Nighttime Rumination in Grief

Some nights feel like an abyss.  It starts small, with a thought or a memory or a worry that cracks the ground beneath me and before I know it my foundation has crumbled away and I am tumbling into darkness. These thoughts are no different than those I have during the day, but in the hurried daylight hours, they seem more random and fleeting. Whereas in the evening they appear while I’m brushing my teeth or putting on pajamas as though on cue, and in the quiet of the night, when working hours are over and my family is asleep and when I know I should be asleep, there is little to stand in the way of the snowballing inertia of my mind’s most distressing thoughts.

I think it’s safe to say that my nighttime brooding is a form of rumination. Rumination definitions vary but generally speaking it is when a person continuously goes over a thought, issue, memory, or problem without making progress, reaching conclusions, or finding peace of mind. Rumination is something everyone does, but for some, it is an itch that they can’t help but scratch raw.

There have been many studies on what psychologists call ‘depressive rumination’ as well as ‘grief rumination’ which may be defined as, “repetitive and recurrent thinking about causes and consequences of the loss and loss-related emotions.” (Eisma & Stroebe, 2017). Both are associated with poorer outcomes following the death of a loved one as compared to non-ruminators, as well as experiences like depression, PTSD, poor problem solving, negative thoughts, and self-blame.

So why do people do it? Is it in hopes of stumbling on some tidbit that might make their worries seem more bearable? Or are these thoughts simply a symptom of an overarching struggle the person has yet to make peace with? The answer to these questions depends on which theorist you ask. Some theorists view rumination as ineffective attempts to confront or problem-solve one’s worries, experiences, and anxieties. Other theorists view rumination as an efforts to avoid accepting reality. For example, if a person continuously ruminates over what they could have been different in the past (you know those old familiar “if-onlys”), they may never get around to accepting the reality of the present. Eisma & Stroebe (2017) explain how this avoidance could potentially have a negative impact on coping with grief,

“This may have negative consequences because such avoidance could interfere with acceptance of the loss and/or could impede integration of one’s personal memories about the loss with existing memories, thereby fueling grief complications”

Coping with Nighttime Rumination

I’m writing this article from the perspective of someone who is searching for a solution, just like many of you. As someone with a background in counseling and grief, my first question was whether a person should try and put their thoughts at bay, or attempt to confront the underlying issues in a more effective way. Interestingly, I think the answer may be both, especially if your ultimate goal is getting a good night’s sleep. Below are a few suggestions that I’ve put together after doing a little reading. You may also wish to read our article Grief and Getting a Good Night’s Sleep for a more in-depth discussion on good sleep hygiene.

Examine your stress-level and how you are coping with grief and stress during the day:

Stress is bound to increase the number of problems and worries that keep you awake at night. If you can reduce your stress during the day, theoretically you should feel calmer and more in control at night. To the extent that you can, get rid of unnecessary stressors and then take a look at how you are coping with the stress that remains. Do you set aside time to engage in self-care activities that will boost positive thoughts and emotions? Do you take the time to constructively cope with your own grief? Does it seem like you problem-solving effectively?

Keep in mind, it’s important to address both stressors related to day-to-day logistics as well as emotions related to your grief. If you are grappling with rumination, guilt, anxiety, fear, intrusive thoughts, etc that are causing you significant personal distress or impacting your day-to-day functioning, you may want to consider seeing a counselor.

Unwind before bed:

Most sleep experts recommend establishing some type of calming bedtime routine that lasts at least 30 minutes. I know it’s hard, but you should turn off all screens. Not only are devices portholes to further stressors (think annoying social media posts, depressing late-night television, and stressful work emails), but the light from these devices can trick your brain into thinking it’s daytime and prevent the secretion of your body’s natural sleep chemical, melatonin. Instead, opt for calming (and boring) activities like taking a shower or bath, meditation, reading, listening to music, etc.

Say “Not tonight!” to distressing thoughts: 

When you notice yourself starting to ruminate, it may be helpful to stop the cycle in its tracks by distracting yourself. Focus on something boring or mundane like making a meaningless list (ex. boys names that begin with each letter of the alphabet). Sometimes I find it helpful to daydream (at night) and make up fictional stories. Or try distracting yourself from thinking about the past and/or the future is by focusing on the present. For example, try naming 5 things you hear around you and 5 things you feel, then 4 of each, 3…2…1…you get the idea. And if all else fails, go ahead and count those sheep.

Learn relaxation techniques:

We’re always quick to recommend easy tools like breathing exercises (focusing on your breathing), progressive muscle relaxation (progressively tensing and relaxing each muscle group from your head down to your toes), meditation, guided imagery, and mantras (repeating a simple word or phrase to focus and calm your mind). I know these may seem new agey to some of you, but they are actually really simple and accessible coping tools.  This is a big topic that begs its own article, but in the meantime check out the following:

UCLA Health has 8 free guided meditations ranging in length from 3 minutes to 19 minutes

Headspace: Headspace is a meditation app that you can also access from your computer. It has paid options, but you can sign up for their free version which walks you through a 10-day introduction. I like the introductory meditations because the incorporate short, engaging videos that explain different meditation techniques.

YouTube: YouTube has a ton of mindfulness and meditation videos. For example, the searches “meditation for sleep” and “progressive muscle relaxation” bring up many different results.

Practice accepting your thoughts:

Sometimes the harder you try to stop thinking about something, the more you wind up thinking about it. In these instances, instead of trying to avoid the thought, you may want to work on changing your relationship with the thought and how you respond to it. Now I’ll admit this does take some work, often through things already mentioned like therapy and meditation, but it’s a worthwhile effort.

Something you could try include:

  • Remind yourself that these thoughts are a normal part of your grief and/or anxiety and that they can’t hurt you.
  • Remember that sometimes thoughts, especially those related to grief, depression, and anxiety, are untrue and irrational and search for evidence that refutes your worst-case scenarios.
  • Try to think of one positive or optimistic thought for every negative
  • Get up and go write about whatever is on your mind in a dimly lit room. Not only do sleep experts recommend you get up and do something like reading and writing when you can’t sleep, but people often find that writing helps them to get a handle on their worries.

Whew, now I’m exhausted! Subscribe to receive our posts straight to your email inbox.

July 10, 2018

10 responses on "Nighttime Rumination in Grief"

  1. I feel you Steve and I am sorry. PtSD is just a name. Your wife still lives in your heart. I wish you the best.

  2. It’s been 2 months and I find night time the hardest. For 42 years we slept in in the same bed together till the last month at the hospice . We talked to each other lots every day, I still go through my day thinking I need to tell my husband about that.I am reaching out every night numerous times and he is not on the other side of the bed 😢I have started to read at night , it seems to help.i know it will get easier as time goes on , but it’s rough.

  3. There is that time in the morning when my body is still tired, but the mind is awake, and grieving thoughts creep in. There is bedtime when I am physically tired, but the mice like to run around inside my skull, and then there is 3:30 AM. At 3:30 AM my wife woke up and sat on the edge of the bed and asked if I would get her some water, and rub her back for a while. She wanted a piece of peppermint candy. She had passed away by 6:00 AM. So for the longest time I had to deal with the 3:30 AM wake-up call. It is funny how the brain or spirit works. I tried to stay up until 1:00 AM or go to bed early at 9:00 PM to break the 3:30 AM wake-up cycle. It didn’t make a difference when I went to bed. At best I would wake up at 3:15 and if really tired, I would wake up at 3:45. When I went to visit relatives I would wake up at 2:30 AM, but they lived in an earlier time zone, so it really was 3:30 AM. Some one said that was my wife’s time to communicate with me, and just go with it, and stop trying to fight for sleep. I had retired, so it wasn’t like I had to be looking sharp and thinking clearly at 8:00 AM. Now this is going to sound crazy: I met someone that was an American Indian and told her the story. She told the tribe medicine man. They had a ceremony, and I found my peace at 3:30 AM. I don’t know anything about the ceremony or the medicine since I couldn’t attend since I am not a Native American. Do I still wake up at 3:30 AM? Yes, it is rare, and I actually welcome it, since I think it is my wife’s way of saying “Hello” and she is watching over me. I am sure some doctors may say I had some PTSD or as the article described some “rumination.” I am retired, but the one thing I do that may be helpful is that I set an alarm and never sleep past 7:15 AM in hopes that keeps my biological clock on schedule.

  4. Great article……helps me remember I’m not losing my mind. Lost my only son 3 yrs ago & altho my depression & anxiety attacks are slowly getting better, I can’t stop ruminating during the day but its 10 times worse at nite. I know it will get easier to live with so I just don’t put pressure on myself, & I still have to remind people ( hubby) that grief never goes away & I am forever changed. Sending hugs to all Angel moms….

  5. Kathleen, I do think the manner of death makes a difference. I know that I am experiencing complicated grief, because of the way my son died. I think rumination is normal; maybe the professionals don’t really understand that the range of normal is huge. They can pathologize that which is normal.

    Nighttime rumination has stopped bothering me so much, because I think I’ve become deadened to it. I do practice deep breathing exercises and pray. And I’m awake at night worrying about other things more than I am rumination about my son’s loss these days. I’ve also learned that if I have a bad night sleepwise, that the next night I will usually get a good night’s sleep.

    Mandy, I love your way of incorporating a new bedtime routinei (yoga) with an old routine (reading).

  6. Does it matter the manner of death? Or is the loss and grief the same? Your love for that person lasts
    a lifetime, you don’t forget the grief, the love, the saddest, I never forget, The years go on, good and bad days, nights I cannot sleep. I only cope,.
    Kathleen

    • Kathleen, with regards to the manner of death, some deaths can be experienced as traumatic which may lead to prolonged and intensified acute-like grief responses. We’ve written about that here, Grief After Traumatic Loss. I think it’s important to remember that no two people grieve in exactly the same way. Your grief is unique to you and your relationship with the person who died and the ways in which you cope with this loss.

      What you said, that “your love for that person lasts a lifetime” is so true. You will always love the person and so there will always be sadness, but hopefully, you are also able to find comfort in your memories and your continued bond with them. My heart goes out to you.

  7. Timely and very helpful article

  8. My boyfriend died 2 years ago and the nights are still the hardest. I thought we would be together forever and at night we’d often joke about whether we’d “still be doing “this” (wink wink) when we’re 80…” 🙂 He was my forever guy and at night the missing can become so overwhelming that it feels as if I’m being turned inside out. I have had these night time ruminations of “if only’s” and “what if’s” which have caused so many sleepless nights. But, along with the small loving rituals that I have been doing for well over a year, I have also begun to practice meditation and yoga at night before I sleep. I have also stopped (for the most part) watching tv at night and I go to bed and read instead. So I combine something that we did together (reading before bed) and something new that is just mine alone (yoga) and I find that I’m having more peaceful nights now. And some of this is probably just the passing of time, but I think some of it has been the slow process (2 years….) of integrating new bedtime routines with the old. And I still have sleepless nights sometimes, but it’s less ruminating and more just a dull aching sadness that is the result of the deep, never ending love that we shared.

  9. Perfect timing-I woke up at 1 am last night, got up, went downstairs, watched a movie and finally fell asleep at 4 am. Tried breathing exercises, you name it. This is a great article.

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