One of humans' special skills is problem-solving. In a century, we've gone from traveling by horse to traveling by rocket ship. But we can't solve every problem—and that can lead to rumination.
Rumination is the process of continuously thinking the same negative thoughts. There's simply no OFF switch.
“In a number of studies, rumination has been shown to predict recurrence of depression,” says Scott Langenecker, PhD, principal investigator, Mechanisms of Rumination Change in Adolescent Depression (RuMeChange).
For Utah residents who experience high rates of depression and suicide, controlling rumination could be critical. The rugged, frontier mentality that many Utahns exhibit discourages discussing mental health challenges.
“If we don't talk about mental health, then we aren't aware of the scope of the problem and can't provide kids with skills and support through the education system,” Langenecker notes.
The RuMeChange research study examines how mindfulness can help teenagers prevent depression. Teenagers between the ages of 14 and 17 who have previously experienced depression are eligible to participate.
“The analogy I often use for rumination is juvenile-onset diabetes. Kids have to learn skills and lifestyle changes to manage it. They may have to take medication. And if it goes untreated, there can be long-term health consequences.”
Scott Langenecker, PhD, Principal Investigator, RuMeChange
Langenecker's research focuses on helping 14- to 17- year-olds who have recovered from depression but still ruminate. Treating well people may seem counterintuitive, but Langenecker explains that depression can distort the way we learn.
The research focuses on youth for three reasons:
- First, they're mentally plastic and can learn new skills readily.
- Also, depression can create additional unsolvable problems for them, like missing school.
- And long-term, negative effects on the brain can impact both development and functioning.
Addressing and treating depression early becomes essential.
Youth who ruminate may use distraction and avoidance techniques—social media, video games, reading, or seeing friends. But their problems don't go away, with consequences that can trigger worry, missed assignments, poor grades, and interpersonal conflicts.
Langenecker's research includes brain scans using functional magnetic resonance imaging, questions about mood and behavior, cognitive and computer testing, meeting with a clinician, 10 weekly treatment sessions, and ongoing assessment of depression for two years.
More than two dozen youth in Utah have received this treatment. Those who respond gain skills to manage depression using problem-solving, increased activity, engagement in specified actions and in patterns opposite the “go-to” for a given emotion, and self-compassion.
“We're going to experience difficult things in life,” says Langenecker. “Self-compassion is one skill we teach that helps manage how we feel about those challenges.”
Rumination-focused therapy restores balance between the brain's task-positive network, responsible for moving, thinking, acting, and speaking, and the default mode network focused on memories, feelings, and thoughts about the past and future. Ruminating is a habit that creates an imbalance between these networks and makes daily tasks difficult. By eliminating that habit, patients change the way these networks orient to each other.
Langenecker mentions a teenager with high rumination who was cutting. He texted with a licensed counselor at the SafeUT Crisis Chat & Tip Line frequently to try to manage self-injury. Medication and other therapies didn't work. After discharge from an inpatient psychiatric unit, he decided to try an offshoot of the RuMeChange study directed by Dr. Mindy Westlund-Schreiner. Six months later, his reduction in self-harm is four- or five-fold.
“This model works for many youth and, when it does, it's a life changer.”