Rumination is a type of obsessive thinking that’s common across many types of OCD. If excessive rumination is starting to add stress to your life, therapy can help you learn to break the cycle.
Have you ever found yourself thinking a negative thought, only to notice that one thought has suddenly become a sea of negative thoughts that you can’t pull yourself out of? Psychologists call this rumination, and we’ve all done it at some point in our lives.
Rumination is a type of repetitive thinking that revolves around negative thoughts and feelings about the past, present, and future. Rumination is a symptom of many mental health conditions, including obsessive-compulsive disorder (OCD). In OCD, it can be a compulsion.
Below, we’ll explore more about rumination in OCD, including what it’s like, what causes it, and how it’s treated.
When people ruminate, they become stuck in a cycle of negative and distressing thoughts about past situations, their current lives, and what’s to come in the future. Once rumination starts, it can often be difficult to think about or do anything else.
But for people with OCD, rumination can become a key symptom that keeps the OCD cycle going — and here’s why.
People with OCD experience two primary symptoms: obsessions and compulsions. Obsessions are intrusive thoughts, urges, and sensations that cause significant anxiety and distress. Compulsions are behaviors aimed at reducing the obsessions and the anxiety they cause.
It’s common for people with OCD to ruminate about their obsessions, which can vary depending on their theme. For example, someone with existential OCD might ruminate on distressing philosophical or existential thoughts and questions.
Some people with OCD may even develop rumination OCD, in which their intrusive obsessions relate to the act of ruminating itself.
Rumination can happen in all OCD subtypes. When it happens in OCD, it’s considered a compulsion. People with OCD can spend hours ruminating in an attempt to neutralize their obsessions or find a way out of their discomfort and anxiety.
Is OCD rumination the same as overthinking?
It’s completely natural for us as humans to overthink things, especially when we feel stressed, anxious, or afraid. For example, you might overthink your outfit before a first date or even the font you chose for your big slideshow presentation at work.
But rumination in OCD is different than overthinking in these situations because it’s a compulsive behavior that people with OCD often have trouble stopping. In fact, OCD rumination can become so severe that it makes it difficult for someone to engage in their daily life.
OCD obsessions typically follow specific themes, which determine the nature of the intrusive thoughts that you might ruminate about. Some of the most common OCD obsessions include:
Rumination as a compulsion can happen in any theme, and people with OCD often attempt to ruminate their way out of these obsessions and the distressing feelings they cause.
For example, someone with contamination OCD might ruminate about everything they touched that day or about ways to avoid contaminating items in the future. Or someone with harm OCD might spend hours ruminating on whether they accidentally harmed someone in the past.
Other examples of rumination in OCD can include mental behaviors like:
- creating and reviewing mental checklists
- reviewing past experiences and behaviors
- reviewing thoughts and feelings they’ve had
- thinking about the same topics over and over
- attempting to solve the obsessions or anxiety
Is rumination an ADHD or OCD symptom?
Rumination isn’t just a symptom of OCD — it’s also linked to a worsening of symptoms in conditions like depression, anxiety, and even attention deficit hyperactivity disorder (ADHD).
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An OCD trigger refers to anything that causes an increase in OCD symptoms. When it comes to rumination in OCD, anything that triggers an increase in obsessions can also increase the urge to ruminate.
OCD is a cycle: obsessions lead to compulsions, which bring temporary relief until something else triggers the obsessions again. So, even though people with OCD may feel better after ruminating about their intrusive thoughts, the relief is short-lived because the cycle will start again.
One of the most important steps in tackling OCD rumination is to understand that it’s a compulsion and that ruminating over your obsessions doesn’t make them go away. Instead, it keeps you stuck in the cycle of obsessions and compulsions.
Once you understand why rumination can make your symptoms worse, the next step is to recognize when you’re doing it. Once you can recognize when you’re ruminating, you can do your best to stop or change the behavior.
It’s also important to work on treating your OCD with evidence-based treatments, like therapy and medications:
- Therapy: Exposure and response prevention (ERP) is the most effective therapy option for treating OCD symptoms like rumination. ERP can teach you how to face your triggers and your obsessions without needing to engage in compulsions like rumination to reduce your anxiety.
- Medications: Medication is another effective treatment option for OCD symptoms, especially when used alongside therapy. Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants are two commonly prescribed medications that can help reduce OCD symptoms.
If you’ve found it difficult to escape the OCD cycle because of constant rumination, help is available. Consider reaching out to your doctor or therapist to discuss what treatment options are available to you.
Rumination is a feature of many different mental health conditions, and it’s one of the most common compulsions in people with OCD.
Although rumination in OCD can bring temporary relief, it eventually becomes harder and harder to stop, which only causes more anxiety and distress. However, the right treatment can reduce OCD symptoms like rumination and help people with the condition better manage their daily lives.