Depression in bipolar disorder has long been thought to be a state characterized by mental inactivity. However,\r\nrecent research demonstrates that patients with bipolar disorder engage in rumination, a form of self-focused\r\nrepetitive cognitive activity, in depressed as well as in manic states. While rumination has long been associated\r\nwith depressed states in major depressive disorder, the finding that patients with bipolar disorder ruminate in\r\nmanic states is unique to bipolar disorder and challenges explanations put forward for why people ruminate. We\r\nreview the research on rumination in bipolar disorder and propose that rumination in bipolar disorder, in both\r\nmanic and depressed states, reflects executive dysfunction. We also review the neurobiology of bipolar disorder\r\nand recent neuroimaging studies of rumination, which is consistent with our hypothesis that the tendency to\r\nruminate reflects executive dysfunction in bipolar disorder. Finally, we relate the neurobiology of rumination to the\r\nneurobiology of emotion regulation, which is disrupted in bipolar disorder.
Loading....