By Kathleen Hall
Woman with worried expression sitting on train looking out window, ruminating with worry about chronic disease

Medically reviewed by Jenny Blair, MD

I can’t believe I had an accident.

I wonder if this treatment will actually work.

You’re never going to make it through that entire dinner. Why bother going?

It’s 4 a.m. You’re replaying a disappointing event in your mind—for the hundredth time. Or, you’re worrying about something that might happen. Sound familiar? If so, you’re ruminating.

Ruminating is closely related to worry, explains Andrea Bradford, PhD, assistant professor at Baylor College of Medicine in Houston, Texas. “People with chronic medical conditions worry a lot: Am I going to get better? Is this treatment going to work? Is it going to stop working?”

It’s normal to worry, but sometimes it helps to step back and ask yourself if your worrying is helping to solve your problem or just keeping you stuck in an unproductive thought process, says Dr. Bradford. Here are a few tips for dealing with ruminating or worrisome thoughts.

Determine Whether Your Problem Is Solvable or Not

If it’s not solvable right away, make a plan to deal with it at a time when it’s useful to do so, says Bradford. If it’s simply not solvable—for example, if you’re worrying about whether your IBD treatment is going to stop working—then find a different way to cope. Try comforting activities like relaxation techniques, meditation or journaling instead.

Reframe Your Worry and Get Involved in Other Activities

Waiting for worry to get better is probably the worst thing to do, says Bradford. “If you wait to feel like doing something, you may be waiting a long time. In the meantime, you’ve missed out on a lot of time or opportunities.

Dr. Bradford says one helpful strategy to overcome these thoughts is to engage in something more productive, more enjoyable and meaningful, and know that worry might come along for the ride. “Trying to suppress thoughts doesn’t often work for the long-term, so I encourage people to embrace the idea that worrying may not be controllable, yet it need not control them.”

Try Mindfulness Training

In an 8-week mindfulness training study, those who participated in guided meditations, daily mindfulness exercises and group discussions found that their anxiety, depression and quality of life improved significantly over those who didn’t participate. The research authors referred to daily mindfulness as “a core psychological skill” associated with positive mental health and well-being that helps keep us from being drawn into ineffective rumination.

Build a Support System

“It’s important to have a support network and to understand the emotional and psychological ramifications of this disease and to treat those things as well,” says Tasneem Ahmed, DO, assistant professor of internal medicine at UT Southwestern Medical Center in Dallas, Texas.

IBD is challenging because it’s mostly an unseen disease, she says. Other people generally can’t tell you have symptoms like abdominal pain and it can be embarrassing to talk to about your bowels. Furthermore, Dr. Ahmed says, body consciousness and self-image in IBD is a huge issue, especially if you have scars from surgery or an ostomy bag.

A support system can be your family and friends, or a group of people who know firsthand about the challenges of living with IBD. The Crohn’s & Colitis Foundation has a searchable database for local support groups and a network specifically for teens with IBD. Your healthcare team may also be able to direct you to a support group at your local hospital.

Seek Help from a Mental Health Professional

If you still struggle with rumination, perhaps it’s time to get help from a therapist, especially one who specializes in Metacognitive Therapy (MCT). MCT is related to cognitive behavioral therapy that helps lessen rumination by focusing on the thought processes that trigger rumination, challenging those thoughts and then replacing them with positive beliefs about rumination and worry. The results of a randomized controlled trial of MCT found clinically significant improvements in anxiety and depression after 10 weeks of therapy.

Remember, ultimately you are in control of your physical and mental health. And if ruminating or worrisome thoughts are a frequent struggle for you, reach out for professional help as soon as you can.

Jenny Blair is a writer and journalist covering science, medicine, and the humanities. She earned her MD at Yale University, then completed a residency in emergency medicine at the University of Chicago. After several years in practice, she transitioned to working with words and ideas full-time. Jenny has contributed to Discover, New Scientist, Washington Spectator, and Medtech Insight, among other publications. She lives in New York City.

Oshi is a tracking tool and content resource. It does not render medical advice or services, and it is not intended to diagnose, treat, cure, or prevent any disease. You should always review this information with your healthcare professionals.