By Dr. Alireza Chizari, President of the Medical and Pharmaceutical Equipment Association
In a thought-provoking and scientifically grounded op-ed, Dr. Alireza Chizari—President of the Medical and Pharmaceutical Equipment Association—delves into the psychological phenomenon of mental rumination, a growing concern in recent years fueled by fast-paced lifestyles, mounting social crises, and heightened everyday stress. With years of experience in public health and systemic healthcare development, Dr. Chizari draws on validated research and field observations to shed light on this silent mental health challenge confronting many Iranian citizens.
Mind wandering refers to an unstable mental state in which one’s attention drifts from the task at hand toward unrelated thoughts about the past, future, or imagined scenarios. When this becomes chronic—especially when dominated by repetitive, negative, and unproductive content—it is clinically referred to as rumination. Dr. Chizari emphasizes that rumination is not just a personal issue but a societal threat, affecting workplace efficiency, family cohesion, and even the broader economy of mental health.
Unlike passing thoughts or neutral daydreams, rumination often revolves around feelings of guilt, worthlessness, fear of the future, or painful past memories. Neuroscience studies show that during such episodes, specific regions of the brain—particularly the prefrontal cortex and the default mode network (DMN)—become hyperactive. This mental overdrive consumes cognitive energy without producing results and is closely linked to major mood disorders such as clinical depression, generalized anxiety disorder, PTSD, and OCD.
Dr. Chizari warns that if left unaddressed, rumination can trap individuals in a self-perpetuating cycle: intrusive thoughts reduce focus and performance; the resulting failures deepen feelings of inadequacy, which then further fuel the rumination. Over time, this may lead to social withdrawal, sleep disorders, indecisiveness, lack of motivation, and in severe cases, self-harming thoughts.
He underscores that while rumination is an internal mental process, its external consequences are highly visible. In the workplace, employees suffering from chronic rumination often face burnout, recurrent errors, prolonged absenteeism, and low job satisfaction. In education, students constantly preoccupied with past failures or fear of the future struggle to absorb new knowledge effectively. At a national level, the phenomenon undermines human capital productivity and drives up the psychiatric costs of the healthcare system.
From a social perspective, Dr. Chizari connects rumination to rising divorce rates, diminished social tolerance, and dysfunction within institutions. He argues that decision-makers caught in cognitive loops of pessimism may fail to grasp the broader picture of national and collective interests. Thus, tackling rumination is not only a matter of individual well-being but a key step toward good governance.
Dr. Chizari categorizes the management of rumination into three tiers: prevention, psychotherapeutic intervention, and social rehabilitation. At the prevention level, he advocates for public education in mindfulness, emotional regulation, resilience, and stress management—skills that should be taught in schools, broadcast through media, and reinforced in the workplace. He points to successful mental health awareness programs in Scandinavian countries, where early education has significantly reduced mood disorders and self-harming behaviors among youth.
At the intervention stage, he highlights Cognitive Behavioral Therapy (CBT) as an effective method for disrupting negative thought patterns. Other approaches, such as Acceptance and Commitment Therapy (ACT) and Dialectical Behavior Therapy (DBT), are also valuable in specific contexts. In more severe cases, antidepressants or anti-anxiety medications may be necessary—but only under strict psychiatric supervision. Dr. Chizari stresses that medication alone is insufficient: active patient participation, lifestyle restructuring, therapist rapport, and gradual re-engagement with daily activities are all critical to successful recovery.
He also emphasizes the indispensable role of families, friends, and caregivers. Individuals struggling with rumination often need emotional safety, compassion, and the assurance of being heard. Rather than offering clichéd advice or judgment, loved ones should practice active listening, support therapy attendance, promote healthy routines (such as regular sleep and exercise), and help create a stable, nurturing environment.
In the final section of his article, Dr. Chizari issues a sharp critique of institutional neglect regarding mental health. Just as investment in physical medical equipment is essential, so too must society invest in its “mental infrastructure.” This includes budget allocations for psychotherapy services, insurance coverage for counseling sessions, training community-based psychologists, and fostering public dialogue on psychological issues through media campaigns.
Dr. Chizari concludes with a warning: in a world increasingly shaped by digital isolation, economic insecurity, and emotional fatigue, ignoring mental rumination could lead to a generation that appears healthy on the outside but is psychologically depleted within.
He calls on the Medical and Pharmaceutical Equipment Association of Tehran Province to take a proactive role—by launching mental health awareness campaigns, distributing educational brochures, and establishing counseling clinics in underserved areas. Such initiatives, he argues, could set a new standard for integrating physical and mental health in Iran. For Dr. Chizari, this is not just a strategic move, but an ethical obligation for all sectors tied to public health.
In this editorial, Dr. Alireza Chizari does not merely speak as an industry leader but as a voice of social responsibility—urging the media, policymakers, and civic institutions to confront a silent yet far-reaching phenomenon. A weary mind weakens the body; and a nation entangled in rumination will find it difficult to walk the path of development, prosperity, and justice.