We all experience rumination from time to time, but if you live with obsessive compulsive disorder (OCD) it could be more of an issue for you than for others. Sometimes medication such as antidepressants can help… but why does this happen in the first place? Here, we’re taking a closer look at how OCD and rumination go hand-in-hand, what causes it, why it could be a problem, and how to handle it.

At Augmentive, we aim to provide holistic, tailored mental health support to everyone so they can live their life to the fullest, so if you have questions about ruminating or other OCD symptoms, we’re here to help.

What is OCD?

OCD stands for obsessive-compulsive disorder, which is a mental health condition that causes obsessive thoughts and compulsive behaviours. It is believed to affect around 1.2% of the population of the UK, and impacts men and women of all ages. Sometimes symptoms of OCD begin as early as 6 years old, but it is thought to begin most often in early adulthood, and can start later in life too.

OCD can cause obsessive thoughts that are usually unpleasant in nature and difficult to ignore. It can also cause urges that are hard to ignore, obsessive and sometimes repetitive behaviours, and feelings of anxiety. Typically an OCD compulsion is something the person feels “must” be carried out in order to give temporary relief to unwanted feelings. Certain things tend to trigger OCD behaviours, and you can read more about these in our article; OCD Triggers: How and Why Do They Happen?

Sometimes OCD can look like checking things again and again even though you know the answer, counting or arranging objects, or obsessively worrying about something in particular — this is when ruminating can become a problem. Studies have found that rumination tends to be common in those diagnosed with OCD.

What is OCD rumination?

Many of us engage in rumination every once in a while, such as before we take part in a stressful event (worrying about the future), or dissecting every detail about a relationship when it ends (reflecting on the past). This is fine every now and then, but when rumination is constant and takes over everyday life, it could become a problem.

One 2022 study on rumination and obsession spectrum states that worry tends to focus on future events, whereas rumination is almost intentional, with the goal of reliving the past and thinking of the things you might have done differently to make yourself feel better.

Rumination is partly about reflection (a positive pursuit that can lead to a solution and help you process emotions), and partly about brooding (a largely negative pursuit that can lead to less proactive behaviour and a worse mood).

Why does OCD cause people to ruminate?

OCD can be overwhelming as it brings on intrusive thoughts, often about negative things that could happen in the future. The rituals that people with OCD perform in order to feel better are only a temporary fix, and the thoughts tend to come back again, leading to further compulsive behaviours.

OCD symptoms vary greatly depending on the individual, but research into OCD structure identified some common symptoms:

1. Obsessions relating to contamination and cleaning
2. Obsessions relating to checking things, thinking it is solely the OCD person’s responsibility to ensure nobody else could come to harm (for example locking doors, turning stoves off, or similar everyday safety considerations)
3. Obsessions relating to symmetry, order and arrangements
4. Obsessive unpleasant thoughts (these could be sexual, religious, violent or something else)

Rumination is the outcome of obsessive unpleasant thoughts, and while studies have found that around 80-90% of the general public experience intrusive thoughts, in the case of those with OCD it is the misinterpretation of these thoughts by way of giving them an unnecessary importance or meaning that turn them into obsessions.

As is the way with OCD, it can be a vicious cycle; one study found that rumination can lead to more negative thoughts, which exacerbate the obsessive symptoms of OCD and cause further distress.

Ultimately, obsessive thoughts and rumination both come from a similar desire to control anything uncertain. For someone with OCD that feels overwhelmed, they may panic and take part in compulsive behaviours they believe will help in order to distract themselves. This gives the illusion of meaningful progress, when in fact it only leads to more rumination.

When is OCD rumination a problem?

Rumination can cause negative consequences for anyone, but for those with OCD it can be an even bigger issue. Research has shown that excessive rumination can cause stress that can raise your cortisol levels, and lead to a negative mindset, self-sabotaging behaviours, a higher disengagement from problems, and less proactive behaviour.

Studies have found that rumination in those with OCD can maintain obsessive–compulsive symptoms and mood, and further studies have reported those with OCD who tend to suffer from excessive ruminations may also experience more severe obsessions than people with other types of OCD.

Rumination has also been thought to be a predictor of mental health conditions such as depression, anxiety disorders, substance abuse, eating disorders, and post-traumatic stress disorder (PTSD) symptoms following a trauma, and according to a 2021 study, rumination can influence the decisions of those who ruminate about suicide, affecting the transition from suicidal thoughts to behaviours.

How does someone with OCD stop ruminating?

If you have heard phrases such as “just snap out of it” or “stop overthinking”, you will be well aware of how unhelpful this is when you suffer from OCD. Simply snapping out of rumination can be extremely difficult, so don’t feel defeated if you struggle to do this.

This is especially true since, as people with OCD repeat depressive thoughts over and over again, the process of rumination starts to become familiar and sometimes even comfortable. According to studies, the mental rehearsal of OCD behaviours makes it easy to slide into rumination.

Tips for those with OCD who ruminate

It is important to understand that advice and support for those with OCD should be individual, since every person with OCD will experience completely different symptoms, and what works for one person may not work for another. If you have OCD and rumination is a major issue for you, we recommend speaking to a professional who can advise on the best way to tackle this based on your unique experiences.

If you are looking for additional things you can do in daily life, at least one study shows that mindfulness meditation can improve resilience to stress, which can make it an easy and beneficial thing to do at home to help manage OCD symptoms. Some other helpful tips that can help with rumination in the more general sense (not specific to those with OCD) include:

• Distracting yourself to interrupt your thought process when you feel rumination beginning. You’ll find some ideas for this in our article about calming your mind
• A set of techniques called cognitive diffusion can be very helpful in identifying and removing yourself from “mental hooks” such as worries, images or ruminations, and many are easy to do by yourself at home
• Exercising to focus your mind on something else. A 2018 study reported that just one exercise session could reduce rumination in those with a mental health diagnosis.
• Take action to stop the cycle of negative thoughts. You can break down your thoughts into actionable tasks that you can tick off a list to help you feel more in control.
• Figure out what you can and cannot change to make it easier to move on from some of the thoughts.
• Change your location to one that you associate with positive feelings.
• Speak to someone you trust and see if you can get some outside perspective on the thoughts you are having.
• Understand your triggers and do what you can to desensitise yourself to them. Therapy usually helps with this, and our article may be useful; OCD Triggers: How and Why Do They Happen?

Can you get treatment for OCD rumination?

Treatment for OCD rumination usually involves therapy, which can help you take back control over your thoughts, identify when rumination is becoming a problem, and find healthier ways to process thoughts. Here are some of the different treatment options you may be recommended:

• Rumination-Focused Cognitive Behavioural Therapy (RFCBT) can be a huge help for this, specifically working on the rumination to help those with OCD regain control over unwanted thoughts. Rumination-focused CBT is concerned with the thinking process, which is different from traditional Cognitive Behavioural Therapy focused on changing the content of thoughts.
• Exposure-Response Prevention Therapy (ERP) may be useful as it can help to break the cycle of obsessive thinking.
• Medication can also be prescribed in some cases, with serotonin reuptake inhibitors thought to help with obsessive thoughts.

If you are unsure of which treatment option is best for you, our free 15 minute consultation could be exactly what you need. You’ll chat with one of our expert therapists to discuss your mental health concerns, such as OCD or rumination, and they can guide you to the most relevant specialist for your specific needs. We also have specialists available for a private OCD assessment to get a better understanding of your situation and the best way forward.

Whether you’re feeling off-kilter or want to shake up your routine, our state-of-the-art mental wellbeing platform gives you quick and seamless access to world-class support on your terms, from private psychiatric assessments and reviews to broader mental health care: join us today.

DISCLAIMER: The content published by Augmentive is not designed to treat, diagnose, cure, or prevent any disease or condition. Always consult your GP or a qualified healthcare provider with any questions regarding a medical condition and before starting any therapy, diet, exercise, or any other health-related programme.