Ruminating on our ruminations causes more depression

Once you have depressive symptoms, it’s easy to fall into a pattern where you aggravate the disorder by ruminative thinking.

One of the key issues is what is called negative metacognitions, a phrase that needs some explaining.

“Meta-thoughts – or metacognitions – are the thoughts we think about the thoughts we think,” says Leif Edward Ottesen Kennair, a professor at the Norwegian University of Science and Technology's (NTNU) Department of Psychology, and main supervisor of the current study.

Psychologist and first author Helene Pedersen at Helse Bergen HF explains, “Having thoughts about our own thinking that we’re more or less aware of is pretty common.”

Thoughts about our own thinking are not harmful in themselves. Positive thoughts about our own thinking can lead us to reflect on topics we want to reflect on more often, and maybe even enjoy more. But that can go awry for some people.

The results of a new study on the topic have recently been published in BMC Psychiatry.

Am I abnormal?

Negative metacognitions can – for example – be thinking that depressive brooding is a sign that we are damaged, or we might think that our brooding is uncontrollable.

For some individuals, this ruminative thinking gives rise to thoughts that can be difficult to break out of. Those thoughts can quickly lead to getting wrapped up in a self-reinforcing, negative pattern.

“It’s only a problem when we have a lot of those negative thoughts about our own thinking, and we fall into an unfortunate thought pattern that can be difficult to stop,” says Pedersen.

But Kennair offers encouragement. “We’re not weak or damaged goods, and learning that you can actually control the brooding yourself can be done pretty quickly with metacognitive therapy.”

So luckily there are methods that can probably help. And you're not alone either.

Girls are more vulnerable

Depressive symptoms and depression are common in young people. Girls have these symptoms more often than boys and more often have a depression diagnosis as well.

A new survey from NTNU included close to 1200 people aged 16 to 20. Girls and women scored higher on all counts, including depressive symptoms. They also scored higher on

both positive metacognitions, or thoughts that rumination is helpful, and negative metacognitions about their own thoughts. Girls and women ruminate more in general.

Here we find clear gender differences. But the reasons that some people get stuck in depressive thoughts are the same for both sexes.

“We find that the main reasons for persistent depressive symptoms are negative meta-thoughts and brooding, and this applies to both sexes and regardless of age,” says Kennair.

Metacognitive therapy can help

Getting better involves overcoming self-reinforcing patterns, thoughts and actions.

“We believe that metacognitive therapy can be an effective treatment in treating depressive symptoms for young people, too,” says Professor Kennair.

Pedersen says that metacognitive therapy focuses on changing what maintains depressive illnesses: the depressive brooding and the negative thoughts about our own thinking.

“Brooding and negative metacognitions can be both triggering and maintaining factors for depressive symptoms. So it can be useful to concentrate on this to prevent depression,” says psychologist and co-author Ingrid Grønnæss.

“This therapy enables us to help both people who are already developing increasing depressive symptoms and to prevent others from developing such symptoms,” she says.

Metacognitive therapy is a new form of treatment developed by Adrian Wells at the University of Manchester, where the main goal is to discontinue negative thought processes and change metacognitions about such worry and rumination.

Reference: Pedersen, H., Grønnæss, I., Bendixen, M. et al. Metacognitions and brooding predict depressive symptoms in a youth sample in society. BMC Psychiatry 22, 157 (2022). Published 1 March 2022. https://doi.org/10.1186/s12888-022-03779-5