease in effective solutions to everyday problems.

In other words, we generate fewer effective solutions to problems (or even none at all), because instead of thinking about these solutions, we spin the problems (ruminative style) .

3. Interference

The fourth of the mechanisms that allow us to understand the relationship between depression and rumination is the interference produced with instrumental behaviours that would provide us with a positive reinforcement , as well as a feeling of control.

In other words, the ruminative style makes it difficult for these behaviours to appear (or interferes with their functioning), as well as preventing the feeling of control that is necessary in depressive disorders and that would allow us to move forward within the disorder.

4. Weakening of social support

Finally, there is a weakening of social support, which translates into rejection by others, or even criticism of oneself .

This is logical to understand since, when our interpretation of reality and our coping mechanism in front of life are based on a constant ruminative style, in the end people around us get tired of these behaviors and move away, because they see that we do not do anything to face depression (neither looking for help, nor putting things in perspective or giving them the importance they deserve, nor recognizing that we have a problem…).

Research and results

Following Susan Nolen-Hoeksema’s theory, which relies on a relationship between depression and rumination, a series of experimental studies on rumination responses were conducted. The results of these studies were as follows.

1. Type of attributions

People with a ruminative style perform a greater number of negative and global attributes to everything that happens to them (i.e., causal attributes).

2. Accessibility of memories

Accessibility to negative memories in this type of person is greater than in people without a ruminative style.

3. Pessimism

There is a pessimism and a negative interpretation of biased reality , in people with a ruminative style in the context of a depression.

4. Poor interpersonal solutions

Eventually, these people generate poorer interpersonal solutions, making them less effective (e.g. in the face of conflict with another person).

Scientific review: what do the neurosciences say?

Beyond S. Nolen-Hoeksema’s theory of ruminative style, we have turned to a scientific review conducted in 2016 by Rayner, Jackson and Wilson, which analyzes the findings of up to 59 functional neuroimaging studies in adults with unipolar depression , in order to understand a little more about the relationship between depression and rumination.

This review also examines the relationship between the brain networks involved in cognitive processes during a depressive disorder and the symptoms of the disorder. Specifically, analyses the relationship between the abnormal functioning of these brain structures and depressive symptoms .

Results

The results of this review indicate that there are two different neurocognitive networks, which may largely explain the symptoms of depression. These two networks are: the autobiographical memory network (AMN), and the cognitive control network (CCN).

Specifically, what was found through this review is that the hyperactivity of the first network, the network of autobiographical memory, is related to three types of symptoms in depressive patients : rumination, self-blame and pathological parenting.

On the other hand, it was found that hypoactivation or abnormal functioning of the other network, the cognitive control network, is related to the following symptoms in this type of patients: negative automatic thoughts (Aaron Beck’s famous “PAN’s”), cognitive distortions and low concentration.

Furthermore, it should be noted that the configuration of these networks can change over time in people ; this is also related to a variation in depressive symptoms over time (i.e., a fluctuating course of depression).

Neurocognitive networks and depression

According to this review, we can say that depression, besides being a multifactorial disorder, where biological, social, psychological factors intervene… could also be framed as a disorder of neurocognitive networks, which links neurobiology with psychiatric practice.

This can be of great help to researchers, doctors, psychologists, etc., and open up a path from a neuroscience perspective that will help us understand and treat this and more mental disorders in the future.

Bibliographic references:

  • American Psychiatric Association (APA) (2014). DSM-5. Diagnostic and statistical manual of mental disorders. Madrid: Panamericana.
  • Belloch, A., Sandín, B. and Ramos, F. (2010). Manual of Psychopathology. Volume I and II. Madrid: McGraw-Hill.
  • García Cruz, R, Valencia Ortiz, A.I., Hernández-Martínez, A. and Rocha Sánchez, T.E. (2017). Ruminative thinking and depression among university students: rethinking the impact of gender. Interamerican Journal of Psychology, 51(3): 406-416.
  • Rayner, G., Jackson, G. & Wilson, S. (2016). Cognition-related brain networks underpin the symptoms of unipolar depression: Evidence from a systematic review. Neuroscience & Biobehavioral Reviews, 61: 53-65.