“Rumination refers to the tendency to repetitively think about the causes, situational factors, and consequences of one’s negative emotional experience. Basically, rumination means that you continuously think about the various aspects of situations that are upsetting. Think about your own tendencies. When something upsets you do you tend to mull on it, and keep going over the problem again and again? If so, then you are probably a ruminator…The research is extremely consistent. People who ruminate are much more likely to develop problems with depression and anxiety, and those problems are hard to overcome for someone who fails to change ruminative thought patterns. Rumination is also connected to many different forms of self-sabotage. For example, if you ruminate on something upsetting a friend did, it’s going to take longer to forgive that friend and get back to enjoying time spent with him or her. If you hold a grudge and constantly ruminate on what that friend did, you might even destroy a good friendship.” (1)
Edward A. Selby Ph.D.
As this quote makes clear, replaying negative events over and over and over again in your head can quickly turn an appropriately sad mood into full-blown depression. Through negative self-talk, unfortunate events are often interpreted by ruminators as proof of their inherent unworthiness. Dr. Aaron T. Beck, father of Cognitive Behavior Therapy (CBT), calls the emotional outcome the four D’s: Defeated, Defective, Deserted and Deprived.
A large part of modern psychotherapy is involved in helping depressed clients forcefully dispute the negative thoughts that precede these feelings. Albert Ellis, the father of Rational Emotive Behavior Therapy (REBT) which is a precursor to CBT, made it his life’s work to counter these irrational beliefs.
In his classic book How To Stubbornly Refuse To Make Yourself Miserable About Anything-yes, Anything, Dr. Ellis wrote:
“Now let us suppose that when you are unfairly deprived of a job or a loan you make yourself feel severely anxious, depressed, self-denigrated, or enraged. You see that you are being treated unfairly. You upset yourself immensely about their unfairness. Can you still choose to have or not have these strong, off-the-wall feelings? Definitely, yes. Clearly, you can.
That is the main theme of this book: No matter how badly you act, no matter how unfairly others treat you, no matter how crummy are the conditions you live under—you virtually always (yes, A-L-W-A-Y-S) have the ability and the power to change your intense feelings of anxiety, despair, and hostility. Not only can you decrease them, you can practically annihilate and remove them. If you use the methods outlined in the following chapters. If you work at using them!”
And I agree, as does the clinical research. How you interpret the unpleasant realities of your life can and does affect how you feel about them. I believe everyone would be well served learning these techniques to make it through life without losing precious sanity.
That said, there has always been some dispute about the assumptions made by proponents of both REBT and CBT. In both causality is chiefly assumed to occur in this manner:
A → B → C
Where (A) represents the event we do not desire, (B) the belief or beliefs we tell ourselves about this unpleasant experience and (C) the emotional and behavioral consequences that flow from that interpretation.
Some have questioned this unidirectional model pointing instead to disturbances in neurotransmitter pathways that lead to negative thoughts not necessarily tied to changes in external reality. The controversy rages between those who emphasize the use of mind-altering pharmaceuticals to control debilitating mood disorders in contrast to those who champion the use of talk therapy based on either REBT or CBT principles.
Today’s study suggests that gut flora plays a crucial missing link in how negative thoughts are initiated. (2) Its results suggest that both psychology and psychiatry need to move beyond talk therapy and the manipulation of neurotransmitters and focus more of their attention on the state of human gut flora.
Forty young adults were chosen to participate in the study. Their mean age was about 20.
Eight were men, thirty-two female. None were reported to have cardiovascular, kidney or liver disease.
Neither were they reported to suffer from allergies or intolerance to either lactose or gluten. No one reported being on any medication or drinking more than three to five alcoholic drinks per week.
All were quizzed with the Mini International Neuropsychiatric Interview (M.I.N.I.). This is a short interview to screen for several psychiatric disorders. All were found to be free from these disorders and none reported having a family history of depression or migraines.
This is important because the researchers wanted to study the effects of probiotics in people free from known psychiatric disturbances. Most studies of this type are done with people already suffering some form of mental imbalance so the results of this study have much wider implications.
Participants were randomized into two groups, one receiving a daily placebo and the other a daily probiotic for four weeks. The probiotic was Ecologic® Barrier produced by Winclove, a company headquartered in the Netherlands.
The probiotic contained the following bacterial strains: Bifidobacterium bifidum W23, Bifidobacterium lactis W52, Lactobacillus acidophilus W37, Lactobacillus brevis W63, Lactobacillus casei W56, Lactobacillus salivarius W24 and Lactococcus lactis (W19 and W58).
This was a triple-blinded trial meaning that the participants, administrators and the assessor of results had no ideal which of the participants received the probiotic versus placebo.
Before and after the intervention, all participants filled out a questionnaire to assess their reactivity to sad mood. They were also assessed for symptoms signalling depression and anxiety.
In order to save me some time, I’ll let the researchers speak for themselves:
“The aim of the current study was to investigate the effect of a multispecies probiotic intervention on cognitive reactivity in healthy individuals not currently diagnosed with a mood disorder. As mentioned in the introduction, cognitive reactivity is an important vulnerability marker of depression; the content and the type of thoughts that are activated when an individual experiences sad mood predicts whether the sad mood will be transient or will persist, and predicts the development of clinical depression…We found that a 4-week multispecies probiotic intervention reduced self-reported cognitive reactivity to sad mood, as indexed by the LEIDS-r [The LEIDS-r is a thirty-four item questionnaire that assesses the extent to which a sad mood reactivates negative thought patterns].
Further analyses showed that the strongest beneficial effects were observed for the aggression and rumination subscales, indicating that in the probiotics supplementation condition participants perceived themselves to be less distracted by aggressive and ruminative thoughts when in a sad mood. Notably, studies have shown that the tendency to engage in ruminative thoughts is sufficient to turn mood fluctuations into depressive episodes, and that individuals who typically respond to low mood by ruminating about possible causes and consequences of their state have more difficulties in recovering from depression…Further, the activation of aggressive thoughts has been associated with suicidal ideation and attempts…In sum, the present results indicate, for the first time, that probiotics intervention can influence cognitive mechanisms that are known to determine vulnerability to mood disorders.
Folks, this is huge!
Here we have a randomized, placebo-controlled trial demonstrating that daily intake of a probiotic can prevent rumination and feelings of aggression in otherwise healthy twenty-year old adults. And this all occurred without psychotherapy or the use of powerful psychiatric drugs.
Now, the researchers did note a few limitations of their study. First, they did not control for diet or the consumption of other probiotics or fermented foods during the study. But given that no one knew whether they were receiving a placebo or not, I’m not overly concerned that this confounded the results.
A second limitation of this trial was that probiotic intake was not independently verified by stool analysis, although I again see no reason why those randomized to the probiotic would have avoided taking it.
A major limitation of the study in my mind, and one readily acknowledged by these researchers, was the predominantly female composition of the participants. Recall that out of the forty people who took part in the study, only eight were men. It would be great to see a similarly constructed study done with a bigger male cohort to verify mood improvement in a larger group of men.
These results mimic what I’ve experienced in my life. Consistently taking probiotics calms me down making me far less anxious or prone to depressive thoughts.
I’m much less likely to “what if” myself to death about events that I have no control over. I’m also more likely to shrug off perceived slights. Rather than enrage myself over an inconsiderate driver cutting me off in traffic, I’m more likely to just ignore it and drive on.
I suspect one of the major reasons for these effects is that beneficial bacteria prevents endotoxemia and the initiation of the Inflammatory-Cortisol Ballet. Chronic inflammation fueled by gut dysbiosis has system-wide effects on all bodily processes, including the brain.
Does this mean that talk therapy is useless? Not at all.
I believe learning the lessons of Rational Emotive Behavior Therapy or Cognitive Behavior Therapy makes life far more bearable than would otherwise be the case. But this type of research is increasingly demonstrating how essential healthy gut flora is to preventing mood disorders.
It’s not an either/or issue. Actively disputing irrational beliefs AND having healthy gut flora is a winning combination to help deal with “the slings and arrows of outrageous fortune.”