Wednesday, August 10, 2011

Ruminate This... (Step 2 of 6)

Did you know that cows regurgitate grass in the form of cud, "a bolus of semi-digested food"?  Then they eat up that cud and chew on it for hours, breaking it down into smaller pieces so it can be fully digested.  Why am I talking about cows and their digestive systems?  Dr. ILardi, author the The Depression Cure, uses the cows digestive process, which is also known as rumination, as a metaphor for how us humans ruminate on thoughts.  We chew on them for hours.  Eh, let me rephrase that.  Most people dwell on something maybe 5-10 minutes, find some clarity in the situation or if none, move on. Depressed people, however, think about things for hours, mostly negative thoughts and then break down and have what I call "a bad day".  I have had way too many "bad days" for me to count, but my mother can vouch, as she is the one I call when I can't pick myself back up.
When a person mulls over things "way past the point when enough is enough", several damaging effects can occur.  One is that it "tends to amplify negative emotions" (93).  I'll give you an example of what might go on in my head.... from thought to thought:
I wonder why she didn't invite me out to dinner with her and her friends?  What is so wrong with me that I can't get an invite?  Does no one like me in here? (Anxiety sets in, pulse goes up, heart starts to race) They must not.  I mean, why else would they not want me there?  I haven't done anything wrong to her, or have I?  Crap, I probably did.  What did I do?  I will never have any friends.  No one will ever love me.  I will always be alone... I hate it here... why am I even living?

Thoughts like this can stew in my head from ten minutes to hours, throughout the entire day, leaving me wanting to climb into a hole and hide from the world.  Which leads me to the second negative effect, it makes you less active and withdraw from others.
When we are brooding, we're especially inclined to avoid activity, as it would force us to shift attention away from our internal machinations and out onto the world around us instead. (93)
And it's true.  When I ruminate, I withdraw.  I withdraw because I feel so sad that I don't even like myself anymore, so why would anyone else like me?  I have no energy.  The last thing I want to do is be social with people.
Another thing I noticed about myself, and the book mentions it as well, is that when I am in phase of negative thoughts, I don't hear what others are saying.  I'll go through a conversations saying "uh huh, yeah, OK" but if they were to say "Cole, what did I just say?" I wouldn't be able to tell them. (Sorry for those I have done that too!!)  It's hard to connect to people when you are in the habit of rumination.
The third negative effect is that "rumination sends the brain's stress response circuits into a flurry of sustained activity" (93).  Which is most likely why I also have a lot of anxiety and trouble breathing when I finally hit rock bottom, call Mom crying, and her saying "just breath, take a deep breath.... breeeeaaath!"
So how do you break the habit?  It's hard.
During an episode of depression, dwelling on negative thoughts is so effortless and automatic - its possible to spend long stretches of time doing so without any awareness of what's happening. (96)
This explains why, in the past, I wouldn't remember any of the drive from Seattle to my house (30 minutes), and then suddenly I'm driving into my garage (crying or on the edge of tears).  So, the first step to stopping this ugly habit is to become aware. Dr. Ilardi recommends doing a "mental inventory", an hour by hour thought journal of your day.  Literally, set your watch and have it beep every hour.  Write down what you were doing, i.e., watching TV, working, making dinner.  Then estimate how much ruminating you did in that hour, i.e., 25 minutes.  Finally, rate your negative mood with 1 being low and 10 being high.  Doing this will allow you to see what part of your day is a risk factor for setting yourself up to mentally abuse yourself.  If you find that you are doing the majority of your ruminating while watching TV, then find a new activity. The hard part for me is that I live alone.
People typically ruminate-and feel the worst-when they have nothing else to occupy their attention.  And, given the depressed mind's inexorable drift inward upon itself, the single biggest risk factor for rumination is simply spending time alone.
Gulp. I am not panicking though.  Dr. Ilardi discusses common risk factors: watching TV (I don't have cable), spending time with other negative dwellers, listening to sad music, driving, doing mindless chores, daydreaming, lying around the house.  The solution is to turn our attention to more doing than thinking.  "By simply engaging in activity-any activity-we can change the brain in a way that helps reverse depression" (101).  Before I discuss activities, I want to also mention that he says that a certain amount of rumination is productive.  Like I mentioned before it can help us a resolve a situation or come to a better understanding of what just happened.
When you're ruminating, how long does it take to hit the point of diminishing returns, when any more fresh insights are unlikely to emerge?  The consensus answer: five to ten minutes.  So, I make a deal with them:  When you catch yourself ruminating give yourself permission to continue thinking about things for a maximum of ten minutes.  But be sure to set a timer, and then resolve it to shut the process down as soon as the timer goes off (if not sooner). 
So with all that being said.  Here are activities that he suggests to turn to when ruminating.

  • Engage in conversation - Make a list of people you can call, your comfortable level with them (1-10) and their availability level (1-10).  I made my list!
  • Pursue shared activities - There is some things that are just more fun doing with people than alone.  From mundane tasks of hammering nails (i.e. building a home for a volunteer project) to joining an exercise group.  Go volunteer, join a knit and bitch group... anything!!  Just as long as it's with PEOPLE!
  • Play - Sports, board games, card games, online games, WII games... anything!
  • Listen to music - Avoid the downer singers though... the ones who sing about loved loss, being lonely and ... well country music basically.
  • Listen to books on tapes - This is something that always sounded cool for me, but I have never bought one.  What a great way to drive in traffic!
  • Watch Videos - Be careful.  If you are single looking for love, do NOT watch a romantic movie. Watch a drama, or a comedy, anything but "Oh love is so easy and I found the most awesome guy (that doesn't exist), and I'm going to live happily ever after... muhahah and you my little lonely depressed girl on the couch, WON'T!)  I sometimes want to tell Katherine Heigl and Kate Hudson to shove it.
  • Brainstorm - Here are some that I am adding to the list: Gardening (I plan on turning a piece of land beside my house into a wonderful flower garden!), baking, shopping, volunteering, exercising, dancing, study Spanish, bike ride (with someone), read a book, clean (very therapeutic for me), writer a letter, hike.
I hope this blog is helping you or giving you perspective on depression.  If you like what you reading, a highly advise you to get the book.  The next few steps will be much shorter blogs.  I felt the need to write a lot about rumination because I feel this is the biggest depression trigger for me, and one that most don't notice they are even doing.  It's the one thing that pulls me back down continuously and I am determined to break the habit.

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