How To Deal With Constant Rumination: 12 Ideas

Last week, the Times re-ran a piece from 2023 about how to stop ruminating. As someone who has had OCD my entire life, compulsive thinking has been a constant challenge for me – one that I feel like I’ve only gotten a handle on recently. What has worked for me may not work for others and my solution is both time consuming and expensive so you can rightfully ask if it’s even any better than the status quo (to me, the mental clarity and peace and contentment is worth it).¹ But with that said, if you struggle with constant rumination – especially if you feel like you have a particularly strong negativity bias so your ruminations are always about your faults and mistakes, locking you into an endless doom loop – here’s what has been working for me.

What I do do:

Meditation: For years and years, I tried and failed and told myself that my brain is just particularly unsuited for meditation. Then I hit a point in my life where I really needed to try everything I could. I started taking weekly meditation classes (I still do) and I practice daily.² Of the 20-25 minutes I spend meditating, I’d estimate that about 30 seconds are purely focused on my breath and that’s about it. But that alone has been enough to give me an extra beat so when I start ruminating, I can usually see what’s happening from the outside in and change course.³ The act of doing it, day in, day out has gone from a chore to something I genuinely value. You do have to make the time every day and I’m not sure meditation is particularly easy for anyone (especially people who have rumination problems to begin with). But like working out and therapy, the value is in the reps so just keep doing it.

Exercise: All science seems to show that exercise is the single healthiest thing a person can do. It helps mentally, physically, emotionally (none of this is a surprise to any of you). I usually exercise five times a week. I lift with my trainer three times a week (unless I’m traveling) which forces me to be at the gym. I have cardio equipment at home and do that twice a week. Not every workout is great. But the collective benefit is clear.

Therapy: I have a really great therapist. And even with that, I’d say it’s only incredibly helpful about a third of the time. About a third of the time it’s worth the 45 minutes but isn’t life changing. And about a third of the time, I make things up to talk about or cut the session short. But the value of doing it every week and having it there as a constant resource is incredibly high. My therapist is almost part psychoanalyst and part coach. She doesn’t hesitate to give me tangible advice on what to do and what not to do. I don’t always listen, but having her perspective is always helpful.

Medication: If you have OCD, my advice is to take medication for it. For the first 40 years of my life, I resisted. I was worried it would slow me down, take the edge off and I would be less effective. That turned out not to be the case. There is no magic pill for OCD because doctors don’t understand what causes it in the first place. But SSRIs can mitigate the symptoms, so when something does happen, it goes away faster. I tried an experiment for most of 2024 where I took mounjaro on the theory that the same GLP-1 properties that help fight other cravings could fight compulsive thinking too. Hard to know if it worked but it felt like it did (the problem is I lost too much weight and muscle mass and had to stop taking it)⁴. My doctor recently gave me Vyvanse as a replacement, which is an ADD medication. I think it helps: it keeps me more focused and present which reduces rumination. Finding the right medications and dosage is a constant experiment (and requires a good doctor), but in my experience, is one worth doing.

Things you carry: I have come to define happiness as feeling good about myself on a sustained basis, which requires being good. That means my actions weigh heavily on me because if I regret something, I know I will ruminate about it. So I’ve found doing the right thing and the generous thing usually makes sense simply because the cost of otherwise carrying it with you isn’t worth it. It’s not because it’s more moral or ethical and therefore better. It simply generates a higher return on investment than not doing it. That doesn’t mean I always do the right thing, but I know it’s in my interest to try (and I usually do).

What I don’t do:

Drugs: I was never into hard drugs, but I loved smoking weed (it calmed the rumination temporarily).⁵ But when weed became legal and both incredibly potent and widely available, it was too much for me. It just got so ubiquitous and easy that I finally realized I was better off just stopping entirely rather than trying to do it in moderation. It’s been 18 months and I am very, very glad I did. I feel better physically and mentally covering everything from diet to digestion to taking less tylenol. And I no longer beat myself up about it, so quitting removed a major topic of negative rumination. I don’t think there’s necessarily anything wrong with weed in moderation, but today’s weed is so potent and the friction is so minimal (both in terms of getting it and using it if all you have to is draw on a smokeless, odorless vape pen) that moderation is difficult for some people.

Alcohol: I wasn’t a huge drinker, but when I hit my mid-40s, my body decided it had enough altogether. One drink or glass of wine resulted in a two day headache. So I stopped and am glad I did. I feel really good, physically and mentally. Every so often, I check to see if my body somehow learned how to better process alcohol (in December, I had a particularly bad day at work, was out for dinner with friends, decided I would join them in having cocktails, finished one, ordered another and had half, and then had a headache for the next three days). It hasn’t.

Social media: To me, social media is the quintessential unhappiness machine. First, you go online and compare your real life to everyone else’s carefully curated profiles, which makes you automatically feel inadequate by comparison. Then, you see everything happening that’s bad, everywhere at once, all of the time — along with everyone’s reactions to it. That makes you feel even worse. Because human beings have a negativity bias (a necessary evolutionary trait), we are far more likely to click on negative headlines and links than positive. The platforms know this so they feed us as much toxic content as they can because the more we click, the more money they make. So we’re constantly fed anger, negativity, violence and hatred. Why choose to expose yourself to that? My kids are teenagers and not being on social platforms really isn’t an option for them. But I’m 51. There’s no need.⁶

People who aren’t a good fit: You’re not for everyone and everyone is not for you. Every relationship is based both the way one person behaves and the other person perceives it. Sometimes the fit is bad. For me, nothing causes more rumination than personal conflict. If there are people in your life who you feel are ceaselessly negative or require endless emotional care and tending or treat you poorly and all of that leads to rumination, you’re better off ending the relationship. It’s just not worth it. Over the past few years, I have gone about removing myself from those relationships. The short term can be very, very difficult. Lots of anger, resentment, recriminations, hurt feelings all around. But the long term is much, much better and well worth it.

What else helps:

Relationships: All happiness science shows that two things make people happy: having people in your life who love and support you unconditionally (and visa versa) and having activities that regularly give you meaning and purpose.⁷ I have different types of relationships with different people, but I have found that the more proactive I am about seeing people, making plans, going to dinner, going to Knicks and Mets games, texting, checking in, the closer I feel to them and the happier I am. This has always been my habit and when I went through a really rough patch a few years ago (divorce and my daughter was sick), people were there for me in droves. I was incredibly grateful for it (I still am). I even made a list of the 50 people I feel closest to and periodically go through it to see if there’s anyone I haven’t talked to recently. When there is, I check in. I never regret it.

The right partner: I am lucky to have a partner I know I can count on for support, care, friendship and love no matter what. It doesn’t go up and down. The baseline is constant. I feel seen. That doesn’t mean Laurel and I agree on everything, but whether it’s a problem one of us is going through or a problem between us, we talk it through until we get to a reasonable resolution. We let each other be who we are. Just knowing I can count on her, day in, day out, gives me incredible confidence, comfort and contentment (even beyond the fact that we just really like and enjoy each other). It makes all the difference in the world.

Purpose: I try to pack my days with as many things as possible that give me purpose and meaning simply because, selfishly, that is better for me. You create more dopamine when you help someone else or have a positive interaction with someone else – far more than when you buy something. I am very aware of what activities give me purpose and meaning, I know that doing them makes me happier, and so I try to make sure that at least some of them are a daily part of my life.

That can be the work we do out of Tusk Philanthropies on mobile voting and hunger. It can be volunteering weekly at the soup kitchen. It can be meeting with people regularly who want advice and help. It can come from trying to be a generous and reasonable employer or neighbor or member of a community. It can come from non-profit work like creating and funding the Gotham Book Prize or creating a way for women in red states to get access to abortion medication via telemedicine. It can also come from activities that are intellectually fulfilling like writing substacks and columns and books, hosting my podcast, teaching, and speaking publicly. It can be just hanging out at my bookstore and knowing that even though it loses money, people seem to enjoy being there and I enjoy the praise I get for that (and because we’re the only podcast studio in NYC that’s free for anyone to use, I still get a mild dopamine hit every time I see someone in there enjoying it). I also carry ten dollar Dunkin Donuts gift cards in my pocket and give them to homeless people or migrants when the mood strikes (it probably does as much for me than it does for them). There are lots of things you can do.⁸ And it should be things you enjoy. The point is to identify them and then actually go do them. It may seem like a hassle, but the reward is far greater than just about anything else you will do with your time or money.⁹

Even with that, not every day is filled with meaning. And I still have to make a living so that means meetings I’d rather not do, personnel issues I’d rather avoid¹⁰, etc… But overall, I have found that having purpose makes you a lot happier.

Are these twelve things a magic bullet for everyone? No. I’ve come to them through a lot of trial and error, a lot of mistakes and missteps. Also, I am lucky to be at a stage in my life where I can afford to do anything that’s important to me, I have a lot of agency over my time and schedule and my kids are old enough not to need constant attention on a minute by minute basis. And not ruminating as much doesn’t automatically eliminate all of the other day to day struggles of emotions, human interaction and conflict. Life is not – and never will be – an endless sea of bliss. Being human means confronting anxiety on a constant basis. You can’t eliminate it. But you can manage it.

Even if these ideas are not right for you, a theme that runs through everything above is being proactive: finding the right medication, putting in the reps for therapy and exercise and meditation, identifying things that are toxic and actively removing them from your life, doing things deliberately and frequently that put you in contact with other people you care about or are activities that give you meaning and purpose. In other words, just do stuff.

OCD is a tough way to live. And hopefully one day, they’ll understand it better and develop a medical treatment that really works. But until then, managing it is the best you can do. So if you do suffer from OCD or even just excessive rumination, some of the ideas above may be worth a shot.

1. It doesn’t have to be expensive. You can work out without a trainer. You can learn to meditate without a coach. You can make sure your therapist is covered by insurance. Same with any medication you take for OCD. The acts that give you purpose don’t have to include financial donations. So if you like the ideas in this piece but are weighing how to go about it, money should not be the excuse to not do it.

2. I’ve tried to combine learning meditation with some learning about Buddhism. The Buddhist view of things is consistently interesting and often in line with how I’m trying to live, so to the extent you can incorporate both, it’s been useful for me.

3. I had an ah-ha moment a few months ago on this. I was in Lisbon for a conference, was upset about something (can’t even remember what), was compulsively thinking about it and then, as I was walking up this narrow, cobblestone street, I paused and thought, “Oh right. I’m spiraling. Here’s why. Here’s what’s bothering me. Here’s the reality of it.” That didn’t change everything immediately but it got me to the right place much faster.

4. They’re already working on versions of GLP-1s that don’t cause sarcopenia so there hopefully will be a time soon where if semiglutides can actually help address the root cause of OCD, you’ll be able to take them without losing muscle mass, which you also really need, especially as you age.

5. The human need for relief from anxiety, even if you don’t have OCD, is incredibly strong which is why we struggle societally so much with addiction. As we all know, the long term harm vastly outweighs the short term relief that drugs and alcohol provide, but it takes all of the steps above — medication and meditation and exercise and therapy and the rest — to be able to develop the tools to just sit with your anxiety. It’s a skill you have to develop — one we need to teach specifically and tangibly in schools rather than just warning about the harms of drugs or alcohol. Knowing the right information alone isn’t enough to reliably act on it. It takes developing the tools and that takes a lot of work.

6. There is some cost for me in terms of not being able to use social media to try to drive more listeners to my podcast or readers to my substack and columns. I’m willing to make that tradeoff and because I don’t charge for my substack or take advertisers for my podcast, that’s my choice to make (I do have a LinkedIn profile that my comms director manages. I don’t check it or even see it as social media but you might).

7. Resisting the siren songs of wealth, status and attention can be very difficult since our society is designed to teach you from birth that those things are all that matter. They’re not, but that underlying belief is the engine for capitalism so it’s very hard to see past it.

8. To be clear, you have to actually do something. Tweeting and posting and complaining won’t make you feel better. Feeling purpose means doing something tangible to help other people. Just expressing outrage and airing grievances is simply puffing up your identity for status within your social group (same for a board and charity circuit designed just for your own status). It means nothing if that’s all you do. If you want things to change, do something real and tangible about it.

9. Would I do all of these things if I hadn’t been fighting a rumination doom loop (or would I be back in it if I didn’t do these things)? I like to think so because I’ve been doing some of these things for decades and I enjoy them and they make me feel good. But moderation has never come naturally to me and there’s a good chance fewer things would still produce a strong sense of purpose and meaning.

10. Another challenge comes with being an employer. It means firing people who aren’t performing. Those people then hate you for the rest of their lives. And they pop into your head sometimes so you have to be able to learn to live with knowing they hate you. It has taken me a lot of time to be able to do it and it’s still sometimes difficult.