Do you think too much? How ruminating hurts your heart

by Carolyn Thomas  @HeartSisters

Before my heart attack, I was a champion ruminator. Give me an ugly little problem to worry about, and I’d thrash it to death before finally flinging it aside in a fit of exhaustion, usually after some sleepless nights, a few extra grey hairs, and incalculable damage to my poor coronary arteries.

The late Yale University professor Dr. Susan Nolen-Hoeksema’s research(1) has revealed some interesting facts about ruminating:

“When people ruminate about problems, they remember more negative things that have happened to them in the past, they interpret situations in their current lives more negatively, and they are more hopeless about the future.”

Research also links the habit of rumination with dangerously high levels of the body’s artery-damaging stress hormones like cortisol.      .       .

Dr. Thomas Denson of the University of New South Wales found, for example:

“Self-focused rumination maintains high levels of cortisol following provocation.”

Rumination can even turn other people away, said Dr. Nolen-Hoeksema, author of Women Who Think Too Much: How to Break Free of Overthinking and Reclaim Your Life.

“     When people ruminate for an extended time, their family members and friends become frustrated and may pull away their support.

“It also becomes the fast track to feeling helpless by paralyzing your problem-solving skills. You become so preoccupied with the problem that you’re unable to push past the cycle of negative thoughts.”

Women, apparently, seem to ruminate more than men, she adds. Why? Part of the reason may be that women tend to be more concerned about their relationships than men.

“Interpersonal relationships are great fuel for rumination, and ambiguities abound in relationships. You can never really know what other people are thinking about you.”

Dr. Nolen-Hoeksema suggested these two steps to stop or minimize rumination.

1. Engage in activities that foster positive thoughts. “You need to engage in activities that can fill your mind with other thoughts, preferably positive thoughts,” she said.

That could be anything from a favorite physical activity to a hobby or meditation. “The main thing is to get your mind off your ruminations for a time so they die out and don’t have a grip on your mind,” she advised.

2. Problem-solve. People who ruminate not only replay situations in their head, they also focus on abstract questions, such as, “Why do these things happen to me?” and “What’s wrong with me that I can’t cope?” And even if they consider solving the situation, they conclude that “there is nothing I can do about it.”

Instead, when you can think clearly, Dr. Nolen-Hoeksema suggested that you “…identify at least one concrete thing you could do to overcome the problem(s) you are ruminating about.”  For instance, she says, if you’re uneasy about a situation at work, commit to calling a close friend so you can brainstorm solutions.

And here’s what Harvard Medical School’s Stress Management Special Health Report suggests for those of us who like to take life’s thorny issues and cultivate them until they are well-rooted deep and wide. According to Harvard researchers:

” Worrying, searching for a solution, and forecasting the future can move from pre-occupation to full-time work.”

When this starts to happen, it’s critical to call a timeout, explain Harvard stress experts Dr. Herbert Benson and Aggie Casey.

“Certain hormones fuel the body’s stress response, speeding breathing and heartbeat, directing extra blood flow to the brain and muscles, perking up the immune system, and triggering other changes that prepare your body to respond to a perceived threat.

“At times, the stress response is appropriate and necessary, helping us rise to meet physical and emotional challenges. But stress hormones that are triggered too often or stuck in overdrive can fuel worrisome health problems—from headaches and heartburn to high blood pressure and heart disease.”

Relaxation techniques can counteract this, they insist. Learning and practicing the relaxation response or other similar stress-reduction techniques for 10–20 minutes a day, for example, can protect your health, improve your mood, and boost your overall well-being.

When you find yourself stuck on a particular worry, there are a number of  techniques that can help you break the cycle of stress. Here are two suggestions from Dr. Benson and Aggie Casey that you may find helpful:

1.  Schedule your worries

When your mind is racing, you feel overwhelmed, and you can’t seem to focus, call a time-out for yourself. Set a timer for 15 minutes and write down everything that you’re worried about. But when the buzzer sounds, put your worries away and allow yourself to focus on something else.

If you are going through a tumultuous or difficult time – perhaps you are in the midst of a divorce or you are facing a financial setback – and worry is persistent, try setting aside a specific time each day to record your worries. Simply having this time each day can help you contain your worries. You know you’ll have time to tend to them without having them take over your day.

2.  Make a worry box

Find any box, decorate it however you like, and keep it in a handy place. (This is a great activity to do with young children, since they love helping to decorate the box). Jot down each worry as it crops up on a piece of paper, and then drop the paper into the box.

Once your worry is deposited in the box, try to turn your attention to other matters. The worry box essentially allows you to mentally let go of your worries.

Later on, you can throw out the notes without looking at them again. Some people decide to look through theirs at the end of the month, and while a few of those worries are still bearing down, most of the time they’ll be unfounded.

I’d add to these helpful lists a favourite anti-ruminating tip from a friend whose longtime advice has been to just say (out loud if absolutely necessary) the word “CANCEL!” if you find yourself starting one of those ruminating downward-spiral fretting sessions.

As a heart attack survivor, seeking ways to reduce chronic stress has now  become as important to me in living with heart disease as regular exercise and healthy eating is.

Worrying and ruminating are more often than not completely fruitless, as a quote from the late best-selling author Dr. Leo Buscaglia underscores:

“Worry never robs tomorrow of its sorrow – it only saps today of its joy.”

  1.  Nolen-Hoeksema, Susan. Journal of Personality and Social Psychology, JPSP 2005 (Vol. 77, No. 4, pp 801-814).

See also:

Worried about the COVID-19 virus?Let’s all be palm trees together in facing COVID-19!”

Productive uncertainty: beyond the sourdough

Listen up, ladies: 16 things I’ve been meaning to tell you

Even heart patients can learn to be optimists

“Stress creep”: are you like the frog in the pot of boiling water?

Four ingredients in the heart patient’s recipe for stress

Is everyday stress gnawing at your arteries?

A heart patient’s guide to the three stages of chronic stress

Is family stress hurting your heart?

Women’s heart disease and chronic stress

Got A Minute? Try This Mini-Relaxation For Your Heart Health

In Praise Of Slowness: How ‘La Dolce Vita’ Can Help Your Heart

Poor Marriage = Poor Heart Health for Women


NOTE FROM CAROLYN:   I wrote more about managing many types of changes brought on by health crises in my book, A Woman’s Guide to Living with Heart Disease”.  You can ask for it at your local bookshop, or order it online (paperback, hardcover or e-book) at Amazon – or order it directly from my publisher, Johns Hopkins University Press (use their code HTWN to save 30% off the list price).


9 thoughts on “Do you think too much? How ruminating hurts your heart

  1. Pingback: Clinical Hearts
  2. Thank you so much for the article. I too have been a life long ruminator. For me it began in my teen years (15 years old) and it started after my first relationship that ended abruptly …”Why me?” “but I love her” “What am I going to do next?” “Life is not fair” etc…etc… and the thoughts would go on and on in hopes of finding an answer which never came.

    Throughout my life I would ruminate about various topics that feared me both past and present and I would just sit there and think about it over and over. Now I am 45 and am beginning to realize that ruminating got me nowhere!!! The only things rumination has done for me was it allowed me to ruminate some more. Now, I am in therapy and I realized I am getting tired of focusing on my misfortunes of the past and the uncertainty of the future.

    When I am in this mode of thinking (rumimation) everything in the present is left unattended due to my constant thinking of the past and future. I allow myself to be so occupied in thought that problems of the present can be difficult to handle and digest… I want to end this way of thinking and pursue some real happiness again.

    Liked by 1 person

    1. Thanks for your comment, Georgette. Check out the links above for more interesting info on this topic.


  3. I recognized myself in every paragraph here.

    “…Worrying, searching for a solution, and forecasting the future can move from pre-occupation to full-time work…”

    Welcome to my world. I seem to have taken “ruminating” to a lifelong preoccupation. It has truly taken over my life and gets in the way of even being able to enjoy normal things. This article is quite the eye-opener for me.

    Liked by 1 person

    1. Dear Worried – well, they say awareness is the first step, right? Good luck in your next step. . .


  4. Interesting & enlightening article. Thank you for sharing that “CANCEL!” tip. I myself had been using the word “delete” whenever a worry thought popped into my head.

    I also like the idea of the worry box and may give it a try.

    This site is a wonderful, helpful resource.
    Thank you.

    Liked by 1 person

    1. “Delete” is a very effective anti-worry command, Reyna! I appreciate your comment here.


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