If it feels like your child’s mind is stuck on a loop—constantly replaying the same worries, fears, or questions no matter how many times you reassure them—it might be more than just overthinking. It could be Rumination OCD. Understanding this mental cycle is the first step toward helping them break free and find peace.
As a subtype of Obsessive-Compulsive Disorder, OCD and rumination trap individuals in a relentless loop of intrusive thoughts, making it feel impossible to break free. Unlike general overthinking, this type of mental replay often centers on unresolved concerns, leaving children and teens feeling distressed and emotionally drained.
In my decades of working with families, I’ve seen firsthand how frustrating and overwhelming this cycle can be—not only for the person experiencing it but also for their loved ones. The good news is that effective, science-backed solutions can help your child stop ruminating and find peace of mind.
What is Rumination OCD?
Rumination, within the context of OCD, refers to the obsessive and compulsive cycle of repetitive negative thinking (Raines et al., 2017). It serves as a mental compulsion that consumes mental space and energy.
It involves a relentless pattern of repetitive negative thoughts, creating a complex mental landscape for individuals, including children and teens. It’s not just overthinking, rumination is marked by its pervasive and distressing nature, often leading to significant distress and impacting the quality of life.
This vicious cycle can be triggered by specific fears, a past scenario or a traumatic experience, or apprehensions about future events. Characteristics of rumination include the inability to control these persistent thoughts, leading to heightened feelings of anxiety and distress.
Rumination vs. General Overthinking
Overthinking can be a good thing when it evolves into constructive thinking focused on problem solving rather than becoming a cycle of rethinking rumination. When your thought process is aimed at understanding a situation or resolving challenges, it can lead to actionable insights and better decisions.
For example, analyzing options thoughtfully or learning to interpret intrusive thoughts can help you address underlying concerns. The key is ensuring overthinking doesn’t spiral into endlessly replaying the same thought or turn into obsessive or ruminative thinking, but instead serves as a tool for clarity and resolution.
Rumination and general overthinking share some similarities, but they differ in terms of their focus, internal process, intensity, and impact on mental well-being.
Here are the key distinctions between OCD and ruminating vs. general overthinking:
General Overthinking | Rumination | |
What do they think about? | Includes repetitive thoughts about a wide range of topics, such as everyday decisions or upcoming events. May not focus on negative emotions or specific themes. | Involves repetitive, intrusive thoughts centered on negative emotions, past mistakes, regrets, guilt, or fears. Often linked to specific themes, such as OCD obsessions that create anxiety and distress. |
How intense are their emotions? | Emotions can be heightened but are not as consistently intense or focused on a specific theme. | Emotions are intense and distressing, often involving anxiety, guilt, or sadness often leading to a depressed mood. Typically linked to a particular event or theme. |
Why do people ruminate? | May occur without a clear purpose or goal. Often a habitual way of processing information but not necessarily driven by a need for resolution. | Rumination plays to make sense of past events, prevent future mistakes, or gain control. Often involves mental acts to alleviate distress but leads to a cycle of unproductive, repetitive thinking without resolution. |
How ruminations impact daily life | May cause stress and hinder decision-making but typically does not reach the level of interference seen in rumination-related disorders. | Significantly impacts daily functioning, interfering with concentration, decision-making, and well-being. Often linked to anxiety, depression, or obsessive-compulsive symptoms. |
How long and how often? | Can be persistent but is usually episodic, triggered by specific situations, and not as deeply ingrained. | Chronic and persistent, with thoughts recurring over an extended period. Often, it becomes a habitual response to stressors and challenges. |
What it leads to | May include attempts at problem-solving, though often less structured and less effective in reaching resolutions. | Lacks adaptability or effective problem-solving. Individuals often get stuck in obsessive thinking patterns without finding constructive solutions. |
What Causes Ruminating Thoughts in Children and Teens?
Children and teens may ruminate for various reasons, often linked to their developmental stage, mental health, and environmental factors. Here’s why they might get stuck in repetitive thought patterns:
1. Cognitive Development
- Struggle to Process Emotions: Young minds are still learning how to identify, express, and process complex emotions like fear, guilt, or regret. Rumination can be an attempt to make sense of overwhelming feelings.
- Problem-Solving Attempts: Children and teens may ruminate as a way to solve a perceived problem, even if it’s something outside their control, leading to mental loops.
2. Anxiety and OCD
- Obsessive Thought Patterns: For kids with OCD or anxiety, rumination occurs from intrusive thoughts or worries about safety, failure, or making the “right” decision.
- Fear of Consequences: They might ruminate on past actions or future scenarios, driven by a fear of making mistakes or experiencing negative outcomes.
3. Perfectionism
- High Expectations: Teens, especially, may ruminate due to an internal pressure to be perfect or fear of disappointing others. They might replay situations in their minds to see how they could have done better.
4. Stress and Trauma
- Unresolved Experiences: Stressful or traumatic events can lead children to replay these experiences in their minds as they try to make sense of what happened.
- Fear of the Unknown: Big life changes, such as moving, changing schools, or family issues, can trigger ruminative thoughts.
5. Emotional Dysregulation
- Difficulty Shifting Focus: Kids with dysregulated nervous systems often struggle to shift their attention away from upsetting or overwhelming thoughts.
- Hyperfocus on Negativity: They may fixate on negative events or outcomes, amplifying their distress.
6. Environmental Factors
- Modeling Behavior: If parents or caregivers engage in rumination or excessive worry, children may adopt similar thinking patterns.
- Pressure and Expectations: High academic, social, or extracurricular expectations can drive kids to overanalyze and stress about their performance.
7. Social Challenges
- Peer Relationships: Friend conflicts, bullying, or social rejection can lead kids to ruminate as they replay interactions and worry about their social standing.
- Fear of Embarrassment: Teens, in particular, may ruminate over perceived mistakes or embarrassing moments as they navigate their desire for social acceptance.
8. Biological Factors
- Brain Wiring: Some kids may be predisposed to rumination due to differences in how their brains process stress and regulate emotions.
- Hormonal Changes: For teens, hormonal fluctuations during puberty can heighten emotional sensitivity and increase the likelihood of ruminative thinking.
By understanding why your child ruminates, you can help them develop strategies to break the cycle and find healthier ways to process their thoughts and emotions.
How to Stop Ruminating Thoughts
Here are steps that parents should know to help their kids learn how to get out of an OCD loop:
- Spot the Pattern: Notice the recurring themes in your thoughts, such as obsessing over social interactions or past mistakes. These patterns are familiar traps designed to pull you deeper into anxiety.
- Embrace the Unknown: Accept that some questions simply have no answers. Remind yourself that seeking certainty or replaying scenarios hasn’t brought peace—it’s only fueled the anxiety cycle. For example, tell yourself, “I can’t control or know what others think, and rehashing this won’t help me feel better.”
- Acknowledge that rethinking isn’t the same as problem-solving: Rumination masquerades as problem-solving, but it never leads to resolution. It tricks you into believing you’re preparing or taking action, but in reality, it keeps you stuck. True problem-solving moves you forward; rumination spins you in endless circles.
- Take Control: Interrupt the cycle by consciously choosing to redirect your focus. Engage in an activity that fully occupies your mind, or simply decide not to analyze the issue further. Though tempting, you don’t need to “figure it out” to move forward.
- Learn coping skills: Effective coping strategies for Rumination OCD focus on redirecting emotional energy toward constructive actions, such as mindfulness or engaging activities, to break the cycle of constant rumination. These techniques can help alleviate depressive symptoms and reduce the distress often linked to mental health conditions like OCD.
- Anticipate the Return: These thoughts are seductive, pulling you in with promises of clarity or preparation. Resist the urge to engage. Remember, rumination thrives on your attention—but you don’t have to take the bait.
- Set Boundaries with Worry: Instead of fighting your thoughts all day, allow a dedicated “rumination window” of 15-30 minutes at the end of the day. Use a timer and plan an activity afterward to help you step away once the time is up. This approach puts you in control rather than letting rumination control you.
Holistic Approaches to Managing Rumination
Ruminating OCD can be managed with a non-medication approach. The first step is breaking the cycle of these mental compulsions and stopping OCD symptoms.
Cognitive Behavioral Therapy
Cognitive behavior therapy (CBT), along with Exposure Response Prevention (ERP) therapy, with its emphasis on breaking negative thought patterns and behavioral cycles, plays a pivotal role in addressing compulsive rumination (Motivala et al., 2017).
This therapy helps one focus on the present moment by employing techniques such as mindfulness meditation and deep breathing. With cognitive-behavioral therapy, your child can gain better control over their thinking. It would be beneficial to locate a specialist who concentrates on rumination-focused ERP.
The parents of kids experiencing distressing thoughts and compulsive behaviors should seek help from a mental health professional. Recognizing the symptoms of distress and understanding the negative impact on daily life is the first step toward getting effective treatments.
A licensed therapist, especially one specializing in ruminating and OCD, can provide tailored treatment plans. Their treatment options often include a combination of cognitive-behavioral therapy, medication, such as selective serotonin reuptake inhibitors, and other therapeutic approaches.
However, medications should never be the first line of OCD treatment for children. Many science-backed natural solutions can produce the same, if not better, results.
Neurofeedback
Neurofeedback is a non-invasive therapy that helps regulate brain activity, reducing obsessive thoughts and compulsive behaviors by training the brain to achieve a more balanced and calm state (Hammond, 2003). My BrainBehaviorReset™ Program incorporates neurofeedback, PEMF therapy, and magnesium supplements in the child’s treatment plan.
The continuous loop of rumination not only affects children with obsessive compulsive disorder but is also a common experience in related clinical issues. Breaking this loop requires a multifaceted approach, therapeutic interventions, and lifestyle changes. Parents should know that there are natural treatments available for OCD that can be managed right in your home. To learn more, check out my Natural OCD Thought Tamer Parent Kit.
Parent Action Steps for OCD Treatment
☐ Learn more about OCD by listening to my It’s Gonna Be OK! Podcast and the OCD series.
☐Understand the main distinction between obsessive rumination and general overthinking.
☐ Explore natural solutions with OCD specialists and consider non-pharmacological interventions.
☐ Acknowledge the potential coexistence of OCD with the symptoms of depression and anxiety disorders.
☐ Encourage spending time on healthy habits, stress-reducing activities, and a balanced routine.
☐ Take the OCD Quiz to help your child with symptoms.
☐ Check out my Natural OCD Thought Tamer Parent Kit.
What does ruminating mean?
Ruminating means repeatedly thinking about the same distressing thoughts or problems without finding a resolution, often leading to increased anxiety and emotional discomfort.
What are some OCD rumination examples in children and teens?
Obsessing over whether they embarrassed themselves in a social situation.
Worrying they made a mistake on homework or tests.
Fixating on whether they’ll get sick from touching something dirty.
Replaying unanswerable questions about life or existence.
Excessively worrying about breaking a religious rule or being “bad.”
Is rumination a compulsion?
Yes, rumination can be considered a mental compulsion in the context of OCD. While compulsions are often thought of as physical actions, such as checking or washing, rumination involves repetitive, internal mental acts aimed at reducing anxiety or resolving uncertainty.
How to stop mental compulsions?
To stop mental compulsions, practice mindfulness to refocus your attention, identify and label intrusive thoughts without engaging, and use strategies like ERP to resist the urge to mentally “solve” or neutralize them. Redirecting your focus to engaging activities or grounding techniques can also help break the cycle.
When does rumination or looping intrusive thoughts evolve into Obsessive-Compulsive Disorder?
A particular thought can become so consuming in OCD that it leads to significant problems in daily functioning. OCD is a mental health condition characterized by persistent, unwanted thoughts (obsessions) and repetitive behaviors or mental rituals (compulsions) performed to reduce anxiety caused by the obsessions.
These compulsions often arise as a way to neutralize disturbing thoughts or feared stimuli, but they typically provide only temporary relief. Common compulsions include excessive cleaning, checking, or seeking reassurance, which can significantly impact emotional well-being.
Early identification of OCD symptoms, such as intrusive thought and compulsive behaviors, is critical for managing its effects on emotional processing and preventing the reinforcement of negative experiences associated with the OCD experience. Recognizing these patterns early can improve emotional well-being and help address the underlying challenges in processing triggers and distressing emotions.
What can excessive rumination lead to?
Rumination OCD can significantly impact a person's mental health and daily life. Prolonged ruminating thoughts may contribute to comorbid depression, generalized anxiety disorder, eating disorders or depress anxiety, as individuals feel overwhelmed by their inability to find resolution. It can also increase the risk of developing other psychiatric disorders due to the constant mental strain.
In some cases, rumination can be accompanied by compulsive behaviours, like excessive hand washing, as individuals attempt to alleviate the distress caused by their intrusive thoughts. Without proper treatment, the cycle of rumination and compulsions can worsen, leading to heightened depressive anxiety and further impairing one's mental health.
What OCD symptoms should I watch out for aside from rumination?
Look for obsessive thoughts, intrusive mental images, excessive doubt, fear of contamination, need for symmetry, or mental rituals like rumination, excessive reassurance-seeking, or attempts to avoid uncomfortable feelings
Does rumination occur in anxiety disorders?
Yes, rumination is common in anxiety disorders. It involves repetitive, distressing thoughts about worries or fears and can contribute to heightened anxiety and difficulty focusing on solutions.
Citations
Hammond, D. C. (2003). QEEG-Guided Neurofeedback in the Treatment of Obsessive Compulsive Disorder. Journal of Neurotherapy, 7(2), 25–52. https://doi.org/10.1300/j184v07n02_03
Motivala, S. J., Arellano, M., Greco, R. L., Aitken, D., Hutcheson, N., Tadayonnejad, R., O’Neill, J., & Feusner, J. D. (2017). Relationships between obsessive-compulsive disorder, depression and functioning before and after exposure and response prevention therapy. International Journal of Psychiatry in Clinical Practice, 22(1), 40–46. https://doi.org/10.1080/13651501.2017.1351991
Raines, A. M., Vidaurri, D. N., Portero, A. K., & Schmidt, N. B. (2017). Associations between rumination and obsessive-compulsive symptom dimensions. Personality and Individual Differences, 113, 63–67. https://doi.org/10.1016/j.paid.2017.03.001
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Disclaimer: This article is not intended to give health advice and it is recommended to consult with a physician before beginning any new wellness regime. *The effectiveness of diagnosis and treatment vary by patient and condition. Dr. Roseann Capanna-Hodge, LLC does not guarantee certain results.
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Dr. Roseann is a Children’s Mental Health Expert and Licensed Therapist who has been featured in/on hundreds of media outlets including The Mel Robbins Show, CBS, NBC, PIX11 NYC, Today, FORBES, CNN, The New York Times, The Washington Post, Business Insider, Women’s Day, Healthline, CNET, Parade Magazine and PARENTS. FORBES called her, “A thought leader in children’s mental health.”
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Dr. Roseann Capanna-Hodge has three decades of experience in working with children, teens and their families with attention-deficit hyperactivity disorder (ADHD), autism, concussion, dyslexia and learning disability, anxiety, Obsessive Compulsive Disorder (OCD), depression and mood disorder, Lyme Disease, and PANS/PANDAS using science-backed natural mental health solutions such as supplements, magnesium, nutrition, QEEG Brain maps, neurofeedback, PEMF, psychotherapy and other non-medication approaches.
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