Decrease Depressive Rumination with Mindfulness
By John M. de Castro, Ph.D.
“Rumination starts off as a dim light that we stop putting energy into, allowing it to get darker and darker until we can’t see anymore.” – Laura Meyer
Worry (concern about the future) and rumination (repetitive thinking about the past) are associated with mental illness, particularly depression. Mindfulness training been shown to be an effective treatment for depression and its recurrence even in the cases where drugs fail. This is especially true for Mindfulness-Based Cognitive Therapy (MBCT) which was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy That is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. These include rumination. It is possible that ruminative thinking is reduced by MBCT and this, in turn, is responsible for the effectiveness of MBCT in reducing depression.
In today’s Research News article “Mindfulness-based interventions for the treatment of depressive rumination: Systematic review and meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6220915/ ), Perestelo-Perez and colleagues review, summarize, and perform a meta-analysis of the published research studies on the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) on ruminative thinking for patients with at least one major depressive episode. They found 11 published research studies that were either randomized controlled studies or pseudorandomized controlled studies comparing MBCT to treatment as usual for depression.
They report that the literature finds that MBCT significantly reduces ruminative thinking with moderate effect size and that this effect is still present one month later. Five of the studies performed a meditation analysis and reported that the reductions in rumination significantly mediated the effectiveness MBCT on depression. Hence, MBCT appears to reduce the levels of repetitive thinking about the past and this is responsible, in part, for MBCT’s ability to reduce depression.
Mindfulness training focuses the mind on the present moment, reducing the influence of memories of the past and projections about the future. So, it would seem to be unsurprising that Mindfulness-Based Cognitive Therapy (MBCT) would reduce the frequency with which the mind is focused on memories of the past (rumination). In addition, since depression is characterized by rumination it is also unsurprising that MBCT would effectively reduce depression.
So, decrease depressive rumination with mindfulness
“Know that practicing is an act of self care and helps stop the cycle of rumination and cultivates more patience, compassion, and peace. Mindfulness is not a panacea for depression, but it’s a good foundation for preventing relapse.” – Elisha Goldstein
CMCS – Center for Mindfulness and Contemplative Studies
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Perestelo-Perez, L., Barraca, J., Peñate, W., Rivero-Santana, A., & Alvarez-Perez, Y. (2017). Mindfulness-based interventions for the treatment of depressive rumination: Systematic review and meta-analysis. International journal of clinical and health psychology : IJCHP, 17(3), 282-295.
Background/Objective: This systematic review aims to evaluate the effect of interventions based on the mindfulness and/or acceptance process on ruminative thoughts, in patients with depression. Method:Electronic searches in Medline, Embase, Cochrane Central, PsycInfo, and Cinahl until December 2016, in addition to hand-searches of relevant studies, identified eleven studies that fulfilling inclusion criteria. Results: A meta-analysis of the effect of the intervention compared to usual care showed a significant and moderate reduction of ruminative thoughts (g = −0.59, 95% CI: −0.77, −0.41; I2 = 0%). Furthermore, findings suggest that mindfulness/acceptance processes might mediate changes in rumination, and that they in turn mediate in the clinical effects of interventions. A meta-analysis of three studies that compared the intervention to other active treatments (medication, behavioral activation and cognitive-behavioral therapy, respectively) showed no significant differences. Conclusions: Mindfulness-based cognitive therapy compared to usual care, produces a significant and moderate reduction in rumination. This effect seems independent of the treatment phase (acute or maintenance) or the number of past depressive episodes, and it was maintained one month after the end of treatment. However, further controlled studies with real patients that compare the most commonly used cognitive-behavioral techniques to treat ruminative thoughts to the acceptance and mindfulness techniques are needed.