The Role of Rumination in Clinical Disorders—and What to Do About It

Dr. Moses Appel

We’ve all had moments when our mind just won’t stop spinning. A conversation replays over and over. A “what if” keeps you awake at night. Or a regret keeps resurfacing no matter how much you try to move on. That cycle of mental looping is called rumination—and while it feels like problem-solving, it often pulls us deeper into distress instead of freeing us.

Rumination is when your mind gets stuck in a mental loop—replaying thoughts, analyzing what happened, or trying to figure out how to fix a problem that can’t be solved in your head.

It shows up in OCD as trying to "figure out" if a fear is true.

In anxiety, it’s often replaying "what if" scenarios.

In depression, it's replaying regrets or self-criticism.

And here’s the key: It feels like problem-solving, but it’s really a form of overthinking—sustaining distress rather than resolving it. It feels productive, but it’s a trap. That’s why it’s so important to catch yourself early in the process, before you get pulled too deep—because like quicksand, the more you struggle with thoughts in your head, the more stuck you can feel.

So what do you do?

Step 1: Notice when you’re ruminating.

You might be ruminating if your thoughts feel stuck on repeat, if you’ve gone over the same issue multiple times without gaining new clarity, or if you feel more distressed instead of calmer as you keep thinking. Another sign is when the thoughts start interfering with your ability to focus on what you’re doing in the present moment.

Step 2: Drop the rope.

You don’t need to fight the thoughts—but you also don’t need to watch or analyze them. The goal is to disengage. You can say to yourself, “Not doing this right now,” and gently shift your attention away instead of wrestling with the thought.

Step 3: Shift your focus to the external world.

Get active! Ask yourself, “What would I be doing right now if I weren’t stuck in rumination?” and then go do that. Engage in value-driven behavior—whether that’s reaching out to someone, taking care of a task, or doing something meaningful—so you’re living in the world rather than stuck in rumination land.

You can’t out-think rumination.

You have to out-behave it.

That’s where real healing happens.

Rumination is sneaky because it disguises itself as problem-solving. But learning to notice the trap, step back, and re-engage with the world around you can break the cycle. It’s not about having fewer thoughts—it’s about choosing what to give your energy and attention to.

If you find yourself stuck in rumination, remember: relief doesn’t come from thinking harder. It comes from shifting into living, acting, and connecting. That’s where true change begins.

Disclaimer: All characters and scenarios in this post are entirely fictional. This content is intended for informational purposes only and is not a substitute for professional therapy or treatment from a licensed mental health provider. To contact Dr. Appel, please email office@ADOPsychologyCenter.com.