"Too Much of a Burden": Lived Experiences of Depressive Rumination in Early Adulthood.

Rumination is an established transdiagnostic factor in mental illness, but there remains a significant gap in understanding the subjective experiences of those affected by it. This study explored the lived experiences of depressive rumination in early adulthood, a population notably susceptible to its effects. We interviewed 20 participants aged between 18 and 35 years using a semistructured approach and generated five distinct but interconnected themes using reflective thematic analysis. The first theme delved into recurrent narratives of past traumas and unresolved pain, with participants unable to move on from their past. The second theme illustrated how participants, due to real or perceived pressure, often equated their self-worth with their ability to meet expectations, leading to a distorted self-view and diminished self-esteem. The third theme captured the relentless pursuit of mental peace, with tranquility remaining ever elusive despite the frequent use of distraction. The fourth theme highlighted the profound isolation stemming from internalized mental health stigma, with participants grappling with fears of being perceived as burdensome and facing rejection from their close ones. Finally, the fifth theme underscored the far-reaching and interconnected repercussions of rumination on mental, emotional, and physical health and individuals' ability to achieve their life goals. These findings emphasize the intertwined nature of psychological, physiological, and social risk factors for the development and maintenance of rumination, advocating for a holistic treatment approach to rumination and paving the way for more timely, tailored care. Public Significance Statement: Our study highlights the complex sources and manifestations of harmful, repetitive negative thinking in early adults. We focus on the maladaptive processing of events, the impact of social expectations and stigma, problems with rest, and how these issues affect overall health. We propose a framework to identify and evaluate these issues early, focusing on prevention and care that is tailored to each person over circumscribed, reactive treatments. [ABSTRACT FROM AUTHOR]

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