Understanding Overthinking and Rumination: How to deal with it?

Published by Aaradhana Reddy

Counselling Psychologist (M.Sc Counselling Psychology)

We all at some point have indulged in overthinking and for some overthinking is a constant. It often feels like a downward spiral with no end and feels impossible to get out of. It is complex, distressing, disorienting and overwhelming, hampering our everyday functioning. Both overthinking and rumination are included under the overarching concept of Repetitive Negative Thinking (RNT). The following article will aim at understanding overthinking and rumination, its causes, links to mental health and techniques that help us deal with them.

Contents

1. What is Overthinking?

2. What is Rumination?

3. Key Differences between Overthinking and Rumination

4. Why Do We Overthink and Ruminate?

5. Link to Anxiety and Depression

6. How to Deal with Overthinking and Rumination?

7. When to seek professional help?

What is overthinking?

Overthinking is a pattern of repetitive negative thoughts that send the individual on a downward spiral/loop leading to mood disturbances and distress. Overthinking is excessive worry about decision making, choices, problem solving etc. It often starts with the intention to take action but ultimately becomes unproductive.

What is Rumination?

Rumination is again a form of repetitive negative thoughts, about certain past events which involves brooding, self-critical/doubting narratives (involving what ifs, why me questions).

Rumination can be divided into categories; trait rumination and state rumination. Trait rumination is a stable, habitual tendency to indulge in negative self-referential thoughts overtime while state rumination is acute, temporary indulgence in negative thoughts in reference and in response to the stressor. State rumination can evolve into trait rumination and both of them have a negative impact on affect and mood (Wei, et al., 2024).

Apart from the above there are four types of rumination:

1. Brooding Rumination: This is a perpetuating, intrusive and often distressing type usually about certain past events or about oneself. Usually consisting of why me thoughts, why did this happen to me etc.

2. Reflective Rumination: This is a solution-oriented type, usually when the individual is trying to solve a problem. This can be helpful but only if it leads to action.

3. Intrusive Rumination: This type is associated with PTSD and is shown to be a significant predictor of post traumatic stress. It is when exposure to stressful events cause intrusive thoughts/feeling, that are difficult to manage and get out of.

4. Deliberate Rumination: This type is seen as a relatively positive type that can lead to post traumatic growth. This is when the individual deliberately engages with thoughts/feelings to understand the situation or themselves more holistically and deeply (García, Duque, & Cova, 2017).

Key differences between overthinking and rumination

Overthinking and rumination are both part of the repetitive negative thinking patterns. They are often used interchangeably. But, from my counselling experience with both adolescents and adults; overthinking and rumination differ along the lines of the content of thoughts. Overthinking is oriented towards the future such as during decisions to make or problems to solve. Rumination is oriented towards the past. Memories of past experiences, which may trigger repetitive and intrusive thoughts.

We can also view overthinking and rumination as levels on a spectrum. Overthinking falls on the lower end of the spectrum which maybe acute and easier to distract from or get out of. For example, one may overthink about a medical intervention or an upcoming exam or problem. Once it has passed or when taken help, it might subside. While on the other end of the spectrum is rumination which maybe more intense, chronic, intrusive often underlying and perpetuating mental health illnesses especially associated with depression.

Overthinking does not really have clinical implications, while rumination does.

In conclusion, both at the end of the day are repetitive negative thinking patterns with downward spirals/loops that are maladaptive and unproductive.

Why do we overthink and ruminate?

Before we understand, the causes lets understand why we concentrate and get stuck on certain thoughts and not others. This is because of the negativity bias of our brain and it has do with evolution.

Negativity bias: In order to survive, we needed to scan our environment for dangers and looking at any and all things around us was necessary for our survival. So, our brain evolved to have something called a negativity bias; where we look at and think about the negative aspects analyzing its solutions so as to ensure our survival. Now, this made sense during hunter gatherer times. But now, situations are very different where we have more psychological dangers more than physical ones per se. But our brain does not know the difference between physical and psychological dangers. So, when we are faced with a problem be it physical or psychological, our brain only senses danger and threat to our survival. Hence, it has to work overtime analyzing everything about it to ensure our survival.

I see a lot of this with adolescents in my counselling practice. When they are narrating an experience or about people who affected them, they usually talk only about the negative aspects and sometimes they maybe right, but not always. So, it becomes important to also ask about other positive experiences as well.

Causes of Overthinking and Rumination

Just like everything else, causes for overthinking and rumination are complex. Why a person is ruminating at any given point depends on the situation, personality, past experiences, life situation and mental health of the individual. We will be looking at the most common ones, although there can be many more. All the causes are interconnected.

1. Low self-esteem: Low self-esteem in simple terms in when an individual views negatively about him/herself. Putting it in context of rumination, the self-reflective thoughts when activated are usually negative and strong. Often because they have core negative believes about themselves. For example, after a breakup (either friendship or romantic relationship) or after experiencing failure, their self-reflective narratives are often pointing blame towards themselves. Attributing breakup to their inadequacies, failures and worthlessness. This can very quickly turn into brooding rumination.

   
   

   There is another form of unstable self-esteem which is fragile high self-esteem. It is when an individual shows outward high self-esteem but internally has an unstable or low sense of self. Hence, when an individual with fragile high self-esteem receives criticism or negative feedback, it causes disturbance to how they feel about themselves and how others feel. They tend to get defensive and may employ rumination to constantly replay the criticism or mistakes to reduce the disturbance which is often counterintuitive. It is linked to depression (Phillips & Hine, 2016).

2. Perfectionism: Perfectionism has been closely linked to rumination. Perfectionist tendency to have exceedingly high expectations, to dwell over perceived flaws, evaluative fears like fear of failure and criticism from others can trigger self-doubt, negative self-reflective thought and overanalyzing. All of which can trigger rumination (Saha & Vijayan, 2024; Abdollahi, 2019). “Furthermore, the negative influence of perfectionism on self-esteem, emphasizes the tendency for rumination” (Saha & Vijayan, 2024, p. 182).

3. Problem solving mechanism: As we read above, rumination can often start off as a problem-solving mechanism. A person might start off with the intention to solve the issue he/she is facing. If other factors like low self-esteem, perfectionism, fragile high self-esteem, ongoing mental health difficulties (depression, anxiety) etc. are also present, it might turn into rumination.

4. Misguided coping mechanism: Not many talk about the function rumination serves. Rumination can often serve as a coping mechanism albeit a maladaptive one. It comes under avoidant coping mechanism. It is the most common form of coping mechanisms I see in both adolescents and adults when faced with a problem. It is categorized under avoidance for two reasons.

   Firstly, rumination is a passive phenomenon. Meaning that rumination allows for passive overanalyzing or brooding that hinders an individual from taking any action toward problem solving.

   Secondly, rumination often is an experiential avoidance strategy. Experiential avoidance is when an individual is unable to or unwilling to remain with distress/uncomfortable or overwhelming emotions. Rumination often bypasses dealing with emotions and being stuck in analyzing why things went wrong or why is this happening or stuck in overanalyzing how the problem can be solved (Smith & Alloy, 2010). Sometimes rumination and other experiential avoidance strategies can go hand in hand to reduce the discrepancy between their current mood (sadness/depression) and their goal towards joy/happiness. Rumination is often employed to problem solve the discrepancy and experiential avoidance is employed to bypass dealing with their current emotional state and the underlying root cause (Schut & Boelen, 2017).

5. Intolerance of uncertainty (IU): People who cannot tolerate uncertainty and lack of control often use rumination (repetitive thinking) as a mechanism to reduce uncertainty and try to gain control by getting a false sense of predictability. Rumination acts as a mediating factor between IU and psychological wellbeing. Meaning, IU leads to increase in rumination and in turn lead to a decrease in psychological well-being (Yook, Kim, Suh, & Lee, 2010; Kaya & Bağatarhan, 2025).

Link to Anxiety and Depression

Rumination and overthinking have been heavily linked to depression. Rumination and overthinking is also associated with several other anxiety disorders like GAD (Generalized Anxiety Disorder), PTSD (posttraumatic stress disorder), social anxiety, OCD (obsessive compulsive disorder) etc. In social phobias, rumination and overthinking is mainly after the event processing, where the individual constantly replays the social interactions, perceptions of other people on self and negative self-reflective thoughts after the event. Rumination has also been linked to alcohol abuse. Studies have shown that, people who ruminate as opposed to people who don’t; show increased alcohol abuse. It is likely another form of avoidant coping strategy they are using along with rumination (Smith & Alloy, 2010). Overthinking is also linked to poor sleep quality (Li, Corkish, Richardson, Christensen, & Werner-Seidler, 2024). Sleep is affected during stressful events and when falling asleep becomes difficult, we tend to stay in bed ruminating and overthinking past and/or future events which exacerbates sleep issues. Additionally, individuals when busy the whole day tend to be distracted from ruminative thoughts might ruminate during at night when free affecting sleep quality (Hairston, Portal, & Carmon, 2022).

Rumination is a risk factor and maintaining factor in depression (Christoff & Fox, 2018). Read more about the symptoms and causes of depression on our blog. There are multiple theories and plethora of researches connecting and explaining the relationship between rumination and depression. Rumination predicts the onset of new depressive episodes, rumination maintains the existing depressive episodes (we will see as to how in the later paragraphs), acts as a mediator between other risk factors like childhood trauma, stress etc. Lastly it is linked to worse prognosis and reduced response to treatment to depression (Ehring, 2021).

The most widely used theory is the Response Styles Theory (RST). Depression is characterized by low mood and negative affect. RST states that how a person responds to the negative affect in turn determines the severity of the symptoms and prognosis of depression. Ruminating about the causes and consequences of the negative affect is linked to more severe depressive episodes and delayed recovery (Smith & Alloy, 2010). Hence rumination according to this model is a risk factor that exacerbates and perpetuates depression. Another model also explains how a person’s belief about rumination ultimately leads to and sustain depression. The model states that when a person has both positive beliefs about rumination (rumination will help me solve the problem) and negative beliefs about rumination (rumination is unstoppable, uncontrollable and has negative consequences); the combined dynamic of these thoughts can lead to and maintain depression. In more concrete terms, a person facing a stressor may believe that rumination can help them reach a solution, but slowly also realizes due to the negative consequences of rumination (prolonged negative affect, lack of action, social consequences) that rumination is maladaptive, uncontrollable ultimately leading to or perpetuating depression (Matsumoto & Mochizuki, 2018; Cano-López, García-Sancho, Fernández-Castilla, & Salguero, 2022).

During my practice with adolescents, I notice that overthinking/rumination is rather high in Gen Z as well. Rumination and social media use which is widely seen in Gen Z are also related. Social media rumination (SMR) involves excessive and repeated thinking about likes, posts, upward comparisons etc. It is linked to anxiety, depression and social media addiction (Chentsova, Bravo, Mezquita, Pilatti, & Hogarth, 2023). Read more on social media usage and addiction.

            I also notice overthinking with academics in adolescents. Academic overthinking can have harmful consequences contributing to adolescent's overall mental health. In schools, I often hear procrastination and no effort and teachers often say its just laziness or their personality. It is usually due to stress, anxiety and academic overthinking. Academic overthinking involves repetitive and excessive thinking about grades, academic evaluations made by others, academic failures and mistakes, fear of failure, unrealistic standards/perfectionism etc. It is caused by internal standards and external expectations from both institutions and family. Academic overthinking is associated with low self-esteem and self-efficacy, stress, burnout, anxiety, procrastination, decreased academic engagement, maladaptive avoidance etc. (Damsa, 2026).

How to deal with Overthinking and Rumination?

There are proven ways to help us deal with rumination and the first step is to take back control and tell ourselves that we can do it.   

1. Mindfulness: Mindfulness is a technique widely used to deal with overthinking and rumination. Mindfulness helps bring back attention to the present and deal with thoughts without getting caught up in them. At the core of mindfulness is non-judgemental awareness. It’s the ability to observe thoughts with curiosity and without judgement (either judging oneself for having the thoughts). Judgements (bad, immoral, unacceptable) usually lead to repetitions and push us down a spiral. Mindfulness helps us observe these thoughts without suppression and judgement. Mindfulness includes at least two distinct components: the self-regulation of attention towards the present moment and the adoption of an orientation marked by curiosity, openness and acceptance (Schut & Boelen, 2017). It involves letting them pass by like clouds in the sky. Practicing mindfulness is easy and can be a short everyday practice. Although it seems difficult at the beginning, it’s a skill and consistent practice can achieve results.

   To practice mindfulness you can start with mindful breathing exercises, body scan exercises, mindfulness of thoughts etc. You can find some mindfulness practice exercises and audio tracks here.

2. Cognitive Behaviour Therapy (CBT): CBT is widely used today and has proved effective in dealing with depression, anxiety, PTSD etc. CBT mainly focuses on the thoughts and its resulting effects on behaviours and emotions. CBT holds that our thoughts about the situation, results in our distress and maladaptive behaviours and not the situation itself. CBT focuses on the aspects that are at the root of overthinking and rumination. After which, cognitive restructuring takes place. This is where the core beliefs, negative thoughts (NATs) are targeted to learn new more balanced ways of thinking about the situation/oneself or the world. We cannot stop our thoughts from coming, suppressing them has the opposite effects and the only way to manage them is by trying to restructure our thoughts, helping our ruminative tendencies. The culminating effect of cognitive restructuring and emotional regulation can help in reducing the overwhelm caused my overthinking and rumination, free up the pre frontal cortex and a switch to taking action when necessary.   

3. Catch Yourself: Catching oneself is essentially about awareness. If we are able to identify our triggers and catch ourselves when we are starting to overthink and ruminate, we can take a step back to identify the thoughts and maybe even why you are thinking a certain way. Having awareness in these aspects is the first step towards change. It is important to do this in the initial phases of trigger and rumination tendencies rather than later, to ensure that our prefrontal cortex and the amygdala are not diminished and overstimulated respectively. When our prefrontal cortex functioning is diminished, we have dysregulated emotions and we are overwhelmed; taking action (DAN network) is very difficult. Learn more about the neurological basis on overthinking and rumination.

4. Worry scheduling: Sometimes we find ourselves repetitively worrying about things. It almost seems like we are stuck like a broken record and can’t get it to shut off. This can often lead to distress causing functional deficits (affecting our work/education/productivity etc.). Scheduling a worry time in a day, can free up the day and help the individual get on with their routine. Set up a timer for the worry time, during this time focus on your worries, thoughts, ruminations. You can also write it out. Try to avoid worry times close to sleep timings so as to not let it affect your sleep.

5. Journaling: Journaling can help in structuring our thoughts and has a cathartic effect. It is often a good way to express your thoughts and emotions instead of bottling them up. The catharsis leads to emotional regulation freeing up our prefrontal cortex and writing down our thoughts and how we feel can help us reflect back to understand where all this came from. Like I mentioned earlier awareness leads to action.

6. Acceptance and problem solving: There are times when we tend to problem solve things we cannot do anything about and vice versa. When you start to ruminate, catch yourself and ask if this something that is in my control to problem solve. If yes, try to come up with an actionable, concrete plan. If not, it is important to move towards acceptance and healthy emotion regulating strategies.  

7. Therapy: Mindfulness based Cognitive Behavior Therapy is especially helpful with overthinking and rumination. If you or anyone you know are experiencing the above, please do take help. Help is available, it can help you with awareness, techniques that help you out and focus on life and even thrive.

In my sessions I often suggest to make a note of strategies you find helpful and keep them accessible so that we can look back and try them when necessary. These maybe affirmations and restructured balanced thoughts, certain techniques that helped you calm down, techniques that helped you express your emotions etc. These maybe affirmations and restructured balanced thoughts, certain techniques that helped you calm down, techniques that helped you express your emotions etc. Overtime we can also tweak them to suit our situation.

When to seek professional help?

If overthinking and rumination has become intrusive and they are affecting your daily routines, your work/education spaces and your relationships and social life, it is important that you seek professional help. Additionally, overthinking and rumination is also starting to affect your mood, it is a sign that you need to start trying to manage them. In my counselling practice, overthinking and rumination is a common occurrence and a risk factor in anxiety and depression.

To know more about our approach to anxiety and depression, you can check our services page.

Overthinking and rumination can be very distressing and may feel difficult to get out of; but with practice it can be managed. At Safe Space Counselling, we believe in holding empathic and safe places for emotional expression and then focus on mindfulness based Cognitive Behavior Therapy for overthinking and rumination. This helps individuals to get to root causes and deal with them effectively.

To learn more about our approach to overthinking and rumination, you can visit our services page.

You can also reach out to us for any further questions or chat with us.

Chat with us on WhatsApp

Author

Aaradhana Reddy is a Counselling Psychologist with over 8 years of experience with both adolescents and adults. She specializes in adolescent mental health concerns and in dealing with various mental health disorders and other psychological concerns. She is a trained and experienced Cognitive Behavior Therapist and a passionate writer about mental health. She aims to raise awareness on mental health through her practice and blog.

FAQs about Overthinking and Rumination

What is the difference between overthinking and rumination?

Overthinking is repetitive negative thinking about the future, like an upcoming exam, medical test results, decisions to make etc. Rumination is mostly about past experiences, like a rejection or past mistakes etc. Rumination contains mostly of self-critical narratives, what if thoughts and why me thoughts.

How do I stop overthinking and ruminating about the past experiences and mistakes?

To stop overthinking and ruminating about the past it is important to deal with some of the thoughts and emotions you are feeling about the experience. Mindfulness, journaling, worry scheduling and catching yourself when you start overthinking and rumination and then using mindfulness or journaling often helps. Therapy is another option if you feel nothing is helping and its affecting your daily routine and life.

Why can't I stop replaying negative thoughts in my head?

Thoughts usually get repetitive because of the judgement we give them. Bad, immoral, horrible, unacceptable etc. are some of the judgements we give our thoughts. And our brain has the tendency to remember and concentrate on these thoughts and experiences due to negative bias. So, we tend to concentrate on them and get stuck in repetitions and downward spirals. Its like clouds in the sky, they usually just pass by until we start to concentrate on one cloud and get stuck to it. 

Why does overthinking and rumination increase at night?

This is a common experience. It increases because, working through the day distracts you and when you are finally in bed at night, that is the time when you start to replay everything, the past and the future with nothing to distract you. This often leads to sleep disturbances and emotional distress.

How can I quiet an overactive mind at night?

To quiet an overactive mind you can try some mindfulness tracks for sleeping or guided imagery visualization to help relax and sleep. You could also try some soothing sleep music without lyrics, preferable calming instrumental music. These can bring your attention back to the present or shift them to something calming to help you sleep. If these are not working and you find its getting worse, then its important that you seek help.

How long does rumination last?

Rumination can last anywhere from hours to days or even weeks. It depends on the type of rumination, other underlying concerns, the content of the thoughts and how you are trying to manage rumination.

How long does it take to break the cycle of rumination?

This depends on the type, other additional issues, the individual and the kind of help that is being taken. This varies from person to person and how they respond to strategies.

What therapy works best for rumination?

Mindfulness based Cognitive Behavior Therapy works best and is often recommended. CBT helps with the awareness and reframing of the negative thinking patterns into balanced and healthy thoughts. While mindfulness helps in relaxation, present orientation, creating non-judgemental observance and awareness. This helps with letting thoughts pass by with observance and curiosity instead of judgment (which leads to repetition and downward spirals)

Why do I keep thinking about the same problem over and over?

If you are thinking about the same problem repetitively without taking any action you might be indulging in overthinking. Overthinking can make you become stuck without leading to any action, causing emotional distress and mood changes.

Is rumination a trauma response?

Yes, rumination can be followed by a traumatic event. One could be repetitively thinking about the experience, mistakes they made, guilt or self-critical thoughts. It can change how they think about themselves and the world. It can also be a risk factor for depression. 

Is rumination a symptom of anxiety or depression?

Yes, rumination is usually and more frequently associated with depression. Rumination is both a risk factor of depression and also intensifies depressive episodes. But, it can occur during anxiety as well.

Can overthinking make anxiety worse?

Yes overthinking can make anxiety worse. Overthinking has a negative effect on mood, so it can increase already existing anxiety. Additionally overthinking does not lead to any action so it is not productive to indulge in overthinking during anxiety. Please seek help, if it is disrupting you daily functioning.

Are overthinking and OCD related?

Yes, they are. Rumination can be detrimental to OCD and may even reinforce obsessive tendencies further. Ruminating about the intrusive thoughts, over analyzing them and social interactions, indulging in what-if scenarios leads to secondary anxiety and depression, fatigue etc.

What causes chronic overthinking and rumination?

There are many factors that cause chronic overthinking and rumination. Low self-esteem, perfectionism, stress, anxiety, unhealthy coping mechanisms such as avoidance, unable to tolerate uncertainty etc. can lead to chronic overthinking and rumination.

Can overthinking and rumination affect mental health?

Yes, both overthinking and rumination can have significant impact on mental health. They are especially associated with anxiety disorders such as Generalized Anxiety Disorder, Social Anxiety, Panic disorder etc. Rumination is also strongly associated with depression. They also lead to sleep disturbances, self-esteem issues, procrastination etc.

What are the signs that overthinking has become unhealthy and I should seek professional help?

Overthinking becomes unhealthy when it is starting to affect your mood, daily routine, your workplace or education and your relationships. If you feel like overthinking is making you more anxious or depressed, unable to take a decision, solve a problem and is making you isolate yourself; it’s become unhealthy. It’s important that you take help to manage your overthinking.     

Does mindfulness help reduce rumination and overthinking?

Yes, mindfulness can be very helpful in managing overthinking and rumination. Mindfulness helps in bringing non-judgemental awareness and observance of thoughts as they come by without concentrating on them. It also helps in bringing your focus back to the present through anchoring. Anchoring is when you bring your attention back to present in case you are wandering into overthinking or rumination territory. It can be done through paying attention to your breathing or to any object of your choice.

Does journaling help stop rumination?

Journaling can help with expressing and venting emotions. It can help your brain relax, giving it space and time for focusing on ways to manage your emotions and/or problems. Writing can also help with awareness, as writing down can give structure and lead to new reflections.

References

Cano-López, J. B., García-Sancho, E., Fernández-Castilla, B., & Salguero, J. M. (2022). Empirical Evidence of the Metacognitive Model of Rumination and Depression in Clinical and Nonclinical Samples: A Systematic Review and Meta-Analysis. Cogn Ther Res, 367–392.

Chentsova, V. O., Bravo, A. J., Mezquita, L., Pilatti, A., & Hogarth, L. (2023). Internalizing symptoms, rumination, and problematic social networking site use: A cross national examination among young adults in seven countries. Addictive Behaviors.

Christoff, K., & Fox, K. C. (2018). The Oxford Handbook of Spontaneous Thought: Mind-wandering, Creativity, and Dreaming. Oxford University Press.

Damsa, B. (2026). Academic Overthinking: When Students Put Too Much Pressure on Success. Journal Educational Verkenning.

Ehring, T. (2021). Thinking too much: rumination and psychopathology. World Psychiatry, 441–442.

García, F. E., Duque, A., & Cova, F. (2017). The four faces of rumination to stressful events: A psychometric analysis. Psychol Trauma, 758-765.

Hairston, I. S., Portal, L., & Carmon, T. (2022). Positive rumination can (also) interfere with sleep: A study in a non-clinical sample. Frontiers in Psychiatry.

Kaya, B., & Bağatarhan, T. (2025). The Impact of Intolerance of Uncertainty on Psychological Well-Being: A Serial Mediating Model of Doomscrolling and Rumination. Journal of Rational-Emotive & Cognitive-Behavior Therapy.

Li, S. H., Corkish, B., Richardson, C., Christensen, H., & Werner-Seidler, A. (2024). The role of rumination in the relationship between symptoms of insomnia and depression in adolescents. J Sleep Res.

Matsumoto, N., & Mochizuki, S. (2018). Why do People Overthink? A Longitudinal Investigation of a Meta-Cognitive Model and Uncontrollability of Rumination. Cambridge University Press.

Phillips, W. J., & Hine, D. W. (2016). En Route to Depression: Self-Esteem Discrepancies and Habitual Rumination. Journal of Personality, 79-90.

Saha, M., & Vijayan, D. (2024). Exploring the Relationship between Perfectionism, Rumination and Imposter Phenomenon among Young Adults. Indian Journal of Mental Health .

Schut, D. M., & Boelen, P. A. (2017). The relative importance of rumination, experiential avoidance and mindfulness as predictors of depressive symptoms. Journal of Contextual Behavioral Science, 8-12.

Smith, J. M., & Alloy, L. B. (2010). A roadmap to rumination: A review of the definition, assessment, and conceptualization of this multifaceted construct. Clin Psychol Rev., 116–128.

Wei, L., Dong, H., Ding, F., Luo, C., Wang, C., Baeken, C., & Wu, G.-R. (2024). Shared and distinctive brain networks underlying trait and state rumination. Behavioural Brain Research.

Yook, K., Kim, K.-H., Suh, S. Y., & Lee, K. S. (2010). Intolerance of uncertainty, worry, and rumination in major depressive disorder and generalized anxiety disorder. Journal of Anxiety Disorders, 623-628.